I wonder if we can get into a discussion involving penises without it turning into a debate? I'm sure hoping so, because what I want to talk about ISN'T about your stance on circumcision -- it's what you do after you've made your choice to circumcise or not to circumcise.
So, what is this post about?
Who just winced? Penis penis penis. Sorry, I won't say "winkie" or any other nickname, so now's the time to get used to it. While we're at it, there's some more anatomy you should know, whether you're caring for the circumcised penis or the uncircumcised/intact one.
Glans: This is known as the head of the penis.
Foreskin: This is the skin that covers the glans, that you have partially or entirely removed for a circumcision.
Okay, got it? I hope you already knew those, but now you do, just in case.
If you choose not to have your son circumcised, there is specific care you need to know:
Leave the foreskin alone. Seriously, I cannot stress that enough.
While you may be told to pull back the foreskin to clean the glans under it, don't do it. It detaches all on its own as the child ages, usually around puberty, but it may be into adulthood -- unless there is a medical concern, this is never a problem (and can be treated easily with steroid creams or even manual stretching).
Aside from the major pain factor, forced retraction can actually cause adhesions, infections, and pain during urination. If the scar tissue that forms is bad enough, it could cause problems during erections as a teen or adult, and it puts the baby at risk for two conditions: phimosis (where the foreskin cannot retract fully off of the glans) and paraphimosis (where the foreskin is stuck behind the edge of the glans and cannot go back over into place).
This is something you need to tell every single person who could possibly be changing your son's diaper -- his doctor, grandma, nanny, anyone. And if a medical professional does it, you should report them.
So, what should you do to care for the uncircumcised penis? Not much.
Simply wash the outside as you'd wash the rest of the body, and don't make any effort to try to "get in there" as "in there" is designed to keep things out. Any white stuff coming out the tip is called smegma, and as long as it's white and doesn't smell bad, it's of no concern -- think of it like earwax. Just wipe it off with a wipe or washcloth.
When to call a doctor:
Call your doctor if you notice redness, swelling, if baby cries when he pees, if he doesn't pee, or if there are foul odors coming from the penis. If your doctor recommends circumcision, look into other options first, as there's likely a non-surgical fix.
Regardless of method of circumcision, your job is to just keep him clean and dry. Gentle water-washing (no soap!), poured from a cup, and then patted dry or even damp with a washcloth is enough. Don't try to rub off any scabbing or clear "crusties" -- you'll just cause pain, make it take longer to heal, and even cause scarring. Clear crusted fluid is lymph or sirus fluid. It helps the site while it heals.
Cloth diapers are much softer and more gentle, but if you don't use cloth (or don't want to gunk it up), laying a strip of scrap fleece down across the diaper can help prevent any friction. Put Vaseline on the glans or the diaper, doesn't matter, but be generous -- you don't want the sirus fluid, any scabbing or raw tissue to stick. It will hurt and can cause problems. In rare cases, not enough Vaseline during this initial healing period can result in adhesions -- where some skin from the shaft of the penis tries to heal (or "stick") to the glans. So, this is a really important step.
If he had the Plasti-bell method of circumcision, keep your hands off. It will fall off on its own. Much like the umbilical cord stump, the best care is just to keep it clean, dry, and leave it alone. Certainly don't try to make it come off, even if it's hanging loose.
Once it's healed, there is no special care, other than just general hygiene -- soap and water.
When to call the doctor:
If you see skin trying to stick to the glans, redness, bleeding, swelling, dark yellow/green/cloudy fluids, any foul odor, or baby cries when he pees, or doesn't pee at all, or if baby starts running a fever.
(Necessary disclaimer: I am absolutely, 100% not a doctor and this is in no way intended as a replacement for real education and instruction from an actual medical professional. This is intended as a general guide, but it is your job to speak with your doctor, and follow their advice.)
Image via gbryson2/Flickr