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#1 of 18 Old 04-23-2010, 12:22 AM - Thread Starter
 
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Help! My 3 year old son is not circumsized and today at the Dr. the Dr. pulled back the skin over the glans and the glans was bright red. My son screamed the whole time he was touching his penis. The Dr. said he had a yeast infection, probably caused by using bubble bath. He prescribed a anti-yeast ointment to put on it 4 times a day, and said to pull back the glans and put it on it.

I am confused and upset and need advice. There is no way my son is going to let me pull back his foreskin 4 times a day. What if I just put the cream on the tip of the foreskin, will it work itself in and heal the infection? This is the 2nd time this has happened- I do not wash his penis in the tub- he doesnt like me to touch it so I dont. What can I do- I am seriously thinking maybe I should have circed him so I would know what was going on with his glans...educate me please!
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#2 of 18 Old 04-23-2010, 12:46 AM
 
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No dont get him circumsiced. There is nothing wrong with your son, just his doctor who isnt informed on uncircumsiced penis's. That white stuff he has is normal its called semegma not sure on the spelling but its normal. If your son wasnt in any pain b4 being forcefully retracted he is fine. I just took my son for a uti he was peeing with blood and pain but his doctor has never once retracted him and neither have i even tough they tell me to i dont do it. I had similar thoughts as well about just getting him circ but i cant do that to him put him thru all that pain when other boys have grown up fine not being touched and being intact. I just read about this book plan on buying it and showing it to my son's doctor so she can get informed. its called What Your Doctor May Not Tell You About Circumcision you can get it on amazon.com
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#3 of 18 Old 04-23-2010, 12:56 AM
 
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First, it is normal for the glans to be very red, because the surface of the glans of the intact penis is a mucus membrane surface, like the inside of your mouth, and it is naturally red because the capillaries underneath rise close to the surface. This redness is normal and is NOT in and of itself a sign of infection.

Second, the doctor should not have retracted your son's foreskin. This can be painful and damaging to the tissue. NO wonder your son was screaming. The foreskin in most three year olds is still attached to the glans and the outlet is naturally quite tight (the foreskin naturally separates and loosens on its own as he gets older).

Third, I am wondering if your son had any symptoms in his penis that caused you to take him to the doctor, or did the doctor just retract and diagnose a yeast infection out of the blue at some other appointment?

Yes, intact boys sometimes get a yeast infection. Yes, bubble bath can cause irritation and inflammation. But, no, you should not be trying to retract your son four times a day! This will be not only emotionally traumatic for your son, but probably physically impossible to do without further physical pain and damage.

You said this was the second time this has happened... Can you describe some more of the symptoms that manifested?

There is a really great post in the stickies above on issues that sometimes come up with intact boys. http://www.mothering.com/discussions....php?t=764732?

Also you can read more on care and development of the intact penis, and on normal variations here:

http://www.mothering.com/health/prot...advice-parents

http://www.cirp.org/library/normal/

http://www.nocirc.org/publish/4pam.pdf

After you read these, you will be more educated about the normal intact penis thatn 99% of the rest of Americans, including your doctor.

Good luck, and let us know how things are going, or if you have any more questions.

Gillian

Edited to celebrate my 1000th post at MDC!
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#4 of 18 Old 04-23-2010, 01:06 AM
 
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Good Article from American Academy of Pediactrics

http://www.cirp.org/library/normal/aap/Uncircumcised Penis

Guidelines for Parents

American Academy
of Pediatrics


--------------------------------------------------------------------------------

At birth, the penis consists of a cylindrical shaft with a rounded end called the glans. The shaft and glans are separated by a groove called the sulcus. The entire penis - shaft and glans - is covered by a continuous layer of skin. The section of the penile skin that covers the glans is called the foreskin or prepuce. The foreskin consists of two layers, the outer foreskin and an inner lining similar to a mucous membrane.

