Baby Foreskin Care - information for new mother of baby boys

The baby foreskin care page is for mothers of little baby boys who are not circumcised.

Why won't my baby's foreskin won't retract?

It is usual that a baby's foreskin will not retract (pull back). Don't be concerned. Over the next few years, with proper care, your little boy's foreskin will be able to retract fully.

What do I need to do to clean my baby's foreskin?

Firstly, never force the foreskin back. Forcing may cause a tear on the lining of the baby foreskin. Not only will this hurt your baby, but when the tear heals, the healed tissue will be tighter. If this keeps happening, your baby will end up with a tight foreskin which will not retract (pull back).

When you are bathing your baby, gently wash the foreskin. Move it back as far as it will go - which isn't very far in the first years - and let any secretions that may have gathered under the foreskin out.

As your little boy grows, teach him to gently pull the foreskin back during bathing (letting out any debris that may have gathered underneath) but never to force the foreskin back.

When should I see my doctor?

See your doctor if:

your baby has a very red inflamed foreskin that is painful - he may have an infection
your baby's foreskin balloons out as he passes urine
your little boy is 5 years old and has a very tight foreskin that will not retract at all

What is the treatment of a tight foreskin?

If your child is 5 years and has a very tight foreskin that will not retract at all, the surgical treatment is circumcision. Circumcision involves the foreskin being cut off.

Before circumcision is considered, some doctors will try to stretch the foreskin with a steroid cream - this will work in the majority of cases and means circumcision can be avoided.

How to use the steroid cream to avoid circumcision for a tight foreskin:

use a strong steroid cream, like Betnovate 0.1%
apply the cream at least 3 times a day (4 times a day if you can)
the cream needs to be applied for a minimum of 1 month - you might not see any improvement for at least 2 weeks so don't stop before that, and even if you do see improvement, keep applying for at least a month
if you miss a day of applying the cream, you need to start again - so at least a month from that day
to apply the cream, gently retract the foreskin as much as you can and apply the cream to the tip of the penis and then let the foreskin come forward over the cream so the cream sits on the inside of the foreskin

Good care of the baby foreskin will usually prevent a tight foreskin (phimosis) later in life.

What are the reasons for circumcision?

Most boys are circumcised for religious reasons.

The main medical reason is a tight foreskin, which is called phimosis. This occurs in about 10% of boys. Circumcision can sometimes be avoided by using steroid cream - see above.

There is evidence that circumcised boys get less urinary tract infections than uncircumcised boys, but the risk of urinary tract infection is so low in most boys, that being uncircumcised doesn't matter.

Should I have my baby circumcised to prevent him having a urinary tract infection?

No. The risk of the operation for circumcision cancels out any benefit from a urinary tract infection in most boys. Urinary Tract infection is not common in baby boys.

Follow the Baby Foreskin Care steps outlined above.

References

Ganiats TG, Humphrey JB, Taras HL, Kaplan RM.Routine neonatal circumcision: a cost-utility analysis. Med Decis Making. 1991 Oct-Dec;11(4):282-93.
Singh-Grewal D, Macdessi J, Craig J. Circumcision for the prevention of urinary tract infection in boys: a systematic review of randomised trials and observational studies. Arch Dis Child. 2005 Aug;90(8):853-8. Epub 2005 May 12.

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Last reviewed 11 April 2008

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