Infant penis is not necessarily a term that a new mom wants to search on the Web -- or that she'd want another person finding in her search history. But our knowledge about "down there" is often as fuzzy as an ultrasound screen image, and once we're in the daily routine of changing diapers, having a clear view doesn't always equal having a clear understanding of what's going on.
Discussing your baby's privates with your pediatrician can be uncomfortable, but try not to be shy. "It's much better to ask a question that might be perceived as embarrassing than not to ask and find out that it is actually an important question," advises pediatrician Peter J. Everett, M.D., of Rockville, Maryland. Doctors have heard it all. Read on for their answers to the most awkward -- and common -- questions about boys and girls.
Is my infant having an erection?
Most likely, yes. This physiologic response is involuntary and sometimes even visible on prenatal sonograms, which makes it a little easier to determine sex. "Before puberty, erections aren't caused by sexual feelings," says Molly O'Shea, M.D., a pediatrician in Birmingham, Michigan. "Erections are normal and indicate that a baby boy's equipment is working just fine." As with adult males, the stiffening is caused by penile tissue filling with blood. Many things can stimulate he blood flow, including a diaper change or washing. Erections can also indicate that your baby has a full bladder, so make sure you have a diaper nearby to avoid an unexpected dousing. Speaking of which...
Why does my baby always seem to pee as soon as I start to change his diaper?
This phenomenon happens with both boys and girls, but the trajectory just isn't as visible with girls. Babies don't fully empty their bladder, so it's actually normal for them to urinate mid-change when cool air stimulates the genitals. Also, "it could be chance," explains Dr. Everett. "Babies urinate up to 20 or more times per day."
Is it normal for my baby to touch herself?
Absolutely. Just as babies begin to discover their ears and feet, so do they grab and explore their genitals. "Think about it: Most of the time genitalia are tucked away inside a diaper, so it's a whole new experience for them to be able to actually reach down and feel what's there," explains Jessica Kaplan, M.D., a pediatrician in San Francisco. And babies will do it again and again simply because it feels good.
What is the best way to clean under the foreskin of a penis that's uncircumcised?
Actually, until the foreskin easily pulls back over the head of the penis -- which typically doesn't occur until age 5 or later -- cleaning underneath isn't necessary. Forcing it back earlier could cause paraphimosis, a painful condition in which the retracted foreskin impairs blood flow to the head of the penis. Call your doctor if you notice unusual redness at the tip, though: Sometimes the white discharge called smegma can accumulate under the foreskin and lead to infection.
What should I do when poop gets in my baby's vagina?
This is one of those things that seems like a bigger deal than it really is. The tissue lining the vagina helps keep it clean, so even the messiest diaper shouldn't be much cause for concern. Cleansing with a wipe ought to do the trick -- just remember to always go from front to back to prevent a urinary-tract infection. If necessary, put your baby in a warm bath to remove anything sticky. Never insert a cotton swab or a tissue inside the vagina because this could push in the fecal matter further or cause injury.
My son has an undescended testicle. How long will this last and is there any way it can be fixed?
Nearly 3 percent of all full-term boys are born with cryptorchidism, a condition in which one or both of the testes are not in the scrotal sac. (For preemies the number spikes to 30 percent.) Most cases resolve themselves within a year, but if the testes haven't descended by 6 months, discuss it with your pediatrician. Your son's testicles may simply be retractile, which means a reflex occasionally causes them to move from the scrotum up into the groin. To check, sit him in a warm bath, which should naturally drop the testes. Otherwise, your doctor may suggest an outpatient procedure after he turns 1 year old called orchiopexy, in which testicles are brought down and sewn into place. It's an important issue to resolve: Testes that remain undescended have an increased chance of developing cancer, according to the Centers for Disease Control and Prevention.
Can my baby have a yeast infection?
Yes. Yeast thrive in a warm, dark, humid environment, which makes dirty diapers a haven. If your baby has a rash anywhere on his bottom or genitals that doesn't go away after a couple of days and is deep red and slightly raised, it may be a yeast infection. Have it seen by your pediatrician, who can recommend an over-the-counter antifungal medication. Both girls and boys get yeast infections, which can also show up elsewhere on the body, especially in between skin folds in places like the neck. A yeast infection in your baby's mouth, called thrush, can spread to his diaper area through the digestive tract. Ingesting antibiotics directly or through breast milk may also encourage the growth of yeast. Air-dry your baby's bottom as much as possible and change wet diapers frequently. Probiotics, available in powder form or in some yogurt, can help prevent future infections by regulating the helpful bacteria that keep yeast in check. Discuss this with your pediatrician.
My daughter's labia are stuck together. What happened and what should I do?
Labial adhesion, in which a portion of the vagina's inner lips, or labia minora, fuse together, is not uncommon, affecting roughly 2 percent of all girls. A baby is particularly vulnerable to this around 3 months, when the estrogen she received in utero drops, resulting in a decreased amount of vaginal secretions, which help keep the skin from sticking. Hygiene plays a part too: When the delicate skin becomes raw from diaper rash, for example, the labia sometimes heal by merging, much the way a cut does. How can you tell? "Instead of seeing open labia, and two holes on the inside for the urethra and the vaginal opening, you'll see a line of tissue where the labia are stuck and a very small area where they aren't," says Parents advisor Ari Brown, M.D., pediatrician and author of Baby 411. "Labial adhesions do not usually need to be treated. The area eventually becomes unstuck once a girl begins making estrogen herself as she goes through puberty," she explains. However, if her urine only dribbles out -- which indicates that the adhesion is significant -- or if she actually gets a bladder infection due to a severe adhesion, then it can be treated with a topical estrogen cream.
Originally published in the December 2011 issue of Parents magazine.
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