Do's and Don'ts for Uncircumcised Babies

Caring for uncircumcised babies is the same as caring for infants who have been circumcised. Gentle, external cleaning during diaper changes and external washing with soap and water during bath time are all that's necessary.

Still, there's a lot of confusing, conflicting or just plain wrong information about how to care for uncircumcised babies, and improper care can lead to a child needing a circumcision later in life. This often happens if a parent is instructed to retract a child's foreskin before it is ready to be retracted.

Here's how to keep your child clean and healthy.

Do...

• Leave the foreskin alone until it begins to retract on its own. Let nature take its course.
• Change diapers frequently and wipe clean externally.
• Bathe gently with mild soap and water.
• Call your pediatrician if the foreskin becomes red, painful, and/or itchy, or if you can see urine accumulating under the foreskin. These could be signs of infection or balanoposthitis (inflammation of the foreskin and tip of the penis), which can be caused by not cleaning the uncircumcised penis properly.

Don't...

• Pull hard on the foreskin to separate it. Forcing back the foreskin, which is almost always attached to the glans in infants, toddlers, and young children, can cause pain, bleeding, or permanent damage to the penis. The natural separation of the foreskin from the glans may take many years.
• Clean underneath the foreskin with Q-tips, irrigation, antiseptics, or special ointments or creams. Normal soap and water, applied externally, will work just fine.
• Be alarmed by whitish discharge coming from underneath the foreskin. This is called infant smegma and is completely normal. Skin cells shed naturally and gather underneath and are pushed out from under the foreskin all the time. Just gently wipe these "white pearls" away during a bath or diaper change.

At birth, the penis has an extra layer of skin protection over the head (glans). This layer is called the "foreskin" or "prepuce." Most of the time, the foreskin is still attached to the head of the penis in babies.

As the child gets older, the foreskin begins to separate naturally from the head of the penis. In some children, it may happen before they are even born, though this is rare. Most parents can expect this natural separation to happen within a few months or even years. Each child is different, and this is perfectly normal.

While most children will experience separation by age five, know that for others it may not occur until adolescence. Your child will be the best judge of when this has happened. All children discover their genitals and so it should be your child that first discovers that he can retract his own foreskin.

Once the foreskin can retract easily on its own, you can teach your son to clean the area. He can gently pull back the foreskin, clean underneath it with soap and water, rinse and dry the area, then put the foreskin back in place (don't leave it retracted).