Hands Off My Foreskin! Dr. Martin Winckler on the Care of Baby Boys

By Martin Winckler, M.D. © 2013
Lire en Français ici. Translated to English by Nicolas Maubert and Danelle Day for Peaceful Parenting with Winckler's blessing. Dr. Martin Winckler is a general practitioner and author in France. Read more from him at his website, MartinWinckler.com  

Many young mothers today are very worried because their mother, or their mother-in-law, or their doctor, told them they must 'clean' the glans (head) of the penis of their baby boy, and that to do so, you must retract (i.e. roll back) the foreskin like a turtleneck. In reality, however, this should not be done. The practice of retraction only causes problems and has no benefits.

What follows is an article interview printed in the L’Arbre à bébé Association's November 2005 issue. For this interview I answered some questions on the delicate topic of proper penile care and retraction that I am now sharing here with you.

Question One: 

What is your position regarding foreskin retraction, as a physician and as a parent? Do you retract your own patients? Do you retract your own sons for 'cleaning?'


I have never retracted the foreskin of a boy. Not any one of my patients, nor any of my five sons. (I believe if I asked them what they think of foreskin retraction they would look at me like something was wrong with me to have such strange ideas!)

Very early in my career, in the early 1980s, while reading the work of pediatrician Aldo Naouri, I had the notion that the practice of retraction was not only unnecessary, but aggressive for everyone -- starting with those most concerned (the boys), but also for their parents. The act itself is aggressive because once you touch a little boy’s penis, an erection is induced. Not all mothers [or fathers] are going to be comfortable with this, and we understand why. Boys will often smile or laugh that it tickles and very quickly we find that parents prefer to leave that area alone to care for itself.

Question Two:

What do you think of the arguments commonly used by proponents of retraction (that retraction will prevent adhesions, phimosis)?


Phimosis is the condition in which the orifice of the foreskin is too tight to allow the glans to leave when the boy is erect. So it can not interfere with boys until the age at which they are likely to have intercourse. However, most studies that have been done on the subject show that any amount of retraction, 'just a little' or a lot, has no medical function, neither for hygienic purposes, nor to prevent phimosis, which is an uncommon condition to begin with. It used to be said that retraction was necessary to fight against adhesions and to 'clean up' anything under the prepuce. However, preputial secretions are as normal as vulvar secretions in the little girls. There is nothing wrong with them whatsoever. Never have we suggested that we 'clean' the vulva of our daughters with a cotton swab, yet I have seen mothers try to pass a cotton swab under the foreskin of their son because a doctor told them to do so!

Quite simply, the foreskin is self-cleaning. The orifice of the foreskin is tight at birth on purpose to prevent dirt (bacteria, viruses, etc.) from creeping into it. Retraction (a dilating force) is then entirely unnatural. And it hurts! Retraction causes tears and can cause paraphimosis (having the foreskin stuck in a retracted position behind a swollen glans) which itself is an emergency. This induced paraphimosis is actually much more common than true phimosis.

A common scenario: A mom wanted to retract a boy (usually in the bath). The manipulation resulted in a retraction after erection. Suddenly, the foreskin 'turtlenecks' (squeezes) the glans, which then swells and turns purple. The child yells. And in a warm bath, it gets worse. [Vasocongestion takes place, leading to more blood flow, a throbbing erection, and tighter constriction.] In short, parents call the doctor and then one of two things happen. Either the doctor panics and sends the child and his parents to the emergency room, or the doctor understands what has just happened solves it very simply:
1) Do not pull the foreskin forward after retraction and paraphimosis (it does not work).  
2) You must first empty the warm water bath. Then pour somewhat cooler water (but not iced/cold water) on the penis. The cooler water deflates the penile engorgement.  
3) Then gently squeeze the swollen glans (head) of the penis. As the penis deflates, the foreskin will start to roll back down over the glans by itself.  
I saw dozens of situations like this one early in my career. It was always among boys whose mothers had a slight obsession of making sure their son was 'clean,' or among those whose parents had conscientiously felt pressure to retract following the advice of a relative or highly invasive physician. So much so that their little boy was retracted three times each week - so often that these little boys begin to develop anxiety when their mothers approached them to change or 'clean' them. The more mothers touched their boys' penises in this fashion, the more young children became angry, the more it hurt, the more retraction became torment, until they developed paraphimosis. And then parents call for help. In short, it is a vicious cycle.

