First off, how old is your son? I ask because I'm not sure that you should be "pulling the skin back" if he is still in diapers. Second, what is his diet like? Is he still breastfed, or other stuff, or what? I ask that because this could be a reaction to food/liquid ingested. Third, has he been on any medications, esp antibiotics? If yes, could be yeast. Last, have you changed anything like laundry detergent, diapers, or wipes? Could be contact dermatitis.
However, all that said, usually the foreskin protects the glans from poop (and other irritants). If he has some bad diaper rash, it can look like a blister (whether on the penis or on the buttocks ... it's all skin, and it can all get irritated and blister up.)
I would *NOT* take him to the ER!! They are likely to do things to him that cause more damage (and you more worry) than help. I would use that ONLY as a last-resort for a super high fever or uncontrolled bleeding -- and that doesn't seem to be his issue currently.
Here's what I would do, and probably in this order:
1. Give him a dose of pain meds -- preferrably baby motrin (Ibuprofen), but baby tylenol (acetominophen) would also be OK. EDITED to add, only if age-appropriate for your child -- check with your child's health care provider regarding age, medicine, and dosage.
2. Draw a nice, warm bath, and sit his booty down into it. Let him soak as long as he's happy, adding warm water as needed. But -- this is important! -- no soap, and no scrubbing. Just let him sit in it. Swish any residual poop away if necessary, very gently.
3. While he is in the tub, give him a sippy of water, or diluted juice, to get him drinking and peeing. Assuming he pees while in the tub, that will "wash out" anything that is in the urethra without burning, and you're golden. EDITED to add, only if age-appropriate for your child; breastmilk (or formula) in a bottle or sippy (or directly from the breast, but that could be difficult to manage while child is in tub!) would aso work -- anything to get age-appropriate liquids in and (therefore) urine out.
4. After the bath, use whatever diaper cream you have handy. I like Butt Paste, or Burts Bees, but anything will work. Slather on generously.
5. If practical/possible, allow some diaper-free time. If not, change frequently, but try not to wipe too much. If necessary, go back into the tub every time he poops, so you don't have to wipe. Friction is NOT your friend; dissolving with water is!
6. If he suddenly takes a turn for the much-worse, becomes inconsolable, or listless; or gets a high fever, then call your doctor on-call. Again, I would try to avoid the ER, but you'll have to follow your instinct. At the very least, I would NOT allow anyone to cath him for what is a superficial issue (skin, not bladder).
Does this help?
Edited by vachi73 - 3/15/11 at 12:57pm