The Sexual Organs
The sexual organs, or genitalia, of both boys and girls may appear relatively large and swollen at birth. This is caused by hormones produced by the mother and fetus, bruising and swelling related to birth trauma, and the natural course of development.
In girls, the outer lips of the vagina (labia majora) often appear puffy. The skin of the labia may be either smooth or somewhat wrinkled. Sometimes, a small piece of glistening pink tissue may protrude between the labia—this is a hymenal tag and of no medical concern; it will eventually recede into the labia as the genitals grow. Most newborn girls will have a vaginal discharge consisting of mucus and sometimes some blood that will last a few days. This "miniperiod" is normal and represents menstrual-type bleeding from the infant's uterus that occurs as the estrogen passed to the infant by the mother begins to disappear. If you see swelling in the groin of an infant girl, it can indicate the presence of an inguinal (groin) hernia, although this condition is much more common in boys.
In boys, the scrotum (the sack containing the testicles) often appears swollen. This is usually due to a hydrocele, a collection of fluid that usually disappears over the first few months of life. The testicles of newborn boys may be difficult to feel because the scrotum is swollen and the muscles attached to the testicles pull them up into the groin briskly when the genital area is touched or exposed to a cool environment. Normal infant boys experience frequent penile erection, often just before they urinate. You should consult your child's doctor if you notice swelling or bulging in your son's scrotum or groin area that persists beyond three to six months or seems to come and go. This may indicate the presence of an inguinal hernia, which usually requires surgical treatment.
The end of an uncircumcised newborn's penis is usually completely covered by the foreskin. The foreskin remains attached to the tip of the penis in infancy, so you shouldn't attempt to pull it back to clean underneath. (By about the age of five years, the foreskin of nearly all uncircumcised boys will have become retractable. At this point the boy can be taught to slide the foreskin back and clean the tip of the penis.) The opening in the foreskin should be large enough to allow the infant to urinate with a forceful stream. Consult your baby's doctor if your son's urine dribbles out.
More than 95 percent of newborns will pass urine within the first 24 hours of life. If your baby is delivered in a hospital, nursery personnel will want to know if this occurs while the infant is with you. Many times, the first urination seems to be delayed, but the infant actually peed right after delivery and nobody noticed (remember, the baby's born soaking wet, so it's easy to miss a little urine).
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