Very quickly I started to pass along the message to young parents that they should not even touch the foreskin. Leave it alone. And with this advice, over the years, I began to see less and less paraphimosis among my patients. There were now more and more happy little boys who tugged on their own foreskin, laughing, without anxiety. And I saw more and more mothers delighted with the fact that they did not have to handle their son's penis - in fact, they did not have to do anything for its care. I have not had any little boys need surgery on their penis during my career as a general practitioner, and I saw very few boys ever in need of surgery during medical school, because in my district, no doctor was a fan of retraction.

Question Three: 

At what age should I be worried and consider surgery for a boy whose foreskin does not retract?


It's simple: you should never worry because there is no reason to worry. Foreskin retraction is a cultural practice [in a few nations], and does not take place at all in other countries. Still, there are no more cases of phimosis or 'problems' among those nations where foreskin retraction is unheard of. Retraction by someone other than a boy himself serves no purpose at any age. And yet, all parents of little boys can testify that fiddling and tugging on the foreskin are commonplace practices among infants and toddlers (up to eight to ten years old). This self-exploration causes no problems. Quite simply, the foreskin is not meant to be retracted by anyone other than the owner himself - it serves as a sheath to the glans in this way, a protector from outside invasion. As a child grows, the foreskin lengthens and softens over time. With puberty and masturbation, the foreskin opens on its own. It stretches along the penis little by little, allowing for erections to take place without cause for concern. By the time the hormones of puberty are in full swing, the vast majority of boys have already retracted their own foreskin and eased the preputial orifice open.  Even if their prepuce was tightly closed in childhood, they do not have phimosis, and this is evident as young adults. So small is this concern that these boys do not even know the word 'phimosis!' In rare cases when there is a real issue, it is at puberty that this is discovered, not before. If a 'problem' arises before puberty, it is likely paraphimosis, because a boy is being retracted - see above.

Throughout my career as a general practitioner [~30 years in 2013] I have only had to circumcise one single man, aged 22 years, who had developed untreatable phimosis that was the result of brutal retraction as an infant and child that left tight foreskin scarring on his penis. This started to bother him at puberty - not before. And, in fact, it was the way he was treated as a baby and child that caused the inflammation that resulted in his phimosis - not the other way around. He had to be circumcised as a result of improper care by those who did not know any better. When we repeatedly tear the foreskin at an age of development, it does lead to scarring, and this in turn tightens the foreskin over time, causing the problems we then blame on foreskin (rather than improper care).

Question Four: 

What is your advice to a mother who does not know what a pediatrician will do to her baby during a check-up? What should she do if a physician suggests that she retract? How should she handle guilt-trips pushing improper care?


Retraction is a problem that exists merely because it is a matter of culture-based opinion and not a factual issue of prevention or health. Again, there is no evidence that retraction has even the slightest benefit, but its disadvantages are medically obvious.

Doctors do not exist to dictate their personal opinions onto parents, and there should be no guilting of mothers who consciously decide they will not 'mess with' the penises of their sons. In fact, I find these mothers to be the ones who are the most mentally stable and emotionally healthy. Would a mother okay the circumcision of her son just to please a physician who tells her it is 'cleaner?' Of course not. The same goes for retraction. If a doctor talks about such things, tell him that you will leave your child to figure things out for himself, and if a problem arises down the road, you will deal with it at that point. Above all, do not let a physician who is suggesting retraction use your child for their demonstration.

Just as there is zero justification in performing vaginal exams on infant and young girls, so also is there never justification to retract and examine the inside of a baby boy's or child's penis when there is nothing wrong. Doing so is not alright for girls, and it is not alright for boys. The only time a physician should be handling your child's genitals (gently!) is if the penis or vulva in question has a visible abnormality that requires examination. If this is not the case, then hands off!

- Martin Winckler, M.D.


