Ask the Experts: Forced Foreskin Retraction


Excellent Pediatric Guideline for babies and young boys:


INTACT = DON'T RETRACT!
ONLY CLEAN WHAT IS SEEN


Question: I am very concerned about my intact son, who is two-and-a-half-years-old. One day, I noticed that he was bleeding lightly at the tip of his penis. This led to the discovery that my son's father, who does not live with us, had been forcibly retracting my son's foreskin "in order to clean the head of the penis." Two days ago my son's penis grew red and swollen about a half-inch from the tip and my son began complaining of pain. I took him to the pediatrician (another advocate of foreskin retraction), who insisted that the infection was due to my failure to retract the foreskin and clean out "all the gunk" that accumulates here. He put him on a ten-day course of antibiotics. I have done my research and know that you should never be prematurely retracting the foreskin and that the pediatrician and my son's father are wrong, but I feel like the damage has been done. At this point, how do I properly care for the current infection and how do I prevent future infections from occurring. I would also like to switch over to a pediatrician who is more enlightened when it comes to genital integrity. Do you know of any in the Miami, Florida area?

Answer by Marilyn Milos, founder of the National Organization of Circumcision Information Resource Centers.

Answer: Your poor son. Both his father and pediatrician are uninformed and the latter has given you terrible advice. Once everyone leaves your son's foreskin alone, he'll return to good health. Even if his foreskin has been retracted, leave it alone! He'll fiddle with it on his own and no one should be attempting to retract it. Please go to the National Organization of Circumcision Information Resource Centers, click on Directory in the menu at the top of the page, and again on Important Articles when the next screen comes up. Then, read the 2nd, 3rd, and 4th articles (two are by Dr. Paul Fleiss and were published in Mothering magazine). Then, back on the home page, click in the box with the pamphlets, and read pamphlets 3, 4, 6, and 7. Once you've read these, you'll know more than your son's doctor learned in medical school. Please print these articles and pamphlets out and give them to your son's father and pediatrician.

Because your son is taking antibiotics, you should be giving him some (a tablespoon or so) liquid acidophilus culture (you can get it at the health food store) two hours after he takes the antibiotic and several times again before he takes the next dose. This will replenish his supply of good bacteria. When the course of antibiotics is done, give him the acidophilus for a few more days.

Remember, too, that bubble baths, soap and shampoo in the bath, and highly chlorinated swimming pools and hot tubs also disturb the bacterial balance and can cause the foreskin to get red, itchy, and sting with urination. Should these happen, eliminating the irritant will allow the foreskin to heal and the process can be helped and hurried by applying liquid acidophilus culture to your son's foreskin six times a day for three days.

Your son is a lucky boy to have a protective mother! He's also lucky to have a foreskin. Now, just make sure everyone (including the doctor) leaves his penis alone.


22 comments:

  1. I need to ask a question, and have NO idea where to ask it, so *maybe* someone here can help me.
    When my first son was born almost 8 years ago, we left him intact. A few months in, and me with not much knowledge of the penis and my husband not intact, we came across an issue we did not know how to handle. My son started having some discharge of sorts. Schmegma? My husband told me to take a q-tip and some neosporin and clean inside the foreskin. I did not retract but tried to clean under it. Looking back now, I cringe every time I think about it. My son will be 8 this summer, and still cannot retract his penis. Did I do permanent damage? Or will he eventually be able to retract? I have three more sons, all still intact as well. I leave that damn thing alone now! How do I learn more? Thank you.
    Jill

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  2. This is a great site for all you need to know, especially with its many links. But don't worry about retraction- average age is 10, I believe.

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  3. Average age is 10.6 years... so some before and some after...

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  4. My sons foreskin was forcibly retracted at age 6 months. I have been retracting it ever since to rinse it with water, but not everyday. He has a bath every night and the outside of his penis is washed and rinsed but with very mild soap. I have been reading all this information and I am very upset that this was done to my son. I am especially worried about causing future damage, skin bridges/adhesion's. My question is now that he is 17 months old should I not retract the foreskin to clean the glans, and why? If I continue to retract his foreskin at this point and I doing further damage? Also the glans of his penis is a purpleish color and always has been, since I could see it anyway. Is this abnormal or a variation that my ignorant Dr. has just somehow missed. He never seems to be in any discomfort, he has no swelling or discharge and he urinates fine.

    Thank you,
    sincerely
    Alanna

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  5. Purple is the color its supposed to be!

