April Rubin, MD
Fellow, American College of Obstetricians and Gynecologists
Graduate, Jewish Theological Seminary Brit Kodesh
Guidelines for Caring for Your Newborn's Circumcision
Here are a few guidelines to help you care for the circumcision in the first few days after the brit milah ceremony:
Care of the circumcision is quite simple. Circumcisions generally heal by themselves. The object of care is to keep the area of the surgery as clean and comfortable as possible until the tissue heals.
There is a gauze square with petroleum jelly on the baby's penis. The first time you change him, leave the gauze. The second time you change his diaper throw away the gauze. If the gauze should fall off before this time do not attempt to replace it. When you change the diaper, clean the diaper area, leaving the penis alone. If you wish to wash the area of the circumcision, or if stool gets on it, use a cotton ball and warm water to gently clean the skin. Do not use alcohol and do not rub the tissue with any force as this may cause bleeding.
It is not necessary to use gauze again, but every time you change him for the next five to six days place some petroleum jelly (about one teaspoon) around the entire circumference of the cut. Continue this until the area looks healed.
The local anesthetic will last about one hour. While many babies do not seem to be in any distress after the circumcision, some may be uncomfortable for the first two or three days, especially when their diapers are being changed or when their urine initially comes into contact with the raw tissue. Feeding or nursing should not be affected. You may give your baby some liquid infant Tylenol for the first twenty-four hours if he is irritable. The dose is 1.25cc every six hours. There is a mark on the dropper.
Healing is usually rapid. You should remember that this is like any other cut and there are many factors that influence healing, but most importantly every child heals differently. First, the cut edge seals and bleeding ceases within minutes. Within twenty-four hours the area behind the glans will become swollen; this inflammation will subside within a week or two. In a day or two there may be an off-white or yellowish, patchy appearance of the glans. These patches are a type of scab and are associated with normal healing. You will also notice that the glans is red and glossy. This is because the skin covering the glans of an uncircumcised penis is mucous membrane (like the skin inside your cheek). Once exposed, the mucous membrane will toughen (or keratinize) and in time take on a normal appearance (like the skin outside your cheek). The penis should take on a 'normal, healed appearance' in about a month. As the circumcision is healing, gently push the skin of the shaft of the penis toward the abdominal wall to expose the entire glans (head of the penis). This will prevent adhesions from reforming between the glans and the skin of the shaft.