Breastfeeding is L♡VE: A Valentine's Celebration

"The beauty, and calm of tandem nursing - having your two little ones climb up on your lap, and both of them looking up at you with love in their eyes... 
Those memories, precious moments never to be forgotten, and forever kept close to the heart!" ~Melanie (pictured above with her two little ones)

Ah, the blessed goodness of one of the very best Valentine's gifts ~ gentle mothering and momma's milk! We've celebrated past holidays with some milk-lovin' albums (Christmas Milk and Halloween Milk), and received several photos today from mothers with their little nursing Valentines. However, all admins on the peaceful parenting page at Facebook are coming off a 3-day block or restriction after lactiphobic persons flagged another mother's beautiful breastfeeding photo that was shared to the pp page. As a result, we've decided to begin this gallery that will reach far more audiences and serve as a beautiful reminder of some sweet Valentine's moments for years to come. ❤

If you have a photo you'd like to add, email it to DrMomma.org@gmail.com (with your name if you'd like a watermark added).

This photo of Lindsey nursing her 3rd baby is really special as it is the very first Valentine's Day
that she's a breastfeeding mom.  Read more of her story here

3 years, 8 months 

"Here, my 4 and a half month old is being nursed to sleep. Having him comforted and feeling secure is one of the most
indescribable feelings of joy! This experience, that no one else can share or intrude, makes it special for the both of us!" ~Joyce 

"Sweet Margo taking her night time sips while cuddling in Mama's bed on her first Valentine's Day.
She was born on 10/25/12. Nursing is such a gift to both of us." ~Lucy 

"Today was very special to me for one reason: my son, who is now 4 1/2 years old, asked for 'mommy milk' before falling asleep. 'Like I used to always have when I was a baby...' he said. I always thought we would be the mother/child duo who would nurse for a full duration of years - and on the long end at that. 5 years, minimum. But right around my son's 4th birthday, I began having some health issues. A mass was found under my chest, beneath my lungs, and my milk dried up. My son continued to nurse on occasion, but without the liquid gold he'd become accustomed to, there was not as much incentive. In addition, he fell ill 3 times in a row for the very first time of his life. I was devastated to not have the one thing he needed most through this last cold and flu season, but with impending surgery and treatment, there aren't many options for re-lactation at this point. Over the past 6 months my son has lost his 'effective latch' and on the rare occasion when he does still ask for 'Mommy Milk,' nursing does not typically last for more than a few brief moments before he pats his 'milk' and looks at me again to say, 'I can't get any out. It's all dried up...' This is the first Valentine's Day in 5 years that I am not lactating - and it is bittersweet, indeed. But my phone was within reach when he asked to nurse this evening and I was able to snap this one (potentially final) photo breastfeeding my baby." ~Danelle 


What About Local Anesthesia?

By Rosemary Romberg

Rosemary Romberg

My earliest work on infant circumcision focused heavily on the infant’s pain and trauma. Only slowly did I realize that the topic involved a myriad of other issues as well.

Back then the medical establishment was the “enemy.” The goal: to make all new parents aware of exactly what happens when a baby is circumcised, and to feel the terror and agony that he feels. Parental protective instincts would then intervene and soon all Gomco clamps and Circumstraints would be thrown in the trash as everyone would quickly learn to accept the body in its natural state.

Many parents have made the decision against circumcision on the basis of pain alone. But for many others, our voices have only been partly heard. Instead of throwing away their Gomco clamps, many doctors have simply pulled out hypodermics filled with local anesthetic.

I cannot fully condemn its use. Local anesthesia probably does at least numb the initial impact of the clamp and blade. But too many people think that this has solved the problem. Use of local anesthesia for infant circumcision has been used by many as an excuse to sweep the other issues under the rug.

I always point out that strapping an infant down and working on him is, in itself, stressful and traumatic for an infant. Injections themselves (directly into the penis) are painful. Local anesthetics such as xylocaine cause a sharp burning sensation when they enter body tissues. Some babies scream and cry just as much when local anesthesia is used. And the wound will be raw and sore for several days, especially when the baby urinates.

I always detail the other facets too important to ignore: the function and purpose of the foreskin, the medical non-necessity of the operation, and the human rights issue of allowing a child to keep all normally occurring body structures. No dorsal nerve block can obliterate those issues!

