As a new parent, it can be quite overwhelming when it comes to knowing how to care for your child's genitalia. Our Paediatrician Dr Lexi Frydenberg explains how to care for your baby's genital area and common conditions and considerations, in this easy-to-follow article.
Caring for baby boy's genitals
The foreskin is the loose skin covering the head (glans) of the penis. The good news is the foreskin needs no special attention in infancy and should be left alone. In most newborns, the foreskin can't be retracted (pulled back from the head of the penis) and will separate naturally by itself over time. The Foreskin is retractable in some 1-year-olds and is retractable in most boys by age 4. For some boys, the separation only happens in puberty and this is totally normal.
Remember – You don’t need to pull back the foreskin to wash or clean it or the glans, you can just clean the outside of the foreskin and penis with warm water.
NEVER forcibly pull the foreskin back to clean under it as this can cause pain and scarring.
Baby girl's genital care
The vulva is the outer part of the female genitals. It is important to treat the skin in the vulval area gently. Don’t over-wash the area or overuse baby wipes. Wash the vulva gently with warm water or use a baby wash instead of soap. Try to wipe from front to back to remove traces of poo, and pat dry.
Redness or inflammation in the genital area
Redness and irritation of the genital area is really common in both boys and girls.
If this happens, try leaving your baby without a nappy for short periods. It is also important to change wet or dirty nappies promptly to help prevent the wetness from irritating the skin. Soaking in a warm bath helps soothe red or sore skin and it's important to dry thoroughly afterwards. You can then use a barrier cream or nappy rash cream. A zinc-based cream is often recommended.
Common issues to look out for in baby genital care
Baby Penis Care
SMEGMA - Sometimes, while separation occurs, small collections of white/yellow lumps can accumulate under the foreskin, which is called smegma. This is very common and completely normal. It is due to collections of dead skin and oils and you do not need to worry or do anything about it.
MINOR REDNESS - You may notice that the tip of the penis is red. This is common If your baby is still in nappies and is due to irritation from wet nappies or soap. It can also happen if you try pulling the foreskin back to clean the penis (which you don’t need to do). If redness occurs, try a barrier cream, change wet nappies more often and see your GP if it is getting worse or if you are concerned.
BALANITIS - This occurs when there is more extensive inflammation of the glans of the penis and foreskin. You might notice a red and swollen penis. This can be due to infection and your baby might be irritable, particularly when passing urine. This is only a problem if it’s a problem for your child. If there is pus or discharge from the penis, it is important to see your GP. Treatment usually includes warm salt baths and topical creams or ointment. If your child is uncomfortable, they may need oral pain relief. (Topical antibiotics do not work).
PHIMOSIS - This occurs when there is ballooning of the foreskin when your son passes urine. It happens when the tip of the foreskin is very narrow and can’t retract over the head of the penis. It doesn’t occur often but if you do notice ballooning, see your doctor and they may prescribe a gentle steroid cream. In severe cases, circumcision may be needed but this is very uncommon.
If your baby's foreskin is retracted and gets stuck, you will need to seek urgent medical attention at an Emergency Department.
Baby Testes Care
UNDESCENDED TESTES (UT) - The testes are usually situated in the scrotum but sometimes one or both testes do not move down from the abdomen into the scrotum when they develop. About 5% of boys are born with undescended testes and usually, the cause is unknown. UT will not cause your baby problems with passing urine and will not cause any pain unless the cord attached to the testis becomes twisted which is rare. An operation is needed if the testes don’t come down into the scrotum by themselves by 6 months of age. This is done to reduce the risk of ongoing health issues.
RETRACTILE TESTES - From about 6 months of age, male babies develop a reflex that temporarily pulls the testicles up to protect them if your baby is cold or frightened. If your baby’s testicles are in the scrotum at some times but not others, this is called retractile testes and is different from undescended testes. This is very common and it is very uncommon for your boy to need any treatment or surgery for this.
Baby vulva and vagina care
BLOODY VAGINAL DISCHARGE - in the first few weeks of life, your baby girl may have bloody vaginal discharge. This is due to a response to mum’s hormones and will disappear on its own.
RED/SORE/ITCHY VAGINA (Vulvovaginitis) - In young girls before puberty, the skin around the vulva is thin and easily irritated. This can cause pain, redness, itch and even vaginal discharge. This is very common and is NOT due to thrush. Simple management includes keeping the skin dry and allow to breathe, vinegar baths to change the acid-base (PH) balance in the area, cold creams to relieve discomfort and treating possible worms. See this link for more details. Kids Health Information: Vulvovaginitis (rch.org.au)
VULVAL PAIN – If your child wakes up in pain in their vulva/vaginal area overnight, think and treat the whole family for worms
LABIAL ADHESIONS - This is when the 2 flaps of skin on either side of the opening of the vagina are joined together. It is common and will usually separate by itself before your daughter hits puberty. There is no need to worry and treatment is usually not recommended. If your baby is having trouble passing urine, then see your Dr and they recommend some simple treatments such as gentle massage, oestrogen cream or physical separation.
Why do boys play with their penis?
Most young boys frequently touch or play with their penis and this is a completely normal part of the development and how they learn about their body
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BOYS
GIRLS
This article is written by Parents You've Got This Paediatrician Dr Lexi Frydenberg. For more information on how to elevate your parenting skills with valuable insights and knowledge, explore our range of informative masterclasses held by leading health and medical experts.
Disclaimer: The information in this article is provided for educational purposes only and is not intended to substitute advice provided by your doctor or other healthcare professionals. The author of this information has made a considerable effort to ensure the information is in-line with current guidelines, codes and accepted clinical evidence at time of writing, is up-to-date at time of publication and relevant to Australian readers. The opinions and thoughts expressed in this article reflects the view of the author only and not the broader medical profession or her places of work. The author accepts no responsibility for any inaccuracies, information perceived as misleading, or the success of any treatment regimen detailed in this information. We recommend you always consult a qualified health practitioner for individualised advice.