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  6. Our pediatrician did a forced foreskin retraction at a 1 month well baby visit without asking! It didn't appear to cause pain or bleeding. Is it possible that damage didn't occur? Can we just make sure no more retractions occur or is it definite that the damage was done? Should we have another dr look at him to make sure there is no long term damage?

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  7. My son's foreskin has been retracted 3 times by his pediatrician. The first two times, happened before I knew anything about its dangers. After reading your posts, I asked him not to touch him in a previous visit. I thought he would remember this time but, yesterday, when we went to the doctor for his 6 months check, he did it again. This time, the skin was completely retracted. My son didn't seem to be much bothered, or hurt. Now, the tip of his foreskin is a bit reddish, but it doesn't seem to hurt him. I'm following your advice for bath time, and so (Basically: leave it alone), but I have some concerns (actually, I'm a bit distressed)
    Is it possible that the foreskin has separated naturally so early? (I say naturally because when the doctor forcedly retracted his foreskin, it seemed to go smoothly, without much pain or discomfort to my child).
    I have another concern: I'm worried that this may cause future damage such as skin bridge. What are the possibilities? I mean, can 3 forced retractions cause such severe future damage?
    Needless to say that I'm not seeing that doctor again and that NOBODY is ever going to touch my son.

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    Replies
    1. Some babies do naturally retract at very early ages. It is not common, but it is possible.

      Repeated forced retraction can cause complications down the road, however, there is no way to know if it will happen with your son. And if it does, the best thing to do is allow the body to try and heal itself, and when he is older (puberty) if there are issues with retraction at that time, steroid cream can be used with manual tugging to loosen things up. Babies' bodies are resilient, so most who are retracted do not see problems in the future, thankfully.

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    2. Thank you very much for your relieving words.

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    3. Hi,
      Similar story here. I retracted my son's foreskin at 6 months (3weeks ago) without knowing that the foreskin is fused to the glans in infants. It wasn't difficult and didn't cause any fuss whatsoever with my son (he just kept playing with his toys) , but I just want to be sure that I do the right thing going forward.
      Now that it has been retracted, is there risk of infection if we leave it alone at Bath time from now on? Or should I continue washing with soap and water now that it has already been retracted?
      I'm still shocked to learn that I wasn't supposed to do this! I'm an intact male and I have no memory of a time when I didn't clean everything down there.
      How did this work out for the rest of you? Any advice?
      Thanks

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    4. To the last Anon -

      Here is an article that addresses 'what to do now.' Forced Retraction: Now What?
      http://www.drmomma.org/2009/12/forced-retraction-what-now.html

      Truly, there should never be soap used on the genitals of infants and children - it is far too irritating and warm water will be sufficient for the genitals (soap can be used on the bum).

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  8. How much is too much? I JUST learned about Only Clean What is Seen and when I bathe my intact almost 2 year old, I ever so gently retract but never with any pressure. Just for the rinse at the end. He never complains and he has never had an infection. Any thoughts on this? Feeling very sorry for all of the boys with forced retractions, I couldn't imagine pulling so hard to separate that layer! We need to get this info out there because these parents have already done the first HUGE step to reject the procedure in the first place!

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    Replies
    1. Here is a thread of discussion that answers your question:

      https://www.facebook.com/photo.php?fbid=626660874019704&set=a.324857987533329.82696.166998263319303&type=1&theater

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  9. Not sure how helpful this comment will be to the thread, but as an adult, I can look back to my nine year old self that had his foreskin forcibly retracted by his local GP. I recall the pain. I had been unable to retract my foreskin but this doctor just did it in one swift movement. I then had ...and now have... a fully functioning penis.

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  10. My son is 19 months and we have been pulling his foreskin back just as far as he would let us because our dr told us to. Three weeks ago he saw her and she told me we need to work harder on this. The other day we left him with my MIL who also has been saying we need to do this. When i got back she had forced it back all the way and removed what she called urine crystals that had adheres to his skin. my poor son!!!! he was and is traumatized, in pain, red, and has raw skin. what do i do??? is infected, how do I know, how do I prevent it, will he possibly beed circumcision now? I remember being told by my midwife it wasn't necessary but I stupidly ended up listening to my dr and MIL. I wish I would have researched then. I just want to stop touching him but people are telling me to pull back and lubricate it. Should I see a doctor?
    Please help! I am soooo upset about this but more importantly I want to help him. Thank you!

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    Replies
    1. Poor baby! I'm sorry this happened to him. :( Here is a blog post addressing forced retraction and what to do now.

