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Caring for Your Newborn's Circumcision

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.

What to Watch For:

There may be a small amount of blood on the gauze. This is normal. If there is a flow of blood, pressure for five minutes (watch the clock) will usually stop it. If the bleeding persists, call your pediatrician or me.
There will be some redness and swelling at the area of the circumcision for a few days. This is normal. If the swelling extends down the shaft and onto the abdominal wall you should call. Infection is extremely rare after circumcision.
Since part of the circumcision is on a mucous membrane, a yellowish-gray area may form at the site of the cut. This may be similar to what you see at the site of the umbilical cord insertion. This is NOT pus and does not represent infection, but is normal for the healing process.
On occasion, a poor aesthetic result occurs when too little or too much skin is removed, or more likely when the cut edge of the skin attaches too high or too low along the length of the penis. In nearly all cases the penis will heal properly and in time take on a normal appearance.

The circumcision should be entirely healed within seven or eight days. If you have questions you may