Pain is only one facet of circumcision. Pain is also only one facet of the concern over trauma. From my own experience as a mother, two cases in point:

Our oldest son, Eric, as a 22 month old toddler grabbed a boiling hot pot of tea and spilled it all over his legs. He sustained horrible first and second degree burns from his thighs to his ankles. We spent the morning in the pediatrician’s office. Eric’s screams were devastating but I did remain with him the entire time. Eric’s legs were fully bandaged. He was given a shot of Demerol for the pain. I brought him home and he slept all afternoon.

Burns are among the most intense types of pain. I expected Eric’s recovering days to be challenging. Surely he wouldn’t even want to walk for some time. We would have to handle him with much care and gentleness. But much to my astonishment, that evening Eric was running around the house, climbing all over the furniture, laughing and giggling. His resiliency was amazing.

The pain Eric felt was certainly tremendous, but I never saw any change in his happy, outgoing nature following that ordeal.

Our second son, Jason, was also a 22 month old toddler when he fell against a window ledge making a deep gash over his right eyebrow. We rushed him to the hospital emergency room for stitching. Soon, the impact of his fall forgotten, Jason was busily exploring every nook and cranny of the treatment room. Finally the doctor came into the repair the wound. I had assumed that I would stay in there holding Jason during the stitching. Instead the nurse picked Jason up and began strapping him into a “Papooser” (an immobilizing device used for small children during medical procedures.) Jason screamed in terror at the prospect of suddenly being restrained. The doctor ordered me out of the room saying, “If you are in here, Jason will associate you with the pain, and be angry at you for not rescuing him.”

I sat out in the hall for about 15 minutes listening to Jason’s screams. (An almost two year old can really howl!) I was in early pregnancy with Ryan when this happened, and this experience was the dawning of my concern over traumatic medical events and how they ultimately effect the nature of the child. (This, and not circumcision per se, was my original concern.)

Jason was given a local injection for the stitching. What he experienced was not, in and of itself, all that painful. But it was devastating to him from a psychological standpoint. The doctor was a skilled technician. The scar is barely visible. But the procedure was not handled humanely in regards to Jason’s mental health.

Over the next several months I observed many distinct personality changes in my formerly happy-go-lucky child. He was much more fearful — deeply suspicious that someone might do something to him. None of my other children have ever had any particular attachment to an object or needed to suck on anything but my breast. But Jason, although still nursing, constantly sucked his finger, and was intensely dependent on his “favorite blankie” that accompanied him everywhere. A subsequent visit to a photographer was a disaster. Jason screamed at the prospect of being placed on the platform for a portrait. An attempt to visit Santa Claus was equally terrifying. Over the next few years new challenges such as potty training, new places, amusement park rides and new friends all were approached with tremendous fear and reluctance. Jason eventually became a happy, confident and high achieving older child and adult, but it took him years to adjust to life’s everyday conquests.

Because of these two incidents, I wonder if the experience of being forcibly restrained and worked on (for a child who cannot understand) is more significantly traumatic and damaging than the pain itself.

The local anesthetic did not prevent Jason’s traumatized reaction to his experience. Similarly, a local injection for infant circumcision is missing the point.

My feelings today about my baby boys having undergone circumcision are no different than had someone taken one of my daughters away from me, tied down her arms and legs, taken a knife and slashed her genitals. (Remember, it was not that long ago that even rape was not taken seriously!) Had something like that happened to one of my daughters, and had she been given a shot of local anesthetic as well, would my horror have been any less?

Come on people, THINK!

Originally printed in Peaceful Beginnings’ Summer/Fall 1988 Newsletter.
(Revised – 2012, edited 2013)

Related by Rosemary Romberg:

Rosemary Romberg (in honor): http://www.savingsons.org/2020/02/rosemary-romberg.html

From Peaceful Birth to Circumcision Trauma: http://www.SavingSons.org/2018/01/from-peaceful-birth-to-circumcision.html

Saturday Evening Post 1981 Circumcision Publication: http://www.SavingSons.org/2008/08/saturday-evening-post-december-1981.html

Circumcision: The Painful Dilemma: https://circumcisionthepainfuldilemma.wordpress.com 

Rosemary has materials at Keeping Future Sons Intact, the Whole Christian Network, and Saving Our Sons' Alaska and Hawaii chapters - all areas she helped with.


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