The penis is covered with an outer layer of skin and inner layer, which is in close contact with the tip of the penis “glans”. This is nature’s way of protecting the tip.
This is the appearance at birth and hence the foreskin will not retract. This situation changes through infancy and childhood and almost all boys by the age of 17 will have a fully retractile foreskin. ( a foreskin that can be pulled back to bare the tip of penis)
Changes through infancy and childhood:
The inner layer of foreskin starts separating from the tip in small areas around the head of the penis. This happens gradually over time, so that some areas are still adherent and some are separated creating small pockets. It is in these areas that the urine collects temporarily causing ballooning which is an entirely normal process.
It is important to know that this inner layer of skin also secretes a whitish substance called “smegma” which can collect underneath the foreskin, giving rise to appearances like “pearls”.
You will now be able to understand that when your child passes urine the foreskin may balloon, there may be whitish “smegma” collection and also within this loose foreskin some drops of urine may remain trapped.
These retained drops of urine and the secretions normally present may invite infection, when the foreskin may become itchy, red and inflammed.
To avoid this, you, as parent need to monitor and help your child to keep the foreskin clean i.e. towards the end of the bath pull back the foreskin “as much as it can” without using undue force, wash it with soap and water and reposition the foreskin back on the tip of the penis.
If you follow the procedure on a daily basis no further measures will be necessary in the majority of boys.
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