Is Ballooning of the Foreskin Unusual in a 6-month old?

January 8, 2007 9:54 AM

Urine gets trapped between my son's foreskin and his penis (he is not circumcised, obviously). He's six months old. Over the weekend we noticed this every single time we changed his diaper, but it is not something we'd noticed before Friday of last week. My question is: is this unusual enough that I should contact his Ped ASAP, or is this basically normal and I can wait and talk with his Ped about it during his regular 6 month check up in two weeks?

A bit of googling turned up that this is called "Ballooning", that its found most often in children ages 3 - 8, and that its a normal part of the foreskin separating from the glans. What worries me is that everything I've read indicates that this separation doesn't normally start until the child is about two or three years of age. I can't find any references on the web to ballooning taking place in a child this young.

He doesn't seem bothered by it, and if I press gently on the balloon a stream of urine comes right out (rather than a fine mist). How unusual is this in a child this age?

His father and I both know that "leave it alone" is the proper care for an uncircumsized infant, but I'm starting to wonder if his daycare provider has been retracting his foreskin when she cleans him up. (She's been caring for children for 30+ years so it really had not occured to me that I needed to talk with her about this.) I haven't tried to retract or manipulate his foreskin in any way other than gentle pressure above the penis to release the urine.

Is this unusual enough that I need to call his doctor ASAP, or is this something that the MetaParentingHiveMind has seen before?

posted by anastasia to health & fitness (13 comments total)

Ballooning is indeed normal, but it usually doesn't happen until a little later. There is, of course, a wide variety with these types of things, because no two bodies are exactly alike. I'm not a doctor, but I do own an uncircumcised penis. If it were mine, I'd leave it alone, unless it were also accompanied by redness, swelling, or pain. You might want to talk with your childcare provider too, as premature retraction can cause damage.
posted by fvox13 at 10:04 AM on January 8, 2007

I would bring it up on your next visit, if there is no sign of infection. Obviously, if there's an infection, you should go right away.

You might want to ask your daycare provider if she's retracting the foreskin. This was common practice at one time and she might not be up to date on the latest. You could just say his health care provider asked you to check with his various caregivers, if that seems less threatening.

However, do note:

[CIRP note: Ballooning of the foreskin now (2006) is considered to be a sign that separation of the foreskin from the underlying glans penis is proceeding normally. It is not a cause for concern. Ballooning is a normal stage of development. Ballooning will stop when the opening of the foreskin enlarges with normal growth and development over a period of time.]

IANAD, just a mom.
posted by acoutu at 10:08 AM on January 8, 2007

I have an uncircumcised 18mo and haven't seen that, but it is the sort of thing I would call the pediatrician about, not ASAP, but just to put your mind at ease. They're there to help you understand what's worth looking into and what's normal, espeically during the first year. You might ask them under what circumstances they would want you to call ASAP about this issue, just so you understand what they consider escalation of the problem and you can keep an eye on things. My guess is that as long as he's not running a fever and is not uncomfortable, he's fine.

I would also mention something to the daycare provider, since you already have doubts or concerns. One of the things I learned to put on my list of questions for potential babysitters was "Do you know how to care for an uncircumcised penis?"
posted by cocoagirl at 10:08 AM on January 8, 2007

IANAD, and you should check with one if you're concerned, but this happened to our son at that age. The doctor said it was "smegma", which totally squicked me out. But there you go.
posted by bondcliff at 10:12 AM on January 8, 2007

My boys are uncircumcised also. My youngest, a three-year old has ballooning, and from what I can remember occurred before he was one-year, but I cannot remember the exact age. He hasn't had signs of infection, and doesn't seem to be retaining urine in the foreskin. But after this question, I will examine more closely. I vote to bring it up in two-weeks at his next check-up.
posted by LoriFLA at 11:06 AM on January 8, 2007

Does your pede have a consulting nurse or someone who can answer these lower priority questions without having to go in? Our pede does, and it's a nice thing to have. This is just the sort of question I'd call about... if I had a boy instead of a girl.

