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The Daycare Risk for Intact, Uncircumcised Babies and Boys: Forcible Foreskin Retraction

You may start the search for childcare by Googling “daycare near me,” then check Yelp reviews, visit the facility, consider the cost, and ask for and speak to references. But if you are the parent of an intact (uncircumcised) baby or toddler, you need to take extra steps to safeguard your child. You must determine whether or not daycare staff know how to clean an intact penis. Otherwise, your child’s foreskin could be damaged when his diaper is changed.

No one—not parents, not caregivers, not doctors and nurses, should ever forcibly retract an intact child’s foreskin, which causes excruciating pain and bleeding. Unfortunately, too many daycare workers—as well as doctors and nurses—know little about intact penises or how to care for them. They mistakenly believe that the foreskin is retractable when the baby is born (it is not!), that parents need to begin partial retraction by the time a boy is two years old (absolutely not!), and that a boy’s penis cannot be considered clean unless you get under the foreskin (no! no! no!).

Parents—you must stay vigilant!

What is forcible foreskin retraction?

When a male child is born, his foreskin is fused to the glans (head of the penis) by a membrane, not unlike the membrane that attaches the fingernail to a nailbed. Over time, hormonal changes help the membrane dissolve, so the foreskin loosens and naturally separates from the glans.

Forcible foreskin retraction (FFR) refers to any attempt to retract the foreskin before it naturally occurs. While the foreskin remains firmly attached to the glans, the foreskin cannot be retracted without painfully ripping it off the glans. FFR traumatizes the baby or the child; causes significant bleeding; can create tiny tears in the foreskin, scarring on the genitals, phimosis, and lead to infection.

What happens if you force the foreskin to retract?

On HealthChildren.org, the American Academy of Pediatrics warns parents and medical professionals that “foreskin retraction should never be forced. Until the foreskin fully separates, it shouldn’t be pulled back. Forcing the foreskin to retract before it is ready can cause severe pain, bleeding and tears in the skin.”

FFR complications also include adhesions, scarring, swelling, and phimosis.

Note to parents living in Georgia: If your child’s foreskin was forcibly retracted by a doctor, nurse, or other medical professional, Intact America will help you file a complaint against that person and the institution in which it occurred. This service is free and available at DoNoHarm.report

How does forcible foreskin retraction affect a child?

FFR can traumatize a child, as J.M., a mother of a two-year-old intact son, can attest. She said she picked up her child from daycare and when she changed his diaper, “I saw that his foreskin was completely retractable. The head looked bald and raw, the way the skin looks when you pull a hangnail too far back. It was really red at the head.” She continued, “He seemed a little dazed and out of it, and he fussed and cried when I tried to clean him. He didn’t want me to touch it at all, and he didn’t want to get into the tub.”

How common is forcible foreskin retraction in daycare centers?

No one tracks the incidence of forcible foreskin retraction in daycare or childcare settings. But individual stories, posted in parent forums, indicate that it is widespread.

“I’ve done so much research trying to do right by my kid,” wrote one mom, who was told by daycare staff that they thought her baby had an infection on his penis. Mom wrote that she took her son to the pediatrician, who found a smegmal cyst, which does not cause any symptoms or problems, and does not require any treatment. The doctor tested for a urinary tract infection (without retracting the foreskin—a very knowledgeable doctor!) and gave the baby an antibiotic just in case.

“We took [the baby] to daycare with foreskin still intact today,” continued the mother. “When I picked him up, one of the providers said I needed to pull it all the way back and clean it. She had already forcibly retracted his foreskin, causing it to bleed…I don’t know why, especially given that I told her what the doctor said and that the doctor didn’t retract the foreskin, that she would think was needed or ok.”

Another mother wrote: “I work at a daycare and I am the only one who works there who has an intact son….we have a new girl who started a few days ago…she was doing her first diaper change, and I was standing there and she looked up with this shocked look and said ‘He’s not circumcised!’ and put her hand on his foreskin like she was going to retract it…she said to the little boy, ‘I have to clean under.’ I jumped in and said ‘NO! You don’t retract it. Just wipe the outside like you would a circumcised penis. My son isn’t circumcised either, and the pediatricians state that the only cleaning necessary is to have the child take regular baths, which all children should.’ She said ‘oh’ and just changed his diaper and hasn’t tried to retract anyone else!”

The mother added, “What if I hadn’t been there!?!….I think I’m going to suggest to our director that all of our new employees be given a handout on proper care of the intact pendis.”

What to do if your son’s foreskin has been forcibly retracted?

Fortunately, in most cases of FFR, the soreness and swelling are likely to resolve on their own. Bathing your son in plain warm water (no soap or bubble baths) is the best recourse for healing. However, watch out for anything that might be amiss. If the swelling and soreness do not improve, or if there is pus or a smelly discharge, seek medical help, as there may be an infection.

How to protect your intact son in daycare

  • Always assume that staff members do not know that the foreskin should not be retracted.
  • Speak to the daycare’s administrator and every person who might change your son’s diaper.
  • Give them written instructions on how to clean an intact penis.
  • Remind caregivers not to retract by writing “do not retract my son’s foreskin” on his diapers and wipes.

