red foreskin, infected??

[gggifts]

Hi,

I really need help. The outer edge and into the center fold of my 9 month son's foreskin is red. It is probably like this about 1/3 of the way around at least. He is obviously agitated about it when I change his diaper and wipe over his penis. Otherwise he is acting normal. Another thing I have noticed it that it seems the foreskin is tighter on this side of his penis. As if it's bunched up or something. I have noticed this for at least a couple weeks (the bunched side, not the redness. The redness seems like two days). What is going on? Is he infected or is foreskin retracting or something? Should I be worried??

Thanks very much!

[tutucrazy]

Infection would be highly unlikely unless he has had a wound to the penis such as forcible retraction. It sounds like he is having some normal separation symptoms. Read this thread and the links:

http://www.mothering.com/discussions...893&highlight=

SPECIAL INFORMATION ABOUT THE DEVELOPMENT OF THE INTACT BOY:

During childhood/adolescence your son will go through a normal separation process as the foreskin separates from the glans. As I said before, the foreskin is fused during childhood to protect the developing penis from feces and other pathogens. Separation is different for each boy and happens at a different age for each boy. During this time he might experience some irritation, itching, stinging, minor redness, minor swelling, ballooning, spraying, smegma pearls, uneven retraction, etc. These are all totally NORMAL and resolve by themselves. I get get many concerned parents come here asking about their son's irritated, red, or slightly inflamed penis. 97% of the time it is just normal separation occurring. Some boys don't experience any of this but most boys have 1 of these symptoms at some point especially around ages 2-5 when boys really begin to explore their genitals with their hands. During self-discovery is a prime time for separation trauma to appear. UNLESS it gets increasingly worse, extremely inflamed, he has fever, or you suspect yeast infection there is nothing to worry about. (Bacterial infections are VERY RARE and usually only occur only after forcible retraction or a wound to the penis.) Usually the symptoms of normal separation resolve themselves within 48 hours. Due to the fact that US doctors know very little about the development of the intact boy, it is wise to wait it out and let this resolve on its own. Since boys tend to be more "hands on" with their genitals and their genitals are not as internal these symptoms appear more frequently than with girls. You may want to remind your son to be gentle with his privates as he begins to self-explore.

Important Article--- Protect Your Intact Son, Expert Medical Advice.
http://www.mothering.com/protect-you...advice-parents

Here is a helpful thread about separation and when to be concerned:
http://www.mothering.com/discussions....php?t=764732?

Remember that just b/c the foreskin has separated from the glans does NOT mean that anyone should try to retract your son. The opening of the foreskin remains very narrow and widens with sexual maturity. A foreskin only becomes retractable after the foreskin has separated and the opening has widened. Hormones play a big role in the widening process. These hormones replace the fiberous tissue with a more elasticy tissue. Through self-discovery your son will learn when he is retractable. Only 50% of boys are retractable by age 10. It is normal for a boy to not become retractable until after puberty. The only person to retract a boy should be the boy himself. Once a boy/man is retractable he can retract his foreskin, rinse with water only, and replace the foreskin back over the glans during his showers. Easy as that!

Give him a soak in a nice warm bath (you can put a tablespoon of baking soda to soothe the area) and be sure to change him frequently until the irritation goes away. Uneven separation is a normal symptom so you should not worry about that.

Also, make sure he doesn't have a hair wrapped around his penis. This happens sometimes with boys b/c mom's hair falls in diaper and can get wrapped around.

[tutucrazy]

Also, make sure that no one who cares for him is trying to retract his foreskin. If he goes to daycare you might need to ask his care providers and insure that they know the proper care of an intact boy.

[gggifts]

Thank you

Thank you for your replies. He shouldn't have been retracted recently at least. When he was in the nicu at birth the doc said she was looking to see that his uretha? was in the correct place. And he has had some messy diapers lately. I don't think I dig in there to clean, but I do try to make sure the top of the foreskin is clean in the crease. But I definitely don't clean inside. Should I be doing something different? What does an adhesion look like? Do you think he would be hurt from the nicu experience? I don't think she pulled down and over , but she did push back somewhat.

Thanks for your help...

[Fellow Traveler]

Perhaps it's just some mild irritation, like diaper rash. A little baking soda in the bath water can help with that.

[MCatLvrMom2A&X]

If it is an infection or yeast you will know it pretty fast. It could be that he scratched it and made a bit of a cut or something like that. The thread linked above http://www.mothering.com/discussions...d.php?t=764732 has some helpful things to help with that.

