Educating NPs who think a 2-year-old should be able to retract?

[blackannis]

DS had his 24-month check-up last week, and during the check-up, the nurse practitioner who is his main care provider was very disturbed that his foreskin didn't retract at all. I was a bit puzzled at her unease, because nothing I'd read about intact penises indicated that they should be retracting at all at this age, and because DS has absolutely no problems with his penis or with peeing. After the appointment, I came back and checked my facts, and lo and behold (as you all know), I was right that there is no problem, and right to be rather horrified at her attempt to retract (which made DS very upset) and her advice that we needed to start trying to retract his foreskin. We're leaving it alone, of course.

So my question: if, and I say if, we take him back to that office, what do I say to the NP and where do I send her for better information on dealing with intact penises? We're probably going to go find an actual pediatrician now, rather than going back to the general practice place, but I want to know how to defend in case we have to take him back at some point and it comes up again.

[MCatLvrMom2A&X]

http://www.doctorsopposingcircumcision.org/ has print outs you can take to give to the NP. Also here is the AAP policy on retracting http://www.cirp.org/library/normal/aap/ specifically this part

Foreskin Hygiene: The foreskin is easy to care for. The infant should be bathed or sponged frequently, and all parts should be washed including the genitals. The uncircumcised penis is easy to keep clean. No special care is required! No attempt should be made to forcibly retract the foreskin. No manipulation is necessary. There is no need for special cleansing with Q-tips, irrigation, or antiseptics; soap and water externally will suffice.

And here is the Avg. age of retraction leaflet which is 10.5yo. http://www.doctorsopposingcircumcision.org/pdf/2008-03retractileforeskinleaflet.pdf

Also you should tell her that she shouldnt be even touching your ds's penis unless there is a concern that you want to show and discuss with her. She could have hurt your ds trying to retract him expecting he was already retractable. (even if he was she still shouldnt be trying).

[Dan Bollinger]

Send them to this web page: http://circumcisiondecisionmaker.com/foreskin-facts/development/

[RM09Mama]

I wouldn't assume that a pediatrician would automatically be more knowledgeable about the normal penis.  You'll have to look around and ask the right questions to make sure you find a doctor who is actually well-informed about this and other topics that might be important to you (breastfeeding, starting solids, approaches to sleep, etc.).

[rebecca_n]

we love our np (even a lactation consultant) but she did try retracting him at his 2 year appt :( it happened so fast i didn't say anything at the time and felt horrible. when i took my dd in i talked to her about and she apologized though i can tell she still thinks she was right. at his  year i just told her he wasnt retractable yet and i didn't want her to try. she said oh yes some people think that and didn't mess with him. just tell them to not retract them and watch them like a hawk is my advice.