Marilyn, My son is 18 months old and he seems to be fully retracted. Is the advice for leaving it alone still applicable? Or should I be cleaning it every once and awhile. The urologist said to pull it back as far as it will go without forcing and to clean the smegma. Is the white film something that should be cleaned or left alone? I have heard different things and was hoping you could clear them up for me.
There was no need for anyone to check to see if your son's foreskin is fully retractile at his age, although I understand that sometimes the information simply presents itself. Such was the case with one of my grandsons. I was caring for this four-month-old boy while his mother was at the dentist, and during our time together, he pooped from stem to stern. Now, remember, I know /not/ to retract a foreskin! However, to wipe his penis clean, I stabilized it at the base, and the glans just popped out. You can imagine my surprise! While I had always heard that one-to-two percent of babies are born with a fully retractile foreskin, I'd been doing my work for more than twenty years before this baby was born, and I'd never seen a retractile foreskin in an infant. I doubted the statistics, until that moment! Since then, no one has attempted to retract his foreskin but now, nearly a decade later, the boy probably manipulates it himself when he's in the bath. Most boys do so without ever having to be told. In non-circumcising countries, no one fiddles with foreskins of boys, worrying about what might be lurking underneath. They simply leave it alone and, at puberty, a boy is taught to retract, rinse (warm water only--no soap), and replace the foreskin in its forward position. The accumulation under the foreskin is called smegma, which is a secretion of mammalian genitals that consists of a combination of exfoliated (shed) <http://en.wikipedia.org/wiki/Epithelium> epithelial cells, transudated skin oils, and moisture. Smegma occurs in both female and male genitalia. It is a protective, lubricating substance and is not a concern for young boys. When your son is older, you can explain that he can pull his foreskin back and, with his fingertips and warm water, rinse the area when he's in the bath. This need only be done once in awhile, if at all, before puberty. During and after puberty, when hormones kick in and and body odors change, your son can be taught that penile hygiene should be practiced once or twice a week for health, prior to sex to be polite, and after sex for cleanliness. In the meantime, your son needs an unconcerned boyhood. No one tells girls to pull their foreskins (clitoral hoods) back to wash under or to use Q-tips to wipe out vaginas to rid the body of smegma. It's a natural secretion (like ear wax) and should be treated as such. Just as with girls, the body is capable of eliminating its own secretions. So, you can relax. You know your son's foreskin is retractile but you need do nothing, except enjoy your perfectly normal son!