[gggifts]

Thank you

Thanks very much. I really appreciate all the responses.

[MCatLvrMom2A&X]

How is he doing?

[eepster]

I'd assume diaper irratation unless new symptoms come up. Clean with plain water, apply a cream (I liked Burts Bees), and get in some naked time each day to let things air out.

[tutucrazy]

Originally Posted by gggifts

Thank you for your replies. He shouldn't have been retracted recently at least. When he was in the nicu at birth the doc said she was looking to see that his uretha? was in the correct place. And he has had some messy diapers lately. I don't think I dig in there to clean, but I do try to make sure the top of the foreskin is clean in the crease. But I definitely don't clean inside. Should I be doing something different? What does an adhesion look like? Do you think he would be hurt from the nicu experience? I don't think she pulled down and over , but she did push back somewhat.

Thanks for your help...

No wiping the exterior is sufficient. If my son has a messy diaper I just rinse him with water as opposed to wiping him since messy diapers would require a lot of wiping which could irritate him. Just turn on the shower and let the water do the work, then wipe him over once to make sure everything is gone.

Don't worry about the incident in the NICU, while it wasn't the best thing for the doc to do and he/she shouldn't have done that, it probably did no harm. Adhesions are a complication of circumcision, for intact boys the foreskin is naturally attached so you don't have to worry about it. Even when a boy is forcibly retracted and unnatural adhesions form, usually they resolve themselves by puberty. Doing what the doctor did in the NICU would not have caused any unnatural adhesions though.

He is probably just a little irritated down there from the wiping and messy diapers. Give him a little baking soda bath and some diaper-free naps.

[gggifts]

Update

Hi. Ds had a sudden fever and a rash on friday so the doctor told us to take him to the children's hospital er. Long story short, they wanted a cathater urine sample. I think I freaked the nurse out because I was so nervous about his foreskin. Anyway, she said she wouldn't forcibly retract. When she looked around gently she said he was still fused? My ds peed into a bag instead. Anyway u/a was negative but the next day the culture grew bacteria and the doc prescribed antibiotics for a bladder infection. Now we might have to follow up with u/s and a catheter dye test in a couple weeks. nobody is sure it is a true uti because it wasn't sterile catheter sample. What do you think? I thought the nurse meant that his foreskin was fused, but maybe she meant his uretha? I asked the doctor today if a cath will hurt him in any way and he said no....

[robertandenith]

fused? babies foreskin are fused to penis throughout boyhood, is normal! only the hormones will dissolve these structures, it will go like this til puberty... it works just like the hymen in little girls. Please make sure no one retract, not even 'gentle' retraction. it will cause tearing, pain, bleeding, etc.

[tutucrazy]

Originally Posted by gggifts

Hi. Ds had a sudden fever and a rash on friday so the doctor told us to take him to the children's hospital er. Long story short, they wanted a cathater urine sample. I think I freaked the nurse out because I was so nervous about his foreskin. Anyway, she said she wouldn't forcibly retract. When she looked around gently she said he was still fused? My ds peed into a bag instead. Anyway u/a was negative but the next day the culture grew bacteria and the doc prescribed antibiotics for a bladder infection. Now we might have to follow up with u/s and a catheter dye test in a couple weeks. nobody is sure it is a true uti because it wasn't sterile catheter sample. What do you think? I thought the nurse meant that his foreskin was fused, but maybe she meant his uretha? I asked the doctor today if a cath will hurt him in any way and he said no....

Fused means that is is fused to the glans, which is normal.

I'd be pretty skeptical about doing a u/s and catheter dye test with just one occurrence of UTI. This might not even be a real UTI if bacteria was not present in the initial u/a. Even if it is a minor UTI, doing those tests for one is just plain unnecessary. Also, remember that catheters are a main cause of recurrent UTIs so you can cause more problems with catheters. Then there is also the risk of accidental forcible retraction which has happened to many of our boys. They always say that they can cath an intact boy, even when they can't.

I'd get another clean catch if I were you. Have him pee into a sterile container upon waking from a nap. I'd almost bet that this is was a false positive.

If he doesn't have any symptoms I'd just let him alone and be sure to give him lots of fluids and breastmilk if you are nursing.

If he still has symptoms and you do the oral antibiotics be SURE that you are giving him a probiotic supplement at least 2 hours after the oral antibiotic. He should remain on the probiotic supplement for at least 1 week after stopping the antibiotic. This will help prevent a secondary yeast infection (thrush) from the antibiotic.