Should I worry?
If there’s one thing we parents do best, it’s worry about our children. Society has told us that foreskins are basically ticking time bombs of infections and problems. We bravely overcame those lies, and kept our sons intact; but then we started to hear about things that actually might be concerns for our intact sons. Your Whole Baby directors have asked these same questions, and we have researched and compiled some answers! Let us help you, parent-to-parent, differentiate between things that are causes for worry, and things that are not.
“Sometimes my son’s foreskin swells up when he pees. Should I be worried?”
No, this is a common and normal part of development known as “ballooning.” Check out our article on that topic here.
“I don’t know what diapers are safe for intact boys. Should I worry?”
No, there are no special or dangerous diapers for intact boys. Any baby can react to any brand of diaper, including cloth. The foreskin has nothing to do with a sensitive skin reaction; rather, each child has an individual tolerance for different brands, fabrics, and detergents. If your son or daughter is reacting to diapers, try a different brand if you’re using disposable, and try stripping your diapers or using a different material if you’re using cloth.
“I’m not sure if our doctor knows how to care for intact boys. Should I worry?”
Yes, you should address the issues of proper intact care and forced retraction with your doctor BEFORE your child’s physical examination. This is a great page for preventing forced retraction and gently educating doctors who are misinformed.
Line on penis
“There’s a visible line on the underside of my son’s penis and down his scrotum, and sometimes it looks red. Should I worry?”
No, there’s no need to worry. The line on the underside of the penis is called the perineal raphe (pronounced “RAY-fee”; also referred to as the penile or median raphe), and it is perfectly normal. When children are forming in utero, they all start off with what resembles female genitalia. When a boy is developing around week 7, the folds resembling female genitalia grow together to form the scrotum and underside of the penis. The perineal raphe is where the tissue came together, and this line extends down the the scrotum as well. The raphe on the penis usually resembles a stretch mark and can be anywhere from 1-3mm wide.
“I’ve heard that swim trunks are dangerous for intact boys. Should I worry?”
Yes, this is an area where all parents should use good judgement and find a safe solution. The mesh that lines most swim trunks can pinch the genitals when the skin becomes trapped in the small holes. This can cause pain and potential injury for anyone regardless of their age, sex, or circumcision status. Easy solutions for this issue include the following:
1. Cut out the mesh.
2. Wear a swim diaper.
3. Buy trunks that have safe, smooth fabric over the genital area.
“The opening of my son’s foreskin is so small. I’ve heard that it can close up. Should I worry?”
No, your son’s foreskin opening is just fine as long as he is peeing normally. Some openings appear large, some look like a slit, and some are nearly invisible. All of those are variations of normal, and the appearance can even change as the position of the foreskin shifts or the boy starts to become retractable. Urine can exit from a tiny hole or a large hole, and what matters is that the urine does exit. Foreskins only “close up” (this is called “pathological phimosis”) when a caregiver or doctor repeatedly retracts the boy, tearing the natural fused membrane and creating scar tissue.
“I know it would be bad if poop got inside my son’s foreskin! Should I worry?”
No, the foreskin is equipped to defend against the invasion of poop. The tip of the foreskin is a sphincter that allows urine to exit, but keeps contaminants out. Picture a blown-up balloon you’re pinching closed with your fingers before tying it shut. If you un-pinch the tip, air will rush out. But just try to get anything to enter that balloon without great force… you can’t! If you can see poop on the foreskin tip that you can’t wipe away, put your son in a warm, clear bath and swish/splash his penis. Remember, every time he pees he is flushing away any possible bits of irritating poop from the foreskin opening.
“My son’s foreskin is red today. Should I worry?”
No. A red foreskin tip, without pain or swelling, just indicates that the skin is a bit irritated from doing its job of protecting the glans!* This could be from rubbing against a diaper or the irritation of poop or pee. Treat as you would any irritated skin. Let your son air out with no diaper on and give it a day to clear up. A soak in a baking soda bath isn’t necessary, but won’t hurt. Remember, the job of the foreskin is to protect the glans. Don’t be worried as it does its job!
*If the redness doesn’t clear up, becomes swollen, painful, or there is discharge, you may be looking at an easy-to-treat case of yeast. Visit YourWholeBaby.org/yeast for more information.
“I know that forced retraction is dangerous for intact boys. Should I worry?”
Yes, but let that worry spur you on to educate everyone who cares for your son about proper intact care. Do not assume that anyone, even a doctor, knows not to manipulate your son’s foreskin. YOU need to inform them. You can print off a Forced Retraction Brochure, get some Intact Care cards or stickers, print this sign to keep with his diapering supplies, or have them read Your Whole Baby’s Intact Care page. By informing all our friends, family, daycare workers, and doctors about proper intact care, we can influence our culture to keep intact boys safe and to keep future sons whole. Note: It is safe for your son to explore and retract himself; just be sure the foreskin is put back in place.
Soap and Bubble Baths
“I read that soap and bubble bath are dangerous for intact boys, but we use them! Should I worry?”
Yes…and no! Every person has their own individual tolerance for different soaps, bubbles, scents, and dyes. Some parents report that their boys and girls react with skin breakouts or yeast infections to even small amounts of soap in their bathwater. Our concern is that if your intact son is sensitive and develops a reaction, a doctor will incorrectly assume that the problem is the boy’s foreskin and recommend dangerous treatment, including circumcision. Foreskin does not make a child more sensitive to soaps and bubbles, but sadly it is often the scapegoat for a child who is reacting. In order to keep all children safe from reactions, we recommend caution with whatever products you choose to use. Babies and even kids can be bathed just fine in plain water, so feel free to take the safest route and use nothing! If you do use soap, just keep an eye out for sensitivities and reactions in all your children. If you are concerned that soap has led to a yeast infection, try the natural remedies in this article. There are several brands of soap and bubbles that are made with natural ingredients. For most children, a natural brand with a clean water rinse at the end will result in zero issues.
Tugging and Pulling
“My son tugs on his penis when his diaper is off. Should I worry?”
No, you do not have to worry. Babies naturally touch their genitals, and they are learning about their bodies when they do so. Your son will know what hurts him and what does not. If he happens to retract his foreskin while tugging, just be sure that it is put back into place before you diaper him.
“I think I’m accidentally retracting my son while wiping him. Should I worry?”
No, normal wiping is not going to hurt him or retract his foreskin. Remember to wipe from base to tip, as if you were cleaning off his pinky finger. The foreskin is not so fragile that gentle pressure, or even squeezing the tip to get that last bit of poop, will hurt him. Just be sure not to push or pull the foreskin back. Manipulating the foreskin, including retracting, isn’t dangerous if he does it himself because he will know if it hurts him. It’s important for parents and caregivers to let him get to the point of retracting in his own time.
“I’ve heard of children getting their penises injured by zippers. Should I worry?”
Yes, because anyone with a penis is at risk for a zipper injury! Simple precautions should take care of it. The foreskin covers and protects the glans of the penis, and yes it can get caught in a zipper. The biggest risk would be children who prefer no underwear, but are wearing zipper pants or zipper pajamas. Please don’t take that chance. If the child is underwear-free, he should be wearing pull-up, elastic-waist clothing. If your child does zip his penis and/or foreskin into clothing, DO NOT try to reverse the zipper and get it off, as this will cause additional damage. Use a pair of scissors to cut the zipper, well below where the penis is trapped. This will break the zipper, releasing its locking power, and allow you to simply pull it apart. Depending on the level of injury, your child may need to immediately see a doctor for stitches. Prevent these situations completely by always having your child wear underwear under zippered clothing!