I wanted to follow up on my initial post for those of you reading now. This post is detailed, for the worried mamas who are going to come after me in search of help. In brief - last week my eight-month-old intact baby boy woke up with an alarmingly swollen, obviously infected penis oozing pus. (It had looked a little red on the outside the evening before, and I decided to keep an eye on it.) I took him directly to his doctor, who gave me a prescription for oral antibiotics and an antibiotic ointment, and directed me to give him a bath frequently throughout the day in warm water with epsom salts, to go without diapers all day, to stay off his belly, and to wear cloth at night instead of the Naty Baby compostables, give Advil for pain, and come back in the morning. (FYI, this was a good course of treatment in my opinion.) The big concern, according to my doctor, was that the swelling would increase so much urine flow would be cut off (he did an ultrasound in the office that showed the amount of urine in the bladder was OK at that moment). He had me tracking the number of times he peed and watching his stomach for rounding from an overfull bladder and monitoring for a fever, and told me to call immediately or go to the ER if he stopped peeing. This is when I wrote my post asking for help.
We did all that, and my baby slept deeply and was very slightly better by the next day. The doctor told me to continue and come back in two days. By the third day he was clearly on the mend, with very little swelling still visible and totally normal looking by day five. I requested a swab culture, which he didn't do on the basis it wasn't accurate and gave me a urine collection bag to take in to be analyzed instead, and I asked for a referral to a pediatric urologist who was expert on this problem, which there wasn't in our area so he referred to a regular urologist who works on a lot of kids instead.
My doctor, a family practitioner rather than a pediatrician, generally has a liberal outlook on medicine (coming to the home for newborn home births, recommending delayed and selective vaccinations, etc) but made several comments during the various visits that shocked me (and prompted my post for help). That is: 'This problem is why people circumcise their boys' and 'He has a very small hole for the urine to escape, this is going to be an ongoing problem' and 'You are getting by on just the narrowest of margins right now, even though he looks better, and you might be OK for a little while but he just doesn't have a big enough hole for the urine to escape' . His treatment recommendation going forward after it was clear my baby was on the mend: 'I recommend stretching the hole with an instrument until it tears a little, or making a slit to make the hole a lot bigger, or full circumcision asleep under anesthesia by a urologist'.
I was horrified at the very thought that a problem could be so severe I would be forced to circumcise my dear little guy, and desperate to find out if there were some alternatives to bring us away from that extreme, and to confirm my doctor's opinion. Basically, I wanted to be 100% certain, without a shred of doubt, that circumcision was absolutely a necessity and the only solution for the problem my baby had before I considered it.
I didn't get replies to this post right away, so I boldly called the number on the NOCIRC website and got no less than Marilyn Milos herself (and she commented on this thread above, I later saw) on the phone at the first ring early in the morning. I badly needed to get some experienced information about WHEN a circumcision is absolutely required. She talked over everything I noted above with me, and made it clear that there is virtually no situation where a circumcision is required, and then put me in touch with someone else with an anti-circumcision group in my own city, Rio Cruz, who I then called in turn. He got back to me twice with two different foreskin-friendly pediatricians in my city, and also offered a lot of great information. I am grateful to them both, and that they were available so immediately when I needed help so badly and had a very sick baby and potentially would have to decide what to do in short order if he stopped peeing altogether and we went to the no-mans-land ER.
We have appointments to meet the two doctors in my city who have a reputation of being foreskin-friendly, those haven't happened yet. My little guy is clearly perfectly fine now. Marilyn Milos pointed out that the doctor framed it as being a chronic problem, but this hasn't actually HAPPENED yet, just one incident, it is being treated, he is recovering perfectly, no saying if it will be a one-off or no.
I wanted to know how an infection like that could have happened; nobody can say, and little research has been done into the hows. My suspicion is some fine sand he ate recently at the beach came out in his poop and a tiny grain got in and couldn't get back out, causing an infection - but that is a wild guess, of course. Both my husband and I did notice the 'head' of his penis was visible through the skin in outline the week before and remarked on it, like 'how interesting, I guess that is how it grows as they get bigger?' but now I assume it was starting to be a bit inflamed. We don't do bubble baths, soaping, etc and only bathe him once a week so some of the big triggers are absent.
The too small hole thing seems to be bosh. Which is logical; I knew a friend's baby with a hole so tiny, the urine was under so much pressure he could pee across the room regularly! And he didn't have any need to have the hole cut bigger. I got an internet education on this one, probably surpassing his doctor who I think was well-meaning but is old and beginning to reduce his practice and didn't feel on confident ground to me dealing with this particular problem.
I definitely feel like the mom of a BOY this week after reading about penises all week! With our girl, I was already kind of an expert being a girl myself. I am humbled by how little I knew about intact boys, although I grew up in a family of them. All I knew was 'wash it like a finger and don't retract'. In some way, I'm glad to know an intact boy has a sensitive system akin to females, I always wondered why my (circumcised) husband had it so easy while I had to be careful with soap, sand, washing, etc etc etc! (Among many others, I found this article and the website in general a good source: http://www.drmomma.org/2010/01/common-questions-regarding-normal.html) A mom of four boys I know said one of hers has this problem occasionally, and some warm sitz baths with Manuca Oil always did the trick for them at the first signs of a problem, so I bought some to have on hand for the future.
OK, that ought to cover all the angles I can think of! Thanks for your support, all, and good luck to any researching mamas coming this way down the road. I will post again in this thread if I learn anything of significance with the new pediatrician visits.