At birth, boys have skin that covers the end of the penis, called the foreskin. One choice you will make for your new baby boy is whether to have him circumcised. Circumcision is a surgical procedure that removes the foreskin, exposing the tip of the penis.

If your son is not circumcised, the following are things you should know and teach your son as he gets older.

How do I clean my baby's foreskin?

In the first few months, clean your baby's penis with soap and warm water. Cotton swabs or antiseptics are not necessary. Do not pull back the foreskin if it's still attached.

When will the foreskin retract?

In the first several years your son's foreskin will separate from the tip of the penis. Some foreskins separate soon after birth or even before birth, but this is rare. When it happens is different for every child. It may take a few weeks, months, or years. Once this happens, the foreskin can be pulled back away from the tip of the penis. This is called foreskin retraction.

Most boys will be able to retract their foreskins by the time they are 5 years old, yet others will not be able to until the teen years. As a boy becomes more aware of his body, he will most likely discover how to retract his own foreskin. But foreskin retraction should never be forced. Until the foreskin fully separates, do not try to pull it back. Forcing the foreskin to retract before it is ready can cause severe pain, bleeding, and tears in the skin.

What is the white stuff under the foreskin?

When the foreskin separates from the head of the penis, skin cells are shed. These skin cells may look like white, pearl-like lumps under the foreskin. These are called smegma. Smegma is normal and nothing to worry about.

Is there anything special I need to teach my son?

If your son's foreskin separates before he reaches puberty, an occasional retraction with cleansing beneath will do. Once your son starts puberty, he should clean beneath his foreskin as part of his daily routine, just like washing his hair and brushing his teeth.

Teach your son to clean his foreskin in the following way:

• Step 1: Gently pull the foreskin back away from the end of the penis.

• Step 2: Rinse underneath the foreskin with soap and warm water.

• Step 3: Pull the foreskin back over the penis.

Is there anything else I should watch for?

While your son is still a baby, make sure the hole in the foreskin is large enough for him to urinate normally. Talk with your pediatrician if

• The urine stream is never more than a trickle.

• Your baby seems uncomfortable while urinating.

• The foreskin becomes considerably red or swollen.