retraction question

[liliaceae]

I've read through some of the info in the retraction stickys, and it was said that the doctor should not retract the foreskin at all. My son's doctor has done this in the past, she didn't force it back, just kind of eased it back and it didn't cause ds any pain. I know some posters have said that there is absolutely no reason to do this, and I was wondering if someone could point me to some resources explaining why it is unnecessary. I also plan to ask the doc next time we go in why she does it, but I'd like to go in prepared. Thanks!

[kldliam]

Give this to your doctor and ask her to sign it:

http://www.mothersagainstcirc.org/care.htm

She is clearly ignorant about the male prepuce.

Frank says it best here:

http://www.mothering.com/discussions...d.php?t=129378

[kldliam]

here is the AAP statement on premature retraction:

http://www.medem.com/search/article_..._typ=NAV_SERCH

Until separation occurs, do not try to pull the foreskin back — especially an infant's. Forcing the foreskin to retract before it is ready may severely harm the penis and cause pain, bleeding and tears in the skin.

[liliaceae]

Thanks so much for the info, I guess what I'm wondering is if there are any online medical resources that say why there is no reason to pull the foreskin back even a little bit. For example, Franks says:

"These uneducated health care providers think there is something inside the foreskin to see when there is absolutely nothing. Even in the case of infection, there is absolutely no reason to pull the foreskin back. Anything that would be apparent from the inside is readily apparent from the outside. That is because the foreskin is a wonderfully sensitive area and just like the lips, if there is anything wrong on the inside, it will manifest itself to the outside within a matter of mere hours. Just like the fingernails, if there is a problem, it is treated either from the outside or internally with oral medication. You don’t pull the fingernails back to treat a problem and you don’t pull the foreskin back to treat a problem."

(I hope it's okay to quote him here)

And while Frank seems to be very well informed, I would rather not take the word of just one anonymous person on the internet, kwim? No disrespect to him or anyone else, and it seems to me that he's probably correct, but I would like to see if there are any sources for this information that I could check out myself.

[Yulia_R]

retraction is very very BAD!

And your doctor is very wrong!
You haven't got many answers in your thread because people here just got tired to write every day the same thing. If you go page by page, you will see TONS of questions about retraction (almost on every page here) with alot of good links.
If you don't trust AAP (american academy of pediatrics) that clearly states do not retract, then maybe you trust Dr. Sears? In his famious "The Baby Book" he also states very clearly about NOT pulling the foreskin back.

You need to tell your doctor to NOT even touch your son's penis anymore, otherwise he may end up with infections and other problems. Retraction is VERY BAD.
yulia.

[Yulia_R]

and one more thing...

Also, I’m not sure if you already looked into vaccinations, but in case you haven’t I’d HIGHLY recommend you do. It’s a matter of fact, I’d *really* advise you to not give your baby any shots until you do your research about it. I’m saying this because it sounds to me that you still have this blind “doctor knows best” thing and that may be *really* not healthy (dangerous I’d say).
Vaccination forum is a good place to start
http://www.mothering.com/discussions...splay.php?f=47

yulia.

[Quirky]

Originally Posted by kldliam

here is the AAP statement on premature retraction:

http://www.medem.com/search/article_..._typ=NAV_SERCH

This is the AAP statement, so it's just about as official as you can get.

Here's another link for you, looking at studies of when boys become retractable (which is often much later than most doctors think):

http://www.doctorsopposingcircumcisi...etraction.html

Part of that document states:

Avoidance of premature retraction. Care-givers and healthcare providers must be careful to avoid premature retraction of the foreskin, which is contrary to medical recommendations, painful, traumatic, tears the attachment points (synechiae), may cause infection, is likely to generate medico-legal problems, and may cause paraphimosis, with the tight foreskin acting like a tourniquet. The first person to retract the boy’s foreskin should be the boy himself.3

And here's the paper cited in note 3: http://www.cirp.org/library/normal/wright2/

The thing is, you're not going to find a lot of "official" information on retraction, just as you won't find a lot of "official" information telling you not to let anyone stick something in your dd's vagina to see if her hymen has started releasing yet, KWIM? In countries where circumcision is not common, it's so generally accepted just to leave the foreskin alone.

Whereas in countries like ours where circ is all too common, up until recently there were hardly any intact boys around, so the level of knowledge learned in medical school or passed on in practice about the proper care of the intact penis is almost nil. Many doctors learn no more about the foreskin in their training than a) how to cut it off or b) that it's a ticking timebomb of a problem waiting to happen, so they often mess around with it because they're looking for problems, unaware that their very actions and poor advice may actually CAUSE problems!

Simply put, there's no need for your doctor to retract, not even a little bit. Put the shoe on the other foot -- ask HER to provide sources and references for why she's doing something to your son's penis. After all, the default on any medical procedure or technique should be don't do it unless there's a reason, right? I will bet you a hundred bucks that she will not be able to come up with current, well-documented references that say "you, the doctor, should ease the foreskin back at well baby visits in order to accomplish xyz."

If you ask her WHY she's doing it and WHO taught her to do it, she will probably mention something about how some old fart during her residency said you have to retract the foreskin to "train" it, otherwise it will seal shut. Or, you have to check for phimosis, because if the boy doesn't retract by age 3 that there's something wrong. Or something equally unfounded. The point is, a lot of doctors don't practice evidence-based medicine -- many of their habits are myths passed down from previous generations.

HTH!

[liliaceae]

Originally Posted by Yulia_R

Also, I’m not sure if you already looked into vaccinations, but in case you haven’t I’d HIGHLY recommend you do. It’s a matter of fact, I’d *really* advise you to not give your baby any shots until you do your research about it. I’m saying this because it sounds to me that you still have this blind “doctor knows best” thing and that may be *really* not healthy (dangerous I’d say).
Vaccination forum is a good place to start
http://www.mothering.com/discussions...splay.php?f=47

yulia.

Hmmm....I guess I didn't express myself very well. I absolutely do not think "doctor knows best." I am simply wondering if there might be a reason the doctor would need to pull the foreskin back to look at the tip of the penis. My doc has never fully retracted ds, never torn anything while touching the foreskin, never caused him any pain. Actually I've had two peds and they've both done this at every visit since he was born, since it didn't hurt him and they didn't fully retract, I thought it was just something they did routinely like feeling his torso or looking in his ears or whatever.

However, now that I've started to look over this information I'm inclined to tell the ped not to touch his foreskin at all. Just wanted to make sure I was not putting my son at risk for anything that would need to be checked out by pulling his foreskin back slightly.

I totally understand that full retraction is very bad, and that the AAP says not to retract, just wondering if there might be a reason to pull it back at all. As I said I will ask my ped her reasons, I just want to be prepared with info in case she actually does have a seemingly valid reason.

Oh and to put your mind at ease, I actually am researching vaccines, and will base my decision on thorough research, not on the opinion of one doctor or of one person on the internet.

And Quirky, thanks for your input, it was very helpful!