My Baby Has a Swollen Scrotum
Medically reviewed by Dr. Michael Okonkwo, MD, FAAP · Board-Certified Neonatologist
Content reviewed against published AAP, AAP, AAP guidelines
Last reviewed:
If your baby has been diagnosed with or you suspect has a swollen scrotum, here is what the evidence says.
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.
Key takeaways
- 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.
- Usually normal when: Your baby has a soft scrotal swelling that has been present since birth
- Call your doctor if: The scrotum becomes firm, hard, or very painful
- Varies by age — see the age-by-age breakdown below
“Fever itself is not an illness — rather, it is a sign or symptom that the body is fighting an infection. Fever stimulates certain defenses, such as the white blood cells, which attack and destroy invading bacteria.”
Parents everywhere have the same worry. You are doing the right thing by looking into it.
What Parents Should Know
According to AAP guidelines, 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. At 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. It is generally considered normal when your baby has a soft scrotal swelling that has been present since birth. However, you should contact your pediatrician promptly if the scrotum becomes firm, hard, or very painful.
Normal vs. Concerning
When to Seek Immediate Care
- 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
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 to Tell Your Pediatrician
- Describe when you first noticed has a swollen scrotum and how it has changed over time.
- Note your baby's current age and which age-specific patterns you are seeing.
- Mention if you've noticed swelling in your baby's scrotum and want it evaluated.
- Mention if the hydrocele seems to be getting larger instead of smaller.
- Bring a list of any questions or observations you want to discuss at the appointment.
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
What You Can Do at Home
- Keep track of when you notice has a swollen scrotum — noting the time of day, duration, and any triggers can help your pediatrician.
- Remember that your baby has a soft scrotal swelling that has been present since birth — this is generally within the range of normal.
- At 0-3 months, focus on observation rather than intervention unless your pediatrician advises otherwise.
- Follow any care instructions from your pediatrician. Keep a written log of symptoms to bring to appointments.
- While monitoring at home, seek immediate care if the scrotum becomes firm, hard, or very painful.
Related Resources
Frequently asked questions
Is has a swollen scrotum normal?
When should I call the doctor about has a swollen scrotum?
When is has a swollen scrotum normal?
What causes has a swollen scrotum?
What should I mention to my pediatrician about has a swollen scrotum?
Is has a swollen scrotum normal at 0-3 months?
Is has a swollen scrotum normal at 3-6 months?
Should I go to the ER for has a swollen scrotum?
Does has a swollen scrotum go away on its own?
References
Doctor Visit Checklist
Bring this checklist to your next pediatrician visit to discuss My Baby Has a Swollen Scrotum.
Things to mention
- Describe when you first noticed has a swollen scrotum and how it has changed over time.
- Note your baby's current age and which age-specific patterns you are seeing.
- Mention if you've noticed swelling in your baby's scrotum and want it evaluated.
- Mention if the hydrocele seems to be getting larger instead of smaller.
- Bring a list of any questions or observations you want to discuss at the appointment.
Observations to share
- 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)
Urgent signs to report immediately
- 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
My notes
From ismybabyalright.com — free, evidence-based baby health guides
All content follows our editorial policy and is reviewed against published clinical guidelines.
2,705 evidence-based guides6 authoritative medical sources5 medical advisory board members
Related Resources
Bottom line
Most cases of has a swollen scrotum are normal. Talk to your pediatrician if the scrotum becomes firm, hard, or very painful.
Trust your instincts. If something feels wrong, reach out to your pediatrician. Worrying about your baby means you care — that is a good thing.
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