The rate of intact boys in America is rising, with about half of newborn boys not being circumcised now. As parents who have chosen to keep their son intact (uncircumcised), or as a care provider that changes diapers, it’s important to understand how to change uncircumcised boys’ diapers.
Sadly, some parents choose to circumcise just because they think that caring for an intact boy is complicated and prone to infection – it’s not at all!
There are a number of myths surrounding care for an intact boy, and some of them are harmful for the infant, the correct way to care for him is very simple. I’ll answer some FAQ below.
You can get this information in a free printable to remind care providers by clicking the button below. Feel free to distribute this printable in parent education classes, and anywhere else you feel it could be useful.
Click Here to get your free printable
So, how do I change that diaper?
When changing a diaper of a boy who hasn’t been circumcised, all you need to do is wipe off the penis with a wipe, just like you would wipe off a finger if it had poop on it. Only clean what you can see, gently. Do not pull anything back.
But I thought I needed to retract (pull back) the foreskin?
There is no need to retract my son’s foreskin to clean, the foreskin is adhered to the glans just like a fingernail is stuck to the finger and has never been forcibly retracted, so there is no risk of infection. You may have heard outdated information, years ago doctors used to forcibly retract the foreskin (and sometimes this still happens), and to prevent re-adhesion and infection from feces getting up in the foreskin, it had to be retracted and cleaned underneath at each diaper change. Now that we know to just leave it naturally attached, there is no danger of poop getting in there and causing infection.
The forcible retraction is also why some people have heard of uncircumcised boys getting infections often, it is much more difficult to keep clean when the foreskin is prematurely retracted and ripped from the glans – it will try to re-adhere (this is also the case for circumcised boys, the foreskin that is left can try to re-adhere) and is painful and prone to infection.
Will the foreskin always stay attached to the glans?
No, sometime around the time the boy is 4-6 (or even later, around the time of puberty), the adhesion will become loose.
This doesn’t sound clean
At the time that the foreskin starts to loosen from the glans, the boy’s parents will teach him how to rinse the glans to clean in the shower, just as parents of girls teach their girls how to clean their pubic area in the shower.
Any feces that gets into the tip (It can’t go far while the foreskin is still attached) will easily be cleaned out with urine the next time the baby pees.
About talking with care providers
You’ll always want to have a conversation with new care providers to make sure they aren’t going to forcibly retract your son’s foreskin. Some people are shy or won’t read the printable because they already think they know what to do. You don’t want them to accidentally harm your son because they had heard the wrong information.
This is what my conversation with new babysitters sounds like,
“Here are the diapers and wipes, have you changed a baby who wasn’t circumcised before?”
Often they say ‘no’
“It’s simple – you may have heard that you need to retract the foreskin, but that’s outdated information. You just wipe the penis off with a wipe the same way you would wipe off a finger. The foreskin is attached to the glans like a fingernail and is self cleaning, so we don’t want to pull it back at all. See – easy, right?”
If they say yes, I still say the same thing to make sure everyone’s on the same page.
When we get the correct information out about how to care for intact baby boys, more people will feel comfortable with the idea of leaving their baby intact. It’s time to squash the myths surrounding caring for an uncircumcised boy.
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Thank you for this post! There is so much fear and bad information floating around America regarding this subject yet in Europe boys are only circumcised for religious reasons (under 30%) and there are not penis infection epidemics. Parenents here almost fear NOT circumcising, and thus we have one of the highest circumcisions rates but it is not nessisary, it is elective surgery that requires more care than if you left it alone. When a boy gets older you teach him how to clean the same way you teach girls how to clean themselves, boys are no less hygienic than girls.
You’re welcome. We make things too complicated in America- and cause problems because of it!
30% is a pretty high number, it’s more like 10%. Even in the U.S. it’s now 50% of newborn males and 75% of men.
I am in Australia and circumcision has declined significantly here, as opposed to 1960’s and 70’s. I was told by my physican when I asked how to clean my son (who is intact) to treat it like an elbow…….do nothing to it. He’s 9 now and hasn’t had any concerns so far!! I have mentioned to him to give it a bit of a once over with the shower but no retracting of the skin is going on yet – we’ll deal with that at puberty by the looks of things.