Before birth, the foreskin and glans develop as one tissue. The foreskin is firmly attached - really fused - to the glans. Over time, this fusion of the inner surface of the prepuce with the glans skin begins to separate by shedding the cells from the surface of each layer. Epithelial layers of the glans and the inner foreskin lining are regularly replaced, not only in infancy but throughout life. The discarded cells accumulate as whitish, cheesy ``pearls'' which gradually work their way out via the tip of the foreskin.

Eventually, sometimes as long as 5, 10, or more years after birth, full separation occurs and the foreskin may then be pushed back away from the glans toward the abdomen. This is called foreskin retraction. The foreskin may retract spontaneously with erections which occur normally from birth on and even occur in fetal life. Also, all children ``discover'' their genitals as they become more aware of their bodies and may retract the foreskin themselves. If the foreskin does not seem to retract easily early in life, it is important to realize that this is not abnormal and that it should eventually do so.

Drawing reprinted with permission of Edward Wallerstein, author of Circumcision: An American Health Fallacy. [CIRP note: The drawing is presented only in the older (1984) edition of the pamphlet.]

[The Function of the Foreskin: The glans at birth is delicate and easily irritated by urine and feces. The foreskin shields the glans; with circumcision this protection is lost. In such cases, the glans and especially the urinary opening (meatus) may become irritated or infected, causing ulcers, meatitis (inflammation of the meatus), and meatal stenosis (a narrowing of the urinary opening). Such problems virtually never occur in uncircumcised penises. The foreskin protects the glans throughout life.] [CIRP Note: This important paragraph, and the drawing, were printed in the 1984 edition of this pamphlet; but were removed in the 1990 version!]

Infant Smegma: Skin cells from the glans of the penis and the inner foreskin are shed throughout life. This is especially true in childhood; natural skin shedding serves to separate the foreskin from the glans. Since this shedding takes place in a relatively closed space - with the foreskin covering the glans - the shed skin cells cannot escape in the usual manner. They escape by working their way to the tip of the foreskin. These escaping discarded skin cells constitute infant smegma, which may appear as white ``pearls'' under the skin.

Adult Smegma: Specialized sebaceous glands - Tyson's Glands - which are located on the glans under the foreskin, are largely inactive in childhood. At puberty, Tyson's Glands produce an oily substance, which, when mixed with shed skin cells, constitute adult smegma. Adult smegma serves a protective, lubricating function for the glans.

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.

Foreskin Retraction: As noted, the foreskin and glans develop as one tissue. Separation will evolve over time. It should not be forced. When will separation occur? Each child is different. Separation may occur before birth; this is rare. It may take a few days, weeks, months, or even years. This is normal. Although many foreskins will retract by age 5, there is no need for concern even after a longer period. [1984 version only: No harm will come in leaving the foreskin alone.] Some boys do not attain full retractability of the foreskin until adolescence.

Hygiene of the Fully Retracted Foreskin: For the first few years, an occasional retraction with cleansing beneath is sufficient.

Penile hygiene will later become a part of a child's total body hygiene, including hair shampooing, cleansing the folds of the ear, and brushing teeth. At puberty, the male should be taught the importance of retracting the foreskin and cleaning beneath during his daily bath.

Summary: Care of the uncircumcised boy is quite easy. ``Leave it alone'' is good advice. External washing and rinsing on a daily basis is all that is required. Do not retract the foreskin in an infant, as it is almost always attached to the glans. Forcing the foreskin back may harm the penis, causing pain, bleeding, and possibly adhesions. The natural separation of the foreskin from the glans may take many years. After puberty, the adult male learns to retract the foreskin and cleanse under it on a daily basis.