I'd be worried if I saw blood or sores or signs of trauma, but this sounds like one of those "odd, but within normal parameters" sort of things. If you can't call someone at the pede, put on your list of things to ask about at the checkup. I always bring a list (or send one with the wife).
posted by dw at 11:30 AM on January 8, 2007

I have two intact boys, and although I haven't witnessed this symptom with them, I have read about it. From what I understand, ballooning is simply not a cause of concern and even leaving the urine in there isn't necessarily bad because the urine itself isn't likely to cause an infection, but you trying to get the urine out with your fingers could introduce an infection. I'm certainly no medical doctor, though.

I second the idea of mentioning it to the pediatrician on the next visit but not going out of your way to contact him/her about it. Without knowing anything about your pediatrician, however, I have heard anecdotally that a large number of physicians in the U.S. are prone to recommending intervention rather than not, and as you know, this is not good with an intact penis. At my son's three year checkup, his (normally conservative) pediatrician instructed me to begin gently trying to retract his foreskin in the bath. Needless to say, I didn't take the advice.
posted by forensicphd at 11:35 AM on January 8, 2007

I will chime in again and post this discussion. My old-school pediatrician is always trying to retract my preschooler's foreskin, and advises me to "retract it a little" at bath time. Like forensicphd, I don't heed his advice.
posted by LoriFLA at 11:52 AM on January 8, 2007

I would just warn you that previous AskMe discussions about the foreskin have been among the most contentious and inappropriate that I have seen on the site.

My opinion is that the right thing to do is wait 2 weeks and discuss it in detail with your pediatrician then.
posted by ikkyu2 at 11:56 AM on January 8, 2007

I have a 3 year old who's uncirc. At about 5months old he got an infection because of urine retention. He did not seem to suffer at all but I noticed while changing him that the foreskin was slightly swollen and reddish. I took him to the ER -was in another country at the time- and the doctors there gave me some ointment to apply. I'd say keep an eye out for infection.
posted by carmina at 1:32 PM on January 8, 2007

Also not a doctor, but an owner. Going to take a slightly different route than most of the above:

You're talking about one of the most important instrument's on the young lad's developing physique. Maybe the heart's more important, the brain - arguably less so...

I jest, but it will be an organ of some focus in the life he has before him. I vote take no chances and get thee to the doc. $20 co-pay now that saves him a life of (mental, physical, etc.) issues is a good investment, even if you were just safer than you were sorry, in the end.

I say this as a child of a very loving, new mother who got some bad advice with her first child who contacted some deviously recurring ear infections. I have a permanent hearing condition in one ear due to some related nerve damage, or so the last ENT I saw speculated. Shudder to think if it I had permanent damage to the happy parts.
posted by allkindsoftime at 5:32 PM on January 8, 2007

Allkindsoftime: she's taking him to the doctor in 2 weeks anyway. He doesn't have signs of infection, fever, pain or anything else that would usually mean a prompt doctor's visit.

This is not specific to babies, but I had a look at the BC Health Guide's "Is it an emergency?" section for genital injuries. Here's the sheet for change in appearance. I don't see anything there to indicate that there's an emergency.

Now, if there are signs of an infection or anything else untoward, get thee to a doctor. But IANAD.
posted by acoutu at 10:15 PM on January 8, 2007

Thanks for asking this. I was uncut as a small boy, and had this 'balooning' thing. I had no idea it was normal. It didn't hurt, it only made it more difficult to be neat when I tried to stand to go pee. (I mention this only as an alert to you parents to know this can make a boy insecure).

But this wasn't retention, it was something that happened when I was going. The baloon would present at the base of the glans, then move up to the opening. When it hit the opening, everything went all over. If I pulled my skin back to go, it went all over then, too.
posted by Goofyy at 2:35 AM on January 9, 2007