Intimate Problems in Newborns

Information

What are the most common intimate problems and inflammations in newborns - girls and boys?

• Hydrocele
• Phimosis
• Hypospadias: the opening of the urethra, instead of being at the tip of the penis, is located elsewhere, in most cases on the underside of the penis or near the scrotum
• Incomplete descent of the testis
• Synechiae

Rarer conditions include entrapment of an ovary or testis in the inguinal canal - rare and mostly in premature infants.

Note: Diaper dermatitis is of inflammatory origin. Conditions such as balanoposthitis and vulvovaginitis do not occur in the newborn period (0-28th day), but in infancy.

What symptoms should the mother be concerned about?
Redness, rashes, discharge, urination disorders, unexplained painful crying, and abdominal bloating.

Which problems resolve after birth?
Hormonal crisis. In this, on day 5-7 the mammary glands enlarge, become slightly painful and dense. With slight pressure, a scant discharge may occur. This is due to the transfer of estrogens and prolactin from the mother in the last months of pregnancy. No treatment is applied - it disappears by the second-third week after birth.

Genital discharge in girls, which is again related to the transfer of maternal hormones.
Hydrocele is the presence of swelling of varying sizes, occupying one or both scrotal halves. In the newborn period it does not require treatment, and progressively decreases with age. Treatment is needed after one year of age.

Is it possible to diagnose problems in babies while still in the mother's womb?
With fetal morphology, ovarian cysts and other developmental abnormalities of the urogenital system can be identified. These require ultrasound monitoring after birth and, if necessary, surgical treatment.

What are synechiae and what causes their appearance?
The fusion of the labia in girls is called synechia. It can be found in newborns, but is most often diagnosed at the age of 1-2 years, in 2% of girls - but the age range is much wider: from 6 months to 6-7 years. The fused area can be small or cover a larger section.

Synechiae can interfere with the urination process and form a closed space, which can serve as a good environment for the development of infections. The exact causes of the occurrence and development of the fusion have not been established, but there are some circumstances that can lead to it:

• Excessive hygiene: too frequent hygiene procedures
• Wearing tight-fitting diapers. Allergic reactions of the contact type
• Urinary tract infections. Vulvovaginitis
• Low levels of the female sex hormone estrogen

Usually, an estrogen cream is used to treat synechia, after which treatment continues with "baby" cream to reduce the risk of re-fusion.

For prevention, it is important to keep diapers dry, apply a thin layer of diaper rash cream after each diaper change to prevent irritation of the sensitive area, and avoid fragranced products, which can also cause irritation.

What is vulvovaginitis and what are its manifestations?
Vulvovaginitis is inflammation of the mucosa of the vagina and vulva. This group also includes infants prone to allergic reactions. In the newborn and infant period, it is most often fungal, less often bacterial. It presents with redness and a whitish discharge that is easily removed. Treatment depends on the cause. Fungal vulvovaginitis is treated by washing with a weak sodium bicarbonate solution and treatment with clotrimazole. For bacterial cases - washing with weakly concentrated antiseptic solutions. Prevention and maintaining good hygiene (proper cleaning of the bottom after bowel movements and frequent diaper changes) are essential.

What special care do parents need to provide for newborn girls and boys?
Proper cleaning for girls is from top to bottom, from inside out. Due to their anatomical characteristics, improper cleaning can lead to frequent urinary tract infections. For boys - genitals - folds - bottom.

What is the difference between physiological and pathological phimosis?
Physiological phimosis - in the newborn and infant period, the glans of the penis cannot be exposed. This is due to fusion between the inner layer of the foreskin and the glans. The accumulated smegma and the inability to maintain good hygiene predispose to the development of an inflammatory process - balanoposthitis.

Congenital phimosis manifests clinically in cases where the opening is very narrow and makes urination difficult. During urination, the penis swells like a balloon. Stagnation of smegma and urine favor the development of pathogenic microorganisms, which is a prerequisite for urinary tract infections.

Is smegma a problem in boys, and what should a young mother do so that it doesn't become an "enemy"?
When the newborn reaches one month of age, after a hygienic bath, a gentle attempt is made to move the foreskin upward, in order to gradually "detach" it and expose the glans of the penis. Daily washing of this area is sufficient.

Problems related to the scrotal sac?
In some of them, the testis may be migratory, i.e. it can move from the scrotum to the inguinal canal. In others, it may be in the abdominal cavity or in the canal. If the testis does not descend into the scrotum and remains in the abdominal cavity (which is confirmed by ultrasound examination), surgical treatment is performed at the age of 2-4 years. After this age, torsion (twisting) of the retained testis is more common, and its structure changes.

What special hygiene rules should the mother follow - for a girl and for a boy?
Prevention of diaper dermatitis - frequent changes, dry diapers, diaper rash cream. Avoid creating a moist environment, which is a prerequisite for the development of fungal and bacterial infections, accompanied by redness, rashes, and discomfort for the infant.

What methods and cleaning products should NOT be used?
Preferably - unscented and with a light texture. If the skin is very dry and sensitive, medical cosmetics for atopic skin and bathing with shower oil are recommended.

For what symptoms should the mother seek a specialist's opinion immediately?
Unexplained and painful crying, swelling and "hardening" of the abdomen, swelling in the area of the inguinal canal. Crying during urination, with a change in color, smell, and quantity. Unusual genital discharge and redness.

When is the "first gynecological examination" - already at the hospital, at the family doctor's, or...?
An examination of the genitals is carried out during the first medical examination, which takes place immediately after birth. At that time, sex, developmental characteristics, and abnormalities of the urogenital system are established.

Your advice to young mothers who have a baby for the first time?
Mothers face many challenges and unexpected situations related to the arrival of the baby. My advice is - stay calm, believe in yourself, and trust the specialists who are taking care of you and your child.