NOTE: If you have any questions about your son’s circumcision, call any time night or day. These care instructions only apply to those using my services – each mohel will have his own set of care instructions. Please read this entire care sheet. Immediately after the Bris· Feed and burp your son as usual. Avoid burping with baby in sitting position.

• Expect your son to be a little irritable the first day.
• The best sleeping position is on his back or side.
• It has been shown that disposable diapers better help promote healing by keeping the area clean and dry. It is strongly recommended that you use newborn size disposable diapers for the first week.
• Have your son examined by his physician within 10 days.

Day 1-5 following circumcision

Keep your son snugly swaddled (especially his legs). The more he moves his legs within the first 2 hours the more discomfort he may experience. Change his diaper with each bowel movement or if it has been 4 hours since the last change. With each diaper change:

1. Wash your hands thoroughly.
2. Squeeze a mound of Bacitracin ointment (the size of a quarter) onto the center of a sterile 3×3 inch cotton gauze square (use the ointment and gauze that I supply).
3. Remove old diaper, clean any mess (except around penis), and place new diaper.
4. Remove old 3×3 gauze square by gently pulling up and out on each of its four corners.
5. Apply the new 3×3 gauze with the mound of A&D ointment placed directly over the head of the penis. Gently squeeze to spread out the ointment.
6. Close diaper (and relax).

Note: Expect the first couple of 3×3 gauze squares to be stained red with blood. This is normal and represents only a drop or two of dried blood mixed with urine. If in fact there was bleeding, the penis would be enveloped with small globs of blood (but this is very rare).

Days 5-7 after circumcision With each diaper change:

1. Wash your hand thoroughly.
2. Remove old diaper, clean any mess (except around penis), and place new diaper.
3. Apply a very thin layer of Vaseline ointment over the entire penis (the penis of a newborn should no longer be sensitive the day following circumcision).
4. Close diaper.

Other Bandaging
There may be a 1/2 x 8 inch petrolatum gauze wrapped around your son’s penis. This bandage 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. This should be sufficient to loosen the gauze so it can be un-wrapped.

Infection is Very Rare
Common of signs of an infected circumcision include: 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 the mohel or child’s physician without delay. Bleeding is rare but is the most frequent complication of circumcision. Aside from direct complications, the most common concern of parents is related to aesthetics. It should be remembered that penises come in all shapes & sizes. While most penises ‘look normal’ within days of the circumcision, some do not take on a completely normal appearance until after the penis starts to grow (age 3 to 5 years). On occasion, a poor aesthetic result occurs 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 will heal properly and in time take on a normal appearance. Even though complications are rare, do not hesitate to consult the mohel or child’s physician if you have any questions about the appearance of the penis or surrounding area.

If you see blood flowing from the wound area do the following:
1. Apply steady pressure for 3 minutes by grabbing the penis between your thumb, index finger, and middle finger (you can do this directly or over the gauze). If you let up before 3 minutes, reapply pressure and start the 3 minute count over.
2. Inspect the area for 2 minutes. If bleeding persists, repeat step one
3. In all cases of fresh bleeding, call the mohel or child’s physician at once for further instructions.

Healing is Rapid
A circumcision is like any other cut and every child heals differently – though most heal rapidly. For most babies, the penis should no longer be tender in a day, be essentially healed in a week, and take on a ‘normal appearance’ in about a month: The cut edge seals and bleeding ceases within minutes. Within hours, maybe a day, the area just behind the glans (especially the underside) will become swollen. This inflammation will subside 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 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 on the inside of your cheek). Once exposed, the mucous membrane will transform and in time take on a normal appearance (like the skin on the outside of your cheek).

Complications

Circumcision is associated with few and infrequent complications, though with any procedure there are occasional problems. The complication most often seen is persistent bleeding (or oozing). In almost all cases bleeding is controlled by direct pressure.

 

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