Recurring infections in uncircd infant

[plantnerd]

Has anybody else had this problem? D is 8 months old and has had 2 penis/foreskin infections. Easily cleared up with zithromax 5 days. It is not yet retractable and we try to keep him as clean as possible. I think part of the issue is as soon as the diaper is off he is xxx like no tommorrow, and introducing bacteria via grubby hands.

Any experience or advice?

[dmpmercury]

If they keep occuring it could be the same infection re occuring or caused by congental abnormalties of the upper GI tract in which case an investigation with sonography or radiography should be done. That isn't circumcision related. It is common for an infection to burrow into the deep tissue of the bladder and to hide from antibiotics so that it will reappear. I wouldn't worry about it yet with only 2 infections that have been treated easily. Infections tend to be more common in babies under 1 so he wil probably grow out of it. It will probably be hard to find a doctor that won't mention circumcising to solve this but I'm sure there are some that will actually investigate if it comes to that.

[glongley]

Not all episodes of inflammation of the foreskin are actually "infections," that is, in the sense of being caused by microbes liek bacteria or yeast.

The most common cause of redness and swelling of the foreskin is probably just diaper rash, aka ammoniacal dermatitis. The diaper area in general can get red and inflamed simply from exposure to the chemical irritants in wet and poopy diapers, and the foreskin can get diaper rash on it as well. You prevent and treat this just like you would any other diaper rash. Warm tub soaks with baking soda in the water can help neutralize the ammonia in the urine in the diaper and help with healing.

Other chemical or mechanical irritation can lead to redness and swelling for the foreskin, e.g. exposure to too much chlorine in swimming pools, or jacuzzis, exposure to soap or bubble bath, getting the foreskin caught in the mesh of a swimsuit.

Another cause of inflammation can sometimes be the natural process of separation of the inner foreskin from the head of the penis. As new areas release, the newly exposed mucosa may be a bit raw for a day or two. This can cause tranistory redness, swelling, itching, stinging with urination. It normally takes care of itself in a few days. Warm tubs soak can help.

Then there's the possibility of yeast. Being on antibiotics in itself can kill off not just any bad bacteria, but also the good bacteria that keeps the pH and natural microbial balance under the foreskin. Just like women sometimes will get yeast infections after being on antibiotics, so can males. You can replenish the good bacteria with application of liquid acidophlius 4-5X a day - dip the penis in it, and let it dry on there.

So your son's situation could be based on these types of issues, rather than needing antibiotics. HTH Gillian

[Quirky]

Gillian's a nurse and she has given you good info! The only thing I would add is to ask whether your doctor actually cultured any discharge to demonstrate that there was something bacterial going on. Redness and swelling by themselves wouldn't prove that there's an infection needing antibiotics.

American doctors are by and large so ignorant of the normal penis and the minor issues that may occur in intact boys. Many of them tend to treat the foreskin as a ticking time bomb of disease and infection, because that's what they were taught in medical school. So it's very common of them to assign the blame to an "infection" and prescribe antibiotics when that's not what's going on at all.

I would also do your best to keep your son's hands clean and his nails short. Too much vigorous exploration can definitely result in redness and irritation.

[eepster]

What are the symptoms of these infections? What kind of diapers are you using? Do they occur shortly after travelling, or any other special activity, such as going to a pool? Does he have skin irritation anywhere else?

[Claire and Boys]

How do you know he is not yet retractable? does that mean you are trying to retract him?

If you are, even if you do not actually manage to retract you could be introducing bacteria to the area by attempting to do this.

I've never tried to retract my sons, I have no idea if they are retractable or not.

Also, what do you mean exactly by keeping him as clean as possible, are you using soap, that can also cause irritation to the area. Simply rinsing with water/wiping the outside is all that is needed.

[MCatLvrMom2A&X]

Do you use soap on his penis at all? If so what kind and how well do you rinse with clear water?

[plantnerd]

To answer the above questions:

Symptoms- pussy discharge, swelling, redness (onset within 24 hours, does not seem like chronic irritation)
diapers- mostly bumgenius and fuzzibunz, some prefolds, some sposies
retractable?- eh, I check every once in awhile to see if it's loosened up, no hard pulling at all
soap/washing- just a once over during his regular bath w/ johnson's.
pool?- actually yes, we swim every day when we can, a water baby D is!
slang term- oy, I have never posted here before and got a message saying that what I posted was not allowed, so, uhhh, he "pulls on his penis" when his diaper is off

[MCatLvrMom2A&X]

I cant help thinking yeast. Or possibly irritation from the pool causing the yeast. Does he have any other rash on his bumm/scrotum at all?

[eepster]

Originally Posted by plantnerd

Symptoms- pussy discharge, swelling, redness (onset within 24 hours, does not seem like chronic irritation)

If it tends to clear up within 24-48 hours, then those can all be caused by separation. The discharge is probably just smegma. Have you seen any ballooning recently? If you have that strongly suggests that the foreskin has started to separate from the glans.

An accurate infection dx requires a culture being taken. The symptoms you describe can have many causes. In the absence of either a positive culture, or a fever, irritation or separation are more likely than infection.

diapers- mostly bumgenius and fuzzibunz, some prefolds, some sposies

That is a wide variety. Do you ever see a pattern with this? Do these "infections" occur after a particular brand/type of diapers?

retractable?- eh, I check every once in awhile to see if it's loosened up, no hard pulling at all

Stop doing this, if they are actually infections, this could be the cause.

There is no need to know when your DS becomes retractable. It is pretty early for it actually. Even though it seems like he he may have started separating early, it is unlikely that the sphincter at the end of the foreskin has started to relax enough to retract. The average age of retraction is 10 yo (there is an extremely wide range of normal) so it is really early to start checking anyway. Your DS will figure out when he become retractable through normal exploration, and there is no need to retract before puberty anyway.

The problem with testing it is, that you can't feel if it is causing little tears or pulling on the natural adhesions. When he pulls on it himself, he can tell what it feels like and is less likely to hurt himself. In my experience, before boy begin to become retractable, they tend to pull the foreskin out and away from their bodies, and not back towards the body.

[plantnerd]

great advice ladies!

I have thought about yeast, but there doesn't seem to be a yeasty-smell (you know what I mean) My guess is bacterial due to immune issues, guess I should have put this in original post, but first infection was 3 days after 3 month vaccinations, and 2nd was 5 days after onset of his first cold. I wonder if there is a genetic influence...I am very prone to bacterial infections (bronchitis) after viral illnesses or stressful times.

Otherwise- huge, happy, hungry, healthy as horse. Can't complain really

[MCatLvrMom2A&X]

I never noticed any smell with yeast infections with my dd or with myself. I didnt even realize it had a smell

[MommytoB]

I also would stop using soap on his foreskin especially johnsons for some reason johnson is a soap that causes very bad reactions chemically wise to some people because one time I used that soap on Brendan head to shampoo his hair he had a bad reaction so we never use that brand.

Also, avoid using soap on foreskin because soap on foreskin can create yeast . I never used soap on my ds foreskin .