Yeah, my sons have never had any problems either.
25 years ago I didn’t want my sons circumcised. Soon before their birth I talked to the doctor, friends, etc. I decided to get them circumcised when I talked with 2 adult men who were circumcised as adults due to infection. Infection doesn’t scare me quite so much anymore now that we eat well and use herbs, but could this type of infection be taken care of naturally? 1 of these men was in the military where there were unsanitary conditions when his infection happened. This scared me enough to have them circumcised, especially when they had to use stitches when having it done as an adult.
I tend to compare it to female circumcision – some women get infections because they don’t clean well enough, but nobody recommends female circumcision of adults that this happens to. It’s my understanding that when a boy hasn’t been forcably retracted, there is no scar tissue, and he’s not prone to infection.
Infections in intact boys and even men are almost always caused by forced retraction in infancy, leading to potentially lifelong complications. There is very little chance of an intact boy getting an infection, if left alone. The best medicine is prevention! :) If an infection does occur, the same treatment that is used for girls can be used for boys, which is often antibiotics. No amputation necessary. ;)
A survey of Finland’s male population (high intact rate) showed that 1 in 16,000 men needed circumcision for medical reasons. Compare this to the rate of 1 in 11,000 newborns who die as a result of their circumcision. A baby has a higher chance of dying from his circumcision than needing it later in life. (FYI… American doctors will assign circumcision surgery even when it’s not medically necessary. They are simply not taught how to handle foreskin, plus it’s a lucrative business opportunity.)
-Genital Integrity Educator
Excellent information, I will pass it on.
Thanks so much for posting this! I already know this from raising two intact boys, but the more people hear it, the more it sinks in. Our experience has been so frustrating – at my son’s last doctor visit I had to practically jump between him and the doctor to stop his foreskin from being retracted. The doctor proceeded to lecture me about how “necessary” it is for the foreskin to be retracted regularly for “hygiene” reasons and to forcibly break the adhesions – or else my son would have to be circumcised later. I’ve been hearing this for 12 years now but in those 12 years we have had not one infection. We HAVE had multiple doctors try to talk us into circumcising for various reasons. It amazes me how much ignorance there still is on this subject.
I’m so glad you commented that. I was fortunate to find a family practice doctor that understands how to care for intact boys, so I haven’t had a problem with that at all.
For everyone else looking, I recommend asking who your local birth center recommends for a pediatrician or family practice doctor. I didn’t use the birth center, but I knew that they’d know who the educated doctors were in the area.
17 yrs ago our new family physician was a so sneaky! I got distracted talking to my 7 mo who was fussing. I looked away from his penis for a sec and he retracted it. I was horrified and shaking. Baby cried, no blood. He had a minor infection I think as a preteen and tea tree oil quickly cleared it up. The doc told me I should do it every day and I told him that the AAP recommends leaving it alone. I think they may have had a pamphlet you could give your doc (not sure). I don’t remember what the dr. said but he must have remembered because he never tried it again. My step-mom tried to scare me with stories of uncirc’d men. It didn’t work. All 6 of our boys are intact and I’m so glad to hear circ. is less common now. Great post!
Hello all! My 9 yr old is intact and still cannot retract but it seems due to a small opening? His penis balloons when urinating. It doesn’t bother him but I’m slightly concerned and of course we’ve heard the you need to get him circumcised line from the pedi. Is this normal still at age 9 1/2 to balloon up? My 2yr old balloons as well but I thought that was a pretty normal thing while their little and cannot retract?
I’ve read that it’s perfectly fine if they don’t retract fully until puberty (18ish)
While I agree with the vast majority of what’s in this post I have to say the idea that without forcible retraction there’s no risk of infection is untrue. My son’s foreskin had never been retracted but shortly before he turned 2 he did get an infection. It was easily cleared by a round of antibiotics and in the three years since has not reoccurred.
The risk may be low and I don’t regret for a moment the decision to keep our sons intact, but I just want to say it is not zero.
Right, they’re just not as prone to infections as if they’ve been forcibly retracted.
if I already retracted on my baby bc that’s what I was told to do, should I continue doing this or is it too late to stop retracting ? Btw, on one of the retractions I did find like a whitish stuff that I easily wiped off.