This site discusses Phimosis, Frenulum Breve and the Epithelium, and their relationship to Male Initiation and Identity.
Much modern medical information on circumcision (from popular literature to reports in medical journals), recommends that the best care for a foreskin is to leave it alone. These reports are all based on Øster's misinterpreted study. Øster made his report following 7 years of education and monitoring. Such care and attention obviously results in less problems.

updates and supporting education on new site : Phimosis.cloud

PREVENTION

How to Encourage a Healthy Development of the Foreskin
by Releasing the Adhesions at an Early Age.

 

Common sense tells us that a boy must be given the opportunity to develop a healthy non-painful, non-inhibitive relationship with his own genitals.

The adhesions must be dissolved or gently released at an early age to allow the development of a supple and healthy foreskin.

Adhesions restrict a child's exploration and self manipulation simply because they hurt. The adhesions should ideally be dissolved (or gently released) at an early age.

It is generally understood that the younger the child is, the more flexible his skin is. It would therefore be most effective for a child to start stretching (as an enjoyable play activity), at an early age.

Interestedly monitoring a boy's foreskin will automatically encourage a young boy to get inquisitive about his foreskin. Forceful stretching exercises will inevitably be painful and thus will discourage a child. To stimulate a boy's awareness, he should be asked to retract his own foreskin.

 

The Importance of Infant Erections
Every infant boy has erections. These erections start in the embryo and they continue throughout his childhood. One can imagine that without infant erections, if boys suddenly started having erections at puberty without any previous exercise, there would be a number of muscle strains not to mention the sudden explosion of a few blood vessels. Equally, if a boy arrives at puberty without any prior exercise of the foreskin, one may expect a degree of tightness and rigidity in the foreskin and some difficulty in retraction.

Stretching While Young
When the preputial skin has moulded round the glans, in the womb and throughout childhood, and has not been allowed any exercise apart from the variation between the flaccid and erect states, the foreskin not only develops a limited elasticity, but also any skin tissue which has a tendency to be stiff will slowly become more rigid.

It is generally understood that the younger the child is, the more flexible his skin is. It would therefore be most effective for a child to start stretching his own foreskin, at an early age..

Infant or Epithelial Adhesions
(Whereas nappies are probably the primary physical hindrance) . . . The primary anatomical hindrance to an infant boy naturally stretching his own preputial skin are the adhesions. These adhesions restrict a child's exploration and self manipulation simply because they hurt as the foreskin is pulled off the glans.

Children who have no adhesions, experience no pain, have no physical hindrance and they naturally and happily pull on, explore, experiment with and stretch any tightness out of their foreskin. - Therefore those who most need to start stretching, are the children who are also anatomically hindered in doing this.

For a detailed discussion of the psychological effects of pain from infant adhesions please see: ADHESIONS and EARLY LEARNING

Solutions
I believe that if a method of dissolving adhesions could be found and children were encouraged in their natural self manipulation of the foreskin, then the majority of foreskin conditions could be prevented.

I hope at some time in the future a method of dissolving these adhesions will be available. (I believe this has never been researched). At present, checking, monitoring and thus encouragement are even more necessary.

Encouragement
If you let him the normal child will start to pull forward on his foreskin. This is the first step of a normal infant child's own self manipulation, This is a very healthy habit because it is the easiest obvious natural way for a child to slowly release his own adhesions. (And in the process, start stretching out the phimosis and extending the frenulum).

The floppy, bottlenose dolphin shape of an infants penis, makes it an ideal bath time play friend. It is helpful to encourage the idea that such play is good and interesting.

Letting your child play with himself will not turn him into a sex maniac; this is far more likely to occur when such innocent play is inhibited.

Retraction
When a toddler relieves themselves in public, the careful parent will often help by gently pulling back the overhang of the foreskin (so that spraying etc., can be avoided), and aiming the penis away from the boy's trousers. By this I wish to establish that it is everyday procedure for the parent to help with gentle retraction.

A second way to encourage the release of the adhesions is when bathing, to gently retract the foreskin as far as it will go, to wash it. A child will easily learn that this part of his body is or could soon be accessible (and may hopefully in the process also learn to wash his own penis).

One should never use force to push or pull back on a boy's foreskin - this cannot be repeated often enough, there are an extraordinary amount of people who support the use of forceful stretching exercises - there are a number of anatomical complications which force may cause, but quite simply such a first step into manhood is a truly ridiculous initiation for our culture. The use of force and pain builds up negative psychological attitudes about what one is attempting to achieve, i.e. retracting the foreskin.

As one is trying to stimulate the child's own interest and awareness about retraction, it is always best to let a child retract his own foreskin and to encourage this. Once the tip of the glans is visible, playful questions like "oooh what's that?" appear to stimulate the infant intelligence better than any book.

I would suggest an appropriate modern initiation would be to discover his glans as the result of self experiment, and that a boy would experience a feeling of excitement and fun about such an interesting new discovery about his own male body.

Conclusion and Summary
Gairdner's much quoted study tells us there is no reason for any great concern during the first year: "the prepuce is non-retractable ... in half of normal males of 1 year." (4). However, seldom quoted is his observation that by the third year the adhesions should have released.

"After about the 3 years of age steps should be taken to render the prepuce of all boys retractable and capable of being kept clean."

Once some form of these ideas are acknowledged and become practised, it appears that in many countries and cultures, at least one boy in ten would have a healthier and happier start to life.

Note
During puberty a certain amount of boys develop a secondary phimosis, and these develop slowly over the period of a few years. The frequency must be very small however the experience appears to be a very bad and embarrassing one ... Therefore the extremely prudent parent will take some step to ensure such difficulties are diagnosed early, this will be difficult because during puberty a boy requires a certain privacy. - It would seem appropriate to our culture's thinking to have some form of education on the subject. ...