When Something's Not Right "Down There"

Featured Article, Growth and Development, Health and Safety
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Ten fingers, 10 toes, all tiny and beautiful … your new baby is the cutest thing under the sun. Then it’s time to get down to business and change his diaper. Your son’s anatomy might not look like you expect. Before you imagine him as the butt of locker room jokes when he’s older, read on for advice from Dr. Danielle Sweeney, pediatric urologist, on some of the most common concerns parents have about their baby boys’ private parts:

His testicles look huge!

Enlarged testicles are very common, with fluid around them making the scrotum look large and stretched tight. This fluid is called hydrocele and will fade by the time Baby is 12-18 months old. Newborns have mom hormones still surging through them, so that has an effect as well for the first couple days.

He isn’t peeing out the end of his penis.

Typically, the urethra opens up into a little hole at the end of the penis. In a condition known as hypospadias, that hole might be located elsewhere. This can be mild, like off to the side or a little towards the top, or more serious like halfway down the underside of the shaft.

If the hypospadias is minimal, no worries. You might have to watch out for getting peed in the face a bit more when you change the diapers but that’s all. For more serious issues, surgery is the only way to go. Hypospadias can also mean a curved penis and weird skin along the back tip. All together, these can lead to problems with fertility and infection later on. Your pediatrician can take a look and let you know if you should see a specialist.

Aren’t there supposed to be two testicles?

When your baby is developing in the womb, his testicles start out up near his kidneys and move down, most of the time. Undescended testicles are more common in premature boys (more than 20 percent) and can affect one or both sides. This can run in families and often takes care of itself over time. If testicles are still not down in the scrotum by 12 months, surgery may be needed, but approximately 75 percent of the time, no intervention is needed.

His penis looks all red and painful. How can I tell if there’s an infection?

Babies pee a lot. This is not so great for diaper changes, but it’s great for keeping the pipes nice and clear. A lot of times redness isn’t an infection but merely a simple irritation. All that wetness and rubbing? It’s no wonder it’s irritated.

If your son is circumcised and things have healed up, a warm bath with baking soda can reduce the discomfort. Diaper cream, especially the clear thick kind, can also provide a barrier between the tip of the penis and the diaper.

For the uncircumcised, irritation of the foreskin can make it painful to pull it back and keep everything clean. Infection is more common in this scenario, so you’ll need to be especially diligent.

In either case, yeast infections can occur in the warm moist diaper environment. In such cases, your pediatrician will likely recommend an anti-fungal cream. Try some naked time to see if the open air helps clear things up before calling the doctor.

His penis seems really small. Like too small. 

“In general the stretched penile length for a full-term infant should be at least 1.9 centimeters long,” says Dr. Sweeney. A lot of times baby boys have fat that presses down and squishes the penis so it looks like there’s nothing much there. This usually resolves as the child grows and his fat gets distributed differently.

There is a real medical condition called micropenis, but it generally comes along with other genetic and endocrine issues and is extremely rare.

If you’re worried that something may be wrong with your little guy’s privates, talk to your pediatrician. She’s likely seen it all and will be able to explain what’s up and calm your concerns.

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