Hi Seili
The fact that you are seeking advice and doing your own research is an enormously positive thing. I wish that I had read more about this issue and had been better prepared. As a parent who had his son forcibly retracted by a pediatrican, at four months, there's a couple of things that I would absolutely do differently if we have another boy. Despite all the reading and research you can do, the Drs office can be rather an intimidating place to be, especially if there is a conflict of opinion over an issue like this. The best advice I can give is to get the issue out in the open before the examination starts. Let the Dr know that you understand that the AAP guidelines say that an infant should never have his foreskin forcibly retracted. Print off the guidlines so that you can show them to the Dr if you need to. If you have a Dr who is uninformed about intact boys, this will really help support your position and educate your Dr at the same time. It will be hard indeed for the Dr to go against the opinion of the organization who he/she is most likely board certified by, and it makes it very difficult to dismiss your opinion as uneducated or formed by 'what you read on the internet.' If you're uncomfortable about the level of care given by the Dr, then of course you put your child first, and walk, and find a better Dr - which is what I did.
Secondly, there's some practical advice for the care of the foreskin itself. I apologize if you already know this stuff, but I think it's worth repeating. The basic advice is to leave it alone. When cleaning the penis, do so as if cleaning a finger - exterior only. There is no need to retract before it's ready, because the skin is naturally fused to the glans and provides protection from germs. Forcibly retracting can cause problems later on if the skin reattaches, causing adhesions, or if the foreskin is damaged, leading to the formation of scar tissue. Both issues can create problems for the future and could prevent natural retraction, possibly leading to conditions called phimosis (unable to retract) or para-phimosis (foreskin stuck in retracted position, requiring immediate medical attention).
Current educated medical opinion says that some babies can be naturally retracted in the first year, for some boys it takes much longer, sometimes several years. There is no schedule and obviously every boy is different. The absolute best advice I can give you is that if you have any concerns with the penis or foreskin, seek out a Dr who knows how to treat intact boys.
Hope this helps!
Peter
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