My Baby Has a Swollen Scrotum
The short answer
A hydrocele is a collection of fluid around the testicle that causes the scrotum to swell. It's common in newborn boys and usually harmless. Most hydroceles disappear on their own by age 1. Your pediatrician will examine your baby to distinguish it from an inguinal hernia, which requires surgery. If the hydrocele persists or is very large, surgery may be recommended.
Parents everywhere have the same worry. You are doing the right thing by looking into it.
By Age
What to expect by age
0-3 months
Hydroceles are very common in newborn boys. You may notice one or both sides of the scrotum look swollen or enlarged. The swelling may be soft and fluctuate in size. Your pediatrician can confirm a hydrocele by examining your baby and sometimes shining a light through the scrotum (transillumination). Most hydroceles in newborns resolve on their own and just need monitoring.
3-6 months
Many hydroceles begin to shrink during the first 6 months. Your pediatrician will continue to check the size at well visits. If the swelling seems to come and go or gets larger when your baby cries, it may be a communicating hydrocele (connected to the abdomen) or possibly an inguinal hernia, which requires surgical repair.
6-12 months
Most hydroceles resolve by 12 months. If your baby's hydrocele is still present at this age but not causing problems, your doctor may continue to monitor it. Hydroceles that persist beyond 12-18 months or are very large may be repaired surgically, though this is elective and can often wait until your child is older.
12 months+
If a hydrocele persists past 12-18 months or suddenly develops in a toddler, your pediatrician may refer you to a pediatric urologist or surgeon to discuss surgical repair. The procedure is straightforward and has excellent outcomes. Recovery is usually quick, and recurrence is rare.
What Should You Do?
When to take action
- Your baby has a soft scrotal swelling that has been present since birth
- Your pediatrician examined your baby and confirmed it's a hydrocele
- The swelling is not painful and your baby is comfortable
- The hydrocele is stable or slowly decreasing in size
- Your baby has no other symptoms like redness, firmness, or vomiting
- You've noticed swelling in your baby's scrotum and want it evaluated
- The hydrocele seems to be getting larger instead of smaller
- The swelling comes and goes or gets bigger when your baby cries (may indicate communicating hydrocele or hernia)
- You're unsure whether it's a hydrocele or another condition
- The scrotum becomes firm, hard, or very painful
- The scrotum turns red, purple, or darkly discolored
- Your baby is vomiting or seems in severe pain
- The swelling suddenly increases dramatically
- Your baby has a fever along with scrotal swelling
Sources
Related Resources
Trust your instincts. If something feels wrong, reach out to your pediatrician.
Worrying about your baby means you care. That is a good thing.
Related Medical Concerns
My Baby's Head Shape Looks Abnormal
Many babies develop temporary head shape irregularities that are completely normal. A cone-shaped head from vaginal delivery reshapes within days. Mild positional flattening (plagiocephaly) from sleeping on the back is very common and usually improves with repositioning and tummy time. However, head shape changes involving ridges, a persistently bulging fontanelle, or rapid head growth changes should be evaluated to rule out craniosynostosis.
Achondroplasia (Dwarfism) in Babies
Achondroplasia is the most common form of short-limbed dwarfism, affecting about 1 in 15,000 to 40,000 births. It is caused by a mutation in the FGFR3 gene and is usually apparent at birth with characteristic features including short limbs, a larger head, and a prominent forehead. Intelligence is normal. With monitoring for specific complications and supportive care, children with achondroplasia lead full, active, and independent lives.
Adenoid Hypertrophy and Breathing
Adenoids are lymphoid tissue located behind the nose that help fight infection in young children. When adenoids become enlarged (adenoid hypertrophy), they can block the nasal airway, causing chronic mouth breathing, snoring, nasal speech, and sleep-disordered breathing. Enlarged adenoids are most common between ages 2-7 and are a leading cause of obstructive sleep apnea in young children. Treatment ranges from watchful waiting and nasal steroids to surgical removal (adenoidectomy) if breathing or sleep is significantly affected.
How to Advocate for Your Child's Needs
You know your child better than anyone, and your observations matter. If you feel something is not right with your child's development or health, you have every right to ask questions, request evaluations, and seek second opinions. Advocating for your child is not being difficult - it is being a good parent.
Air Quality and Baby Health
Babies and young children are more vulnerable to air pollution than adults because they breathe faster, their lungs are still developing, and they spend more time close to the ground where some pollutants concentrate. The EPA recommends keeping babies indoors when the Air Quality Index (AQI) exceeds 100 (orange level). During wildfire smoke events, keep windows closed, use air purifiers with HEPA filters, and monitor your child for coughing, wheezing, or difficulty breathing. Long-term exposure to air pollution can affect lung development.
Altitude Sickness in Babies
Babies and toddlers can experience altitude sickness when traveling above 5,000-8,000 feet (1,500-2,500 meters). Symptoms are harder to recognize in infants because they cannot describe how they feel. Watch for unusual fussiness, poor feeding, disrupted sleep, vomiting, and fast breathing. Gradual ascent is the best prevention. Most pediatricians recommend avoiding sleeping at very high altitudes (above 8,000 feet) with infants when possible, and descending immediately if symptoms appear.