Copyright © 1984, 1990. American Academy of Pediatrics
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#5 of 18 Old 04-23-2010, 01:11 AM - Thread Starter
 
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I asked the Dr. to look at him because he pees every 15 min or so, making it hard to potty train. The glans was BRIGHT red, I am inclined to think it is infected- my kids use a lot of bath products so it wouldnt surprise me. But how am I going to get the nyastatin cream on it without pulling back his foreskin?
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#6 of 18 Old 04-23-2010, 01:36 AM
 
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OH mama, he was screaming and crying because at his age the foreskin is still fused to the head of the penis. It was being torn away. My son is almost five and I have NEVER seen the inside of his penis until last week he pulled it back himself a little in the bathtub (surprised himself and me lol!).
The glans of his penis is very red, that is normal, since unlike a circed penis, it not all dried out and calloused.

Please read up on some of the links that have been provided in this thread. Please do not retract your son. Only he should ever be the one to do that. Just leave it alone. Good for you for keeping him intact. Its hard when even Drs don't have correct information and advice. So glad we have this forum to come to! My son is the first and only boy in both my husband's and my family to be intact, so I know how it is trying to learn about a normal penis and how hard it can be to get correct advice.

Roxanne, mama to Alexandra (6), Matthew (5), and my VBAC babe Lauren (2). Expecting late April!
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#7 of 18 Old 04-23-2010, 01:40 AM
 
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Really, bright red is perfectly normal. However, if you are concerned he is using to many harsh soaps and detergents at bath time, just bat him in plain water.

The Dr retracting is a huge problem though. It is very risky and obviously painful to your DS. The guideline to not forcefully retract are quite clear. It can cause infection, scarring or even paraphimosis.

The extremely frequent peeing would make me more concerned with his bloodsugar levels than his foreskin and glans. Frequent urination is a sign of diabetes. It can be a sign of several other less serious things too, such as constipation or UTI, but I've never seen it linked to yeast infection. (If you've had a yeast infection, did it make you pee a lot?)

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#8 of 18 Old 04-23-2010, 06:40 AM
 
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It does not really sound like a yeast infection. With a yeast infection more than only the glans goes red - the "pouch" (or whatever you call what the testicles are kept in!) often goes purple. My son had that when he was about a year old - not because of bath products, but because of disposable nappies (diapers). It was easily gotten rid of without touching the foreskin, which no doctor here would ever try to retract on a small boy. That is completely unnecessary and can cause pain and damage. Any cream that he may need is not supposed to go under the foreskin.

A healthy glans is supposed to be quite red! An extremely red glans sounds more like it may be sore from having been forcibly retracted. It is of course possible that the bath products that you have been using have been irritating to your son's skin, but the glans will have been protected by the foreskin. It is probably a good idea to bathe your son in only water, or use only unperfumed baby oil, or - if he wants bubbles - to find some very mild soap in a health food shop.

You should never retract to clean under the foreskin! That would only cause more irritation.

I'm sorry your son had to go through this painful experience!
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#9 of 18 Old 04-23-2010, 08:15 AM
 
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The normal appearance of the intact glans is a bright purple/red because it is mucosa membrane like the inside of the vagina or mouth.

What the Dr. did is inexcusable and your ds was hurt by it. What the Dr. did was the equivalent of ripping open a girls hymen Please mama dont ever let anyone do that again and please dont consider circ for your perfectly healthy ds.

Even if he did have yeast it wouldnt cause urination every 15mins. For the Dr. to say that and from what he did to your ds he is ignorant of the current intact care guidelines.

By forcing the foreskin back the Dr. probably tore what was left of the attachments because it is pretty rare for a boy to be retractable at his age.

If you still insist on using the cream even though there is no need from your description then just put in on the foreskin itself the tip and around the shaft. Do NOT retract him and never ever let anyone do that to him again. The more this is done the more damage will be done to your ds. Please read the threads linked to earlier and educate yourself so that you can protect your ds from now on.

I pray for the day when posts like this are a thing of the past because Dr's have finally learned proper care of the intact penis and not just how to cut it off. I want so badly to go to every medical school and talk to the new students about this as well as visit every ped./Dr. so that they will stop hurting boys like this. If they where doing it to girls there would be so many law suits and rightly so.

