Learning how to care for, and clean your baby’s penis or vaginal area is one thing, but some babies are born with genital conditions that can make life a little more complicated.
Most of these conditions are temporary, and may not require any treatment, but others may present ongoing issues for your little one.
Here’s our guide to the some of the more common newborn genital issues, and what you can do about them.
Boy bits
1. Undescended testicles
A baby boy’s testicles form inside his abdomen, and shortly before he is born his testicles usually descend into his scrotum. Sometimes one or both of the testicles do not move into the correct position prior to birth, this condition is known as cryptorchidism (or undescended testicles).
Around five percent of Aussie baby boys will be born with this condition, which is easily diagnosed by physical examination shortly after birth.
It can also happen that a baby might be born with his testicles in the scrotum, and then after a period of time (anywhere during the first 10 years), the testicles may relocate back into the abdomen.
Occasionally, a little boy’s testicles might tuck up into his body under certain conditions, such as when he is cold. This is known as retractable testicles, and is not a problem so long as the testicles remain in the scrotum most of the time.
What can you do about it?
In the majority of cases, no treatment is necessary and the testicles naturally move into the scrotum during the first six months of life.
Occasionally, surgery is required to correct the problem. This would usually be performed between six months and two years old, so as to prevent any possible fertility issues in adulthood. Hormone therapy may also be prescribed in certain cases.
2. Hypospadias
This condition of the penis usually presents as a three-part problem:
- The opening of the urethra is not in the correct place
- The penis may be bent or curved
- Sometimes part of the foreskin is missing
Doctors usually diagnose hypospadias shortly after birth, although occasionally a boy may only be diagnosed years later. The cause of the abnormality is unknown, it is not an inherited condition but it does seem to occur more frequently where there is a family history of the condition.
What can you do about it?
In mild cases, where the penis is relatively straight when erect and where urinating is not problematic, no treatment is necessary. However, in more severe cases, surgery may be required to move the urethral opening, to straighten the penis, and to make the foreskin look more normal (which may mean removal). Usually, the surgery will take place before the boy is two years old.
3. Inguinal hernia
An inguinal hernia is a lump that appears in the groin region. It is usually a protrusion of intestinal or fatty tissue that has pushed through the inguinal canal – the passageway the testicles travel down when they descend from the abdomen to the scrotum. Girls have a similar canal in their bodies, and while females can develop an inguinal hernia, it is much more prevalent in little boys.
What can you do about it?
Doctors may decide to leave the hernia to see if it will reduce on it’s own, or they may apply pressure to the lump to encourage the contents back into the abdomen. In some cases a herniotomy (or surgical repair) is necessary.
4. Hydrocele
A build-up of fluid around one or both testicles is known as a hydrocele. When this occurs in a newborn, it usually means that the sac surrounding the testicle did not close properly prior to or just after birth.
If a hydocele is present, the scrotum appears swollen or red and it may be painful. Sometimes the condition is also associated with an inguinal hernia (see above). Adult men can also develop this condition as a result of injury or infection.
What can you do about it?
Usually, a hydrocele will disappear on its own within the first year of a baby’s life – as the body reabsorbs the fluid. Occasionally it won’t go away, or may even get bigger, in which case surgery will be required.
5. Balanitis
Balanitis refers to an infection or inflammation of the tip of the penis. Symptoms include redness, swelling, an unusual odour and pain.
Both circumcised and uncircumcised babies can develop balanitis as a result of nappy rash, it can also be the result of too much or too little cleaning of the area. Sometimes it can also be brought on by certain medications.
What can you do about it?
Bathing the penis in warm water and applying either an anti-fungal or anti-inflammatory cream (as advised by your healthcare professional) is usually the only treatment that is required – and the condition usually clears within a week. If the problem persists, circumcision (if not already done) may be recommended.
Girl bits
6. Labial fusion (or labial adhesion)
Sometimes the labia (the lips covering the vagina) become stuck together with a thin membrane. It is unusual for a baby to be born with this condition, it is something that is more likely occur within the first one to two years.
Doctors are not 100 percent sure what causes it, but it can develop as a result of an earlier infection.
What can you do about it?
More often than not, no treatment is necessary as the condition will likely correct itself before puberty begins. Surgical treatment is not recommended as it can actually encourage the adhesion to reoccur, and it can also be very painful.
Sometimes creams can be prescribed but mostly doctors will elect to leave things alone and allow the condition to resolve naturally.
7. Hymenal skin tags
The hymen in a newborn can be swollen due to oestrogen passed on from the mother. Sometimes, small pieces of smooth pink tissue can protrude. These vaginal (hymenal) tags occur in about 10 percent of newborn girls and are considered normal and harmless.
What can you do about it ?
Hymenal skin tags usually resolve themselves over a period of about two to four weeks. Sometimes it may take longer than this, but parents are advised to be patient. No treatment is necessary.
Issues that affect both boys and girls
8. Swollen genitals after birth
It is very common for the genitals of both newborn boys and girls to be swollen and red after the birthing process. This can be due to a combination of things, including a long or traumatic labour and the extra surge of hormones passed on from the mother just before birth.
Newborns also carry a lot of extra fluid, which causes them to appear puffy in certain areas - around the genitals and face in particular. Little girls can sometime have a vaginal discharge or some vaginal bleeding, which usually lasts just a couple of days.
What can you do about it?
Nothing needs to be done about normal genital swelling in newborns. All newborns are given a thorough medical examination after birth, and the genital area will be assessed as part of that examination.
9. Urinary tract infection (UTI)
An infection in the urinary tract - which means in the bladder, kidneys or urethra - is very common in babies and young children in nappies.
In most cases bacteria from the bowels or faeces gets into the urinary tract and causes an infection. A UTI can make it very painful to pass urine, and is often accompanied by a fever. Sometimes a baby can have a UTI without any obvious symptoms.
What can you do about it?
A UTI is diagnosed by testing a urine sample, and the infection is treated with a course of antibiotics. If your child experiences recurring UTIs, an ultrasound of their kidneys or bladder may be ordered. Sometimes it may be necessary to perform a more invasive test, known as an MCU, which involves injecting dye into the bladder via a catheter.