How do you clean an uncircumcised penis without retracting the foreskin?

There’s a saying that people who are foreskin-friendly like to use: “only clean what can be seen.” The foreskin is attached to the glans at birth for a reason. The foreskin protects the baby from urine and feces in the diaper. There is no need to try to clean underneath it. During bathtime, you just wash an intact penis with warm water. When you change a diaper, use the baby wipe to clean the penis. There’s no reason to manipulate the foreskin and try to get under it.

What should daycare workers know about intact penises?

Unfortunately, daycare training doesn’t typically include care of the intact penis. Daycare and childcare workers must learn:

  1. The foreskin is solidly attached to the glans at birth to protect the penis from urine and feces. (That’s one reason circumcision is so horrible for and painful to infants. The foreskin has to be pried off the glans before it is cut.)
  2. The foreskin will gradually detach from the glans at its own pace and the boy will play with it and help it along.
  3. The foreskin will become retractable when it’s ready. Sometimes, a five-year-old will be able to retract his foreskin; sometimes boys have to wait until they are teenagers before their foreskins fully retract. The average age of retraction is 10.4 years but it is not uncommon for retraction to occur well into puberty

Never doubt that you did the right thing in keeping your son intact, and never hesitate to teach someone the proper care for an intact penis. Remember, if your child’s foreskin was forcibly retracted by medical professional and if you live in the State of Georgia, file an official complaint at DoNoHarm.report, Intact America’s free and simple complaint reporting platform. Please help Intact America roll out the platform to every state in the country. Donate here.

 

 

Author

  • Jeannie Ashford is a writer, editor, public relations professional, and communications specialist who has supported Intact America for more than a decade. She received a BA in English Honors at Queens College, City University of New York, and an MS in Journalism from Columbia University.

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Marilyn

Marilyn Fayre Milos, multiple award winner for her humanitarian work to end routine infant circumcision in the United States and advocating for the rights of infants and children to genital autonomy, has written a warm and compelling memoir of her path to becoming “the founding mother of the intactivist movement.” Needing to support her family as a single mother in the early sixties, Milos taught banjo—having learned to play from Jerry Garcia (later of The Grateful Dead)—and worked as an assistant to comedian and social critic Lenny Bruce, typing out the content of his shows and transcribing court proceedings of his trials for obscenity. After Lenny’s death, she found her voice as an activist as part of the counterculture revolution, living in Haight Ashbury in San Francisco during the 1967 Summer of Love, and honed her organizational skills by creating an alternative education open classroom (still operating) in Marin County. 

After witnessing the pain and trauma of the circumcision of a newborn baby boy when she was a nursing student at Marin College, Milos learned everything she could about why infants were subjected to such brutal surgery. The more she read and discovered, the more convinced she became that circumcision had no medical benefits. As a nurse on the obstetrical unit at Marin General Hospital, she committed to making sure parents understood what circumcision entailed before signing a consent form. Considered an agitator and forced to resign in 1985, she co-founded NOCIRC (National Organization of Circumcision Information Resource Centers) and began organizing international symposia on circumcision, genital autonomy, and human rights. Milos edited and published the proceedings from the above-mentioned symposia and has written numerous articles in her quest to end circumcision and protect children’s bodily integrity. She currently serves on the board of directors of Intact America.

Georganne

Georganne Chapin is a healthcare expert, attorney, social justice advocate, and founding executive director of Intact America, the nation’s most influential organization opposing the U.S. medical industry’s penchant for surgically altering the genitals of male children (“circumcision”). Under her leadership, Intact America has definitively documented tactics used by U.S. doctors and healthcare facilities to pathologize the male foreskin, pressure parents into circumcising their sons, and forcibly retract the foreskins of intact boys, creating potentially lifelong, iatrogenic harm. 

Chapin holds a BA in Anthropology from Barnard College, and a Master’s degree in Sociomedical Sciences from Columbia University. For 25 years, she served as president and chief executive officer of Hudson Health Plan, a nonprofit Medicaid insurer in New York’s Hudson Valley. Mid-career, she enrolled in an evening law program, where she explored the legal and ethical issues underlying routine male circumcision, a subject that had interested her since witnessing the aftermath of the surgery conducted on her younger brother. She received her Juris Doctor degree from Pace University School of Law in 2003, and was subsequently admitted to the New York Bar. As an adjunct professor, she taught Bioethics and Medicaid and Disability Law at Pace, and Bioethics in Dominican College’s doctoral program for advanced practice nurses.

In 2004, Chapin founded the nonprofit Hudson Center for Health Equity and Quality, a company that designs software and provides consulting services designed to reduce administrative complexities, streamline and integrate data collection and reporting, and enhance access to care for those in need. In 2008, she co-founded Intact America.

Chapin has published many articles and op-ed essays, and has been interviewed on local, national and international television, radio and podcasts about ways the U.S. healthcare system prioritizes profits over people’s basic needs. She cites routine (nontherapeutic) infant circumcision as a prime example of a practice that wastes money and harms boys and the men they will become. This Penis Business: A Memoir is her first book.