      Forced Retraction: Now What?
      http://www.drmomma.org/2009/12/forced-retraction-what-now.html

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    2. Whether or not a child should continue to be retracted or let the prepuce readhere and heal over the glans is not entirely agreed upon. There are 'experts' who go both ways on this. In general, most agree now that the hormones of puberty will loosen readhesions just as they do initial adhesions, and if separation is needed via steroid creams and manual tugging, it is better done post-puberty vs. constant retraction in childhood that tends to lead to more problems, more irritation, more balanitis, more bacteria and viruses introduced into the prepuce space. http://www.drmomma.org/2009/12/forced-retraction-what-now.html

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    3. It breaks my heart to hear that your son has been through so much unnecessary pain! Please do not continue forcibly retracting him. It is clearly painful for him and can cause further issues to develop. This gives a deep look into why the practice of forced retraction began and why it continues (poorly educated medical professionals): http://www.psychologytoday.com/blog/moral-landscapes/201110/what-is-the-greatest-danger-uncircumcised-boy

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  11. Our nearly 17 year old son is having problems with skin not retracting far enough when he has an erection. There is no problems normally but causes pain when erect (which happens without much provocation in puberty). We were all set for the Dr but am now wary after all the above comments about incorrect advice. Has anyone had this issue and resolved successfully.

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    Replies
    1. Your son should be doing manual tugging/stretching exercises as a conservative approach. If this does not ease discomfort/pain within a few weeks, he can apply steroidal cream to allow temporary loosening of the skin. He will need to continue the manual tugging/stretching to provide a permanent solution.

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  12. Surgery is not necessary, men who have had a tight foreskin often find just some manipulation will rectify the problem. Some gentle stretching of the foreskin tip away from the body a few times a day will also help. The more he uses his foreskin and manipulates it the looser it will become and retracting back over the glans will become easier. If need be, a steroid cream may also help.

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  13. So my son is 2. For the past year we have been dealing with issues. He is uncut obviously.he was alway a very small guy. That it was only foreskin that you could see when he was 1... So much pubic fat that his penis never Hung out. Any way, at one visit a different dr retracted him and his glans were exposed and I was horrified. Pretty much since then we had an issue. He would cry and grab at it. He seemed to be in horrible pain! It would last 3-5 minutes of agony. And then be fine!!! I was left confused. Never a fever or anything. It was not before he peed or after, just randomly. But then he he grew fearful of peeing, scared it would hurt! Then we started to train him. Everything was fine. He'd go great. Then randomly would cry in pain and I would have to just hold him and help him through it. Sometimes I'd see faint spot of blood in his diaper. I never retracted him. I clean normally. We do lots of sitz baths to help. Then we go awhile and everything was fine. Then now as he is older, and is getting bigger (penis) we are having issues. He would have an episode and be so terrified to pee when the day before he was fine. I would see his penis get bigger bc he had to go, so I pushed the foreskin back just a smidgen and see a blood droplet that seems to be stuck in the foreskin. To me it doesn't seem like the blood comes from the inside of him. I would dap the blood off and pee droplet and he'd seem better and eventually go potty. This is happening a lot more now. He freaks out and grab and pulls at it and says penis hurts. So we took him to the dr a few times and told her not to retract. Uti tests were always fine. They'd push back just a bit to see the opening and his glad would be red and they would say it looks irritated and to put cream on it and keep it dry. So I do. And I made a urology appointment 3 months ago and finally it was yesterday. I was fed up with not ever being told why this is happening. Most drs say to retract and clean. But I was always told not to by fellow moms. Since I have been keeping the glans dry after he pees, I push the skin back to see the opening. And he is mostly detached, I could expose his whole glans if I wanted to. He is only attached at the very bottom just a little. The dr yesterday told us that it doesn't seem like its internal, that it seems like the skin is breaking if he gets an erection or something like that. That it may just be from detaching. He said he is pretty much fully retractable and that we should clean the smegma off and retract and clean it in the bath. He started off saying to never retract it. I'm guessing he is saying to retract because he is pretty much detached.
    And of course he had blood today and an episode of pain.
    We are supposed to get X-rays on his kidneys to rule out it being an internal problem. He seems confided that it's not because of how long we have dealt with this that if it was a problem that it would have presented itself by now.
    I'm so lost in how to care for him, how to clean him and what to do. I mean how many drs, urgent cares and so many conflicting things...what am I to do. He said since he is retractable and that he still has that tiny patch left that is attached, that we can't go back, once it starts detaching that we should help it along bc it could be trying to heal itself and then break skin bc of getting hard. I'm exhausted over this.

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