 
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#10 of 18 Old 04-23-2010, 02:47 PM - Thread Starter
 
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I truly appreciate everyones replies but still have some concerns. All today when changing my sons diapers he screams when I just gently wipe his penis and says its hurts, which makes me think I do indeed need to be using the cream. Also I looked at the links several of you provided and it did semm as if a red glans was indeed a sign of a yeast or bacterial infection. I wish I had photos or knew what was normal...I just dont know what to do - if it is infected I dont want to ignore it....
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#11 of 18 Old 04-23-2010, 02:51 PM
 
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You said in your op how the Dr. retracted him and your ds's pain during it. So IMO the reason he is hurting today is because your dr ripped his foreskin loose from the glans It is like having your finger nail ripped into the quick.

I would get some otc bacatracin cream to put on there to help with the pain and keep infection out since he now has an open wound on his glans.

I cannot stress enough that your dr hurt your ds badly by doing what he did. It will take up to a week for your ds to heal from the physical trauma and remember he suffered emotional trauma as well so he may be fearful for a long time of anyone messing about his diaper area.

Keep a close eye out for things getting worse and if it does definitely get the bacatracin to go on there. If you do have to take him back make sure to keep the Dr's hands off your ds's penis.

If he wants to look you hold his penis and show him the outside only. I would also strongly consider filing a complaint against this dr.

Yes a sign of yeast can be redness but your ds didnt have that before the dr yanked his foreskin back like he did. He was just using the bathroom a lot right? Yeast would have shown up on the foreskin itself and redness, flaking skin and pain.

 
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#12 of 18 Old 04-23-2010, 03:16 PM
 
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Originally Posted by tehjo View Post
All today when changing my sons diapers he screams when I just gently wipe his penis and says its hurts, which makes me think I do indeed need to be using the cream.
Your DS is in pain today b/c of what the DR did to him. It is extremely traumatic to be fully retracted like th so prematurely.

It is hard to have pictures of what a normal toddler glans looks like. The first problem is since most toddlers are not retractable, it isn't something you would do to a child just to get a photo. Then once they are retractable (more likely as preschoolers or school age kids) they are going to be embarrassed to retract themselves for a photo (which is something that shouldn't be discouraged.) Of course an adult one is going to look somewhat different.

Just trust from those of us who have seen our now naturally retractable boys retract themselves, it is bright red and that is perfectly normal. Since the Dr forcefully retracted your DS, his may have been a bit more raw looking than is normal, but that is not do to infection but do to the damage of premature forcible retraction.

Just let the area heal. Do try to keep it clean (ironically the forcible retraction does mean he is vulnerable to infection at the moment) but do so very gently wiping from the base towards the tip. I would only wipe away poopy, and not worry about wiping after each wet diaper since urine is sterile anyway. Just change him very frequently.

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#13 of 18 Old 04-23-2010, 06:27 PM - Thread Starter
 
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OK, one more question - how does one go about finding a Dr. that is familiar ( not just friendly) with non- circumcised boys? I would love to have someone I could trust that knew what they were talking about to look at any further concerns. I live in the North Atlanta area.

Thanks so much for the replys.
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#14 of 18 Old 04-23-2010, 07:53 PM
 
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OK, one more question - how does one go about finding a Dr. that is familiar ( not just friendly) with non- circumcised boys? I would love to have someone I could trust that knew what they were talking about to look at any further concerns. I live in the North Atlanta area.

Thanks so much for the replys.
You can post the question in the "Finding Your Tribe" section here on MDC and see if any Atlanta area moms have a recommendation.

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#15 of 18 Old 04-24-2010, 10:10 AM
 
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Just wanted to reiterate that the red coloring is probably very normal considering what happened. It sounds like your son's foreskin was probably still adhered when the dr ripped it from the glans, and if so, would likely be extremely red and raw looking. You can also expect it to be painful for some time while it heals.

