Congratulations! You gave birth to a baby boy, you protected him from circumcision, and you took him home whole, happy and peaceful!

So – we’re good! That should be the end of it, right?

Unfortunately, too often that’s NOT the end of it. Most North American health care professionals are woefully uninformed about the anatomy, functions, development, and care of the normal penis. And, also unfortunately, many of them are ready, willing – and even insistent – on trying to turn your boy’s healthy, normal foreskin into a problem.

Every few days, either via Facebook or email, Intact America hears from a parent who’s taken their baby to the doctor for a well-child visit, and encountered unexpected trouble.

Before I knew it, she grabbed my son’s penis and forced his foreskin back. It’s swollen and raw, and he’s been crying for hours. What do I do?

My son’s pediatrician has diagnosed our 2.5 year old with Phimosis and performed a retraction. I feel very uneasy about this…

We also hear from parents who have taken their baby to the Emergency Room with a fever and have faced a doctor or nurse who zeroed in on his foreskin as the culprit – insisting that it needs to be retracted to insert a catheter for a urine sample.

My son was at the ER and they wanted to cath him. [They told my wife] they couldn’t do a clean catch because he had foreskin and his foreskin cells would interfere and eventually threatened to call CPS [Child Protective Services] because she refused to forcibly retract him.

What you need to know:

  • A baby’s foreskin should NEVER be forcibly retracted! “Phimosis” (a tight or adherent foreskin) is normal in babies and boys, and the foreskin will loosen and separate naturally from the head of his penis over time. The average age of spontaneous foreskin retraction is actually around 10 years of age, which means that many boys’ foreskins separate sooner, and many separate later. Forcibly pulling back a boy’s foreskin is painful, and can cause swelling, bleeding and infection. Nobody but the boy himself should handle his foreskin.
  • “Catheterization is an intervention that carries risks…, [including] discomfort and introduction of bacteria into the urinary tract, which could actually lead to infection…,” as pointed out in this recent article by experts Adrienne Carmack, MD and Marilyn Milos,RN.
  • Absent other symptoms (smelly, bloody or cloudy urine; pain while urinating), suspecting a urinary tract infection (UTI) simply because a boy is intact and has a fever makes no sense. And even if the child has symptoms of a UTI, various methods exist to obtain a clean urine sample without inserting a catheter.
  • Finally, if catheterization is truly called for, it is NOT necessary to retract a boy’s attached foreskin to accomplish the insertion. (Again, see this article by Carmack and Milos detailing gentle methods for inserting a catheter without retracting the foreskin.)

You have the right as your child’s parent to refuse to allow a doctor, nurse or – of course – anybody else to forcibly retract your intact son’s foreskin. If you believe that your child is at risk of forcible retraction, state calmly and clearly that you do NOT give the clinician permission to handle your son’s penis and foreskin. Make a point of telling your pediatrician this up-front, and providing this information in his medical chart. If you do have to take your intact boy to an emergency room, let the provider(s) know that foreskin retraction is off-limits.

If your son’s foreskin has been forcibly retracted by a health care professional, here is what you can do.

For your baby: If his penis is swollen and sore, it is likely this will resolve on its own. Watchful waiting, and bathing him in plain warm water (no soap or bubble baths), are your best recourse for healing. If it does not improve, or if you see pus or smelly discharge, seek medical help – preferably from a foreskin-knowledgeable physician. At a minimum, let the new doctor know that you will not tolerate further tampering with his intact foreskin.

Official actions: You are entitled (and we encourage you) to complain in writing to the doctor who performed the retraction and the facility where this took place. At a minimum, you should provide them with factual information, such as the article by Carmack and Milos and this information sheet. You can also file a complaint with your state’s medical board or office of professional discipline.