Changing nappies isn’t fun, but has to be done. But how do you ensure you’re cleaning your new baby’s genitals correctly? Fortunately, genitals are “self-cleaning”. The linings of the urethra, vagina and rectum are made from mucous membranes that are slightly acidic (thanks to natural “good” bacteria), and these help to keep germs under control. Unnecessary fussing can do more harm than good.
How do I clean my baby’s bum when changing a nappy?
When your baby passes a soft, bulky stool, it’s best to wipe most of this away (from front to back) with the nappy he is wearing, and then to wash his bottom in a basin of warm water. This is also practical if your baby has a nappy rash because keeping the skin clean is imperative. When possible, leave your baby without a nappy for a short time for his skin to dry. Barrier cream over the rash will protect the skin while it heals.
What’s the best nappy to use?
Disposable nappies are more expensive, but they’re convenient and super-absorbent, so they’re less likely to cause nappy rash.
Toweling nappies work just as well, provided they are changed regularly and any laundry detergent has been rinsed off, so as not to cause a reaction. These nappies also need to be kept super-soft so that they don’t irritate the skin.
Wipes, cotton wool and warm water or a dedicated face-cloth can be used to clean the skin, but the latter must be kept scrupulously clean and soft.
What’s normal and what’s not?
Your newborn’s genitals tell us a lot about his maturity. Well-developed, slightly swollen labia (outer lips covering the vagina) in baby girls, and a pendulous scrotum for boys means your baby has reached maturity. Small labia with the inner lips exposed can be seen in underdeveloped baby girls and a small scrotum (often with undescended testes) is common in premature baby boys.
Your newborn should pass urine and a stool within the first 24 hours of his life. The urine may look pink in colour, which is caused by acid crystals. This is normal. The first stool, called the meconium, is black and sticky. As your baby’s milk intake increases, so will his urinary output (1ml per kilogram every hour). The meconium changes from black to green to mustard yellow. If your baby has not passed a stool by the second day, tell your doctor/midwife. Although rare, some babies are born with anus problems. Also tell your doctor if your baby strains when passing a stool or wind. The anus may be tight and need to be gently stretched.
An inguinal hernia (lump in the groin) is more prominent in boys. It usually only happens on one side, but it can be seen on both sides – particularly in baby girls. The hernia becomes prominent when the baby cries because abdominal pressure forces some of the bowel into a gap of the abdominal lining called the peritoneum. This can be eased back, but surgery is imperative to avoid complications.
Caring for your baby boy’s genitals
A newborn’s penis is small and the foreskin covers the tip (called the glans) to protect this delicate tissue. If your baby boy is uncircumcised, it’s important you don’t pull the foreskin back because, up until the age of four, this skin is naturally tight. If it is forced back, the foreskin can tear or even get stuck. The best advice is to leave the penis alone! Your baby’s dad can teach his uncircumcised son about cleaning the tip when he is older.
Circumcision (cutting off the foreskin) is usually done for religious or medical reasons. Depending on the method used, the doctor will advise parents on cleaning and healing.
Your healthcare provider will check that both testes have descended into the scrotum. If they have not done so by your son’s first birthday, this must be done surgically. The risk of not having the operation is infertility (in later life) or even malignancy (cancer).
If the scrotum looks swollen, this may be caused by fluid that’s collected in the testicles (called congenital hydrocele). This usually corrects itself, but tell your doctor if it does not.
Caring for your baby girl’s genitals
Always wipe from the front to the back. This is because the urethra, vagina and rectum are close together, and it’s easy to wipe germs from the rectum into the vagina and urethra. Girls have a shorter urethra so it’s easier for them to get urinary tract infections.
The outer lips of a full-term baby girl are often swollen because of hormones from her mom. If these lips are stuck together, they can be eased apart using an ear bud. A small lump of yellowish jelly or slightly blood-stained mucous from the vagina may be alarming, but this is caused from hormones and usually only happens once a few weeks after birth.
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