If you want to get an idea of what's a "normal" appearance for that situation, you only need to look at pictures of newly circumcised babies penises (not difficult to find at all, unfortunately). They usually look somewhat like raw liver because the tightly adhered tissues have been torn apart.

I would give him frequent baths with just baking soda in the water to help him heal right now. In the future I would completely get rid of the bubble bath and irritating soaps and just use a small amount of mild, organic baby soap (and not on his penis). If you think there's a floral imbalance (cause of yeast infections) you can apply acidopholus directly to the area (without retracting).

You should NEVER allow a doctor or anyone else besides your son himself to retract him.

Single mom to the Crunchy Froglets, Keith and Carlin, twin boys born 1/30/09. Frozen for 10 years, now unleashed on the world.
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#16 of 18 Old 04-24-2010, 10:16 AM
 
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I asked the Dr. to look at him because he pees every 15 min or so, making it hard to potty train. The glans was BRIGHT red, I am inclined to think it is infected- my kids use a lot of bath products so it wouldnt surprise me. But how am I going to get the nyastatin cream on it without pulling back his foreskin?
This is the NORMAL appearance of the intact boy's glans. The pain he is experiencing is b/c your doctor ripped the foreskin off the glans, which is naturally adhered. Please read the link below thoroughly. It is normal for the intact boy to experience some discomfort as the separation process happens too, but NO ONE should ever try to retract your son, including you. Retraction is a sexual function and not necessary. I highly doubt your son has a yeast infection and if he did a culture of the tip would be sufficient to test, no retraction is necessary. You have come across a very foreskin-ignorant doctor. I'm sorry for the unnecessary pain your son experienced.

http://www.drmomma.org/2010/01/basic...act-child.html

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#17 of 18 Old 04-24-2010, 12:47 PM
 
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Frequent peeing can be a sign of seperation trauma of foreskin to start to seperate .

How many days was your son peeing ever 15 minutes ? How are you doing the potty training does he pee a little bit on the toilet then says he needs to go again ?

Are you treating him with a reward like candy for using potty or does he go on the potty then pees in his pullup/diapers ?

If he is requesting to go pee on the potty every 15 minutes especially if a reward is given like a treat like how kids sometimes get M&M's then if that's the only time they get a M&M to eat or some little treat you betcha you will find your kid on the potty tons of time just to gain more than that one treat every hour .

But if that's not the case and he pees on the toilet then 15 minutes in his pants it's a possiblity that he is like not really fully ready for potty training & possibly bored of sitting on the toilet while peeing then making himself stop in the middle of his peeing then as he walks around he's not focused or seemed to be made to pee that he just pees without thinking because he's a bit more relax.

Also, take a break from that potty training because for that doctor to pull back your son's foreskin to expose his full glans that would majorly hurt and your doctor could have risked causing your son to have doctor caused paraphimosis .

Your doctor proably assumed with your son reaction of screaming while retracting the penis that he had some penis problem and I bet your son's doctor never did any culture because next time you want a culture for bacterial or yeast you hold your son in your lap you hold his penis & request for the swabbing at the tip of the foreskin if there is any yeast or bacteria it will be found at the tip without the need of retracting at all.
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#18 of 18 Old 04-27-2010, 10:09 PM
 
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I asked the Dr. to look at him because he pees every 15 min or so, making it hard to potty train. The glans was BRIGHT red, I am inclined to think it is infected- my kids use a lot of bath products so it wouldnt surprise me. But how am I going to get the nyastatin cream on it without pulling back his foreskin?
They are right, the glans are suppose to be bright red, that is normal. I agree that he was screaming because of what the dr did to him. My DS will pee every 15 minutes if he drinks a lot or the sun shines right that day as well. I wouldn't even put the nyastatin on it if it were me. I would leave it alone and never let the dr touch his penis again.

Hugs, it is hard to go through! Welcome to Mothering, it is a very informative crowd here that know there stuff!

~Katie~ married to J, mom to DD- A 13 yrs ,DS- L 7yrs , and my little nursling DD2- R 5yrs.

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