After the bris
Aftercare instructions
If you have any questions about your son's circumcision, call or text me at any time, day or night. 310-721-2149
Right after the bris
- Feed and burp your son as usual.
- Expect him to be a little irritable the first day. You can give him infant acetaminophen as needed to ease some of the discomfort. The dose is 1.25 ml.
- Disposable diapers have been shown to help healing by keeping the area clean and dry. I strongly recommend newborn-size disposable diapers for the first week.
Days 1 to 3
Keep your son snugly swaddled, especially his legs. The more he moves his legs, the more discomfort he may feel. Change his diaper with each bowel movement, or if it has been 4 hours since the last change.
With each diaper change
- Wash your hands thoroughly.
- Squeeze a mound of Bacitracin ointment, the size of a quarter, onto the center of a sterile 3x3 inch cotton gauze square.
- Remove the old diaper and clean any mess, except around the penis.
- Remove the old 3x3 gauze square by gently pulling up and out on each of its four corners.
- Apply the new 3x3 gauze with the mound of Bacitracin placed directly over the head of the penis. Gently squeeze to spread the ointment.
- Close the diaper, and relax.
Bathing
No bath during these 3 days. A sponge bath is fine, but that area should stay dry. If he gets feces on his penis, gently wipe the testicles with a gauze or a soft cloth and warm water. Do not wipe the shaft of the penis; gently dab it instead.
After three full days, give your son a bath or a sponge bath, depending on the state of his belly button.
What is normal
Expect the first couple of 3x3 gauze squares to be stained red with blood. This is normal: it is only a drop or two of dried blood mixed with urine. If there were actual bleeding, the penis would be covered with small globs of blood, and that is very rare.
The bandage
There may be a 1/2 inch gauze wrapped around your son's penis. It should fall off on its own during the first 24 hours. If it is still in place after 48 hours, it will have to be removed: bathe your son in a lukewarm bath for about 10 minutes. That should loosen the gauze enough to unwrap it.
Infection is very rare
The common signs of an infected circumcision are a pus-like discharge from the wound, a foul smell from the groin area, excessive swelling or redness in the groin area, or a fever. With any of these signs, call me or your child's physician without delay.
Bleeding is rare, but it is the most frequent complication of circumcision.
How it looks
Aside from direct complications, the most common concern of parents is how the penis looks. Remember that penises come in all shapes and sizes. Most look normal within days of the circumcision. Some do not take on a completely normal appearance until the penis starts to grow, at age 3 to 5 years.
On occasion, a poor aesthetic result happens when too little or too much skin is removed, or 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 heals properly and in time takes on a normal appearance. Complications are rare, but do not hesitate to consult me or your child's physician if you have any questions about the appearance of the penis or the area around it.
If you see actual blood flowing from the wound
- Call me immediately.
- Apply steady pressure for 10 minutes by holding the penis with a gauze between your thumb, index finger and middle finger. If you let up before 10 minutes, reapply pressure and start the 10 minute count over.
- Inspect the area for 2 minutes. If bleeding persists, repeat step one.
Healing is rapid
A circumcision is like any other cut, and every child heals differently, though most heal rapidly. For most babies, the penis is no longer tender in a day, essentially healed in a week, and back to a normal appearance in about a month.
The cut edge seals and bleeding stops within minutes. Within hours, maybe a day, the area just behind the glans, especially the underside, becomes swollen. This inflammation subsides within a week or two. In a day or two there are usually off-white or yellowish patches on the glans. These patches are a type of scab and are part of normal healing.
You will also notice that the glans is red and glossy. That is because the skin covering the glans of an uncircumcised penis is a mucous membrane, like the skin on the inside of your cheek. Once exposed, it transforms and in time takes on a normal appearance, like the skin on the outside of your cheek.