Our doctors are parents as well and they understand that safety concerns are always number one. For your peace of mind, your doctor will be available anytime in the days after your son’s circumcision.
How to care for your son in the first 24 hours following the circumcision:
1) Keep your son snugly swaddled (especially his legs). The more he kicks his legs, the less comfortable he may be.
2) Please check your baby’s diaper every hour for the next 24 hours to look for any abnormal bleeding.
3) Leave the gauze in place and remove it after 24 hours. If it has fallen off, do not panic- just replace it with a fresh 3×3 gauze with some Vaseline on it and put it over the penis. Close the diaper
4) For the following four days, put a small amount of Vaseline on your finger and rub it over the incision site placing a thin layer of ointment over the entire head of the penis. No gauze bandages are required after the first 24 hours, just ointment.
5) It is important to push the skin down off the head of the penis if it has moved up a little to ensure it heals properly just behind the back rim of the head. Do not do any pushing on the skin for the first two days because it will be swollen from the surgery. If you are unsure of the appearance of your son’s penis, bring him to see us, and one of the doctors will adjust the skin for you if it is required.
General care following the circumcision:
1) It is normal for your son to be a little irritable for the first 24 hours following the circumcision.
2) Most babies like to nurse in a quiet environment following the circumcision. A baby who cries for more than a few minutes is usually suffering from air swallowed during the circumcision and needs to be burped. Take care when burping and holding your baby. You will want to avoid putting pressure on the circumcised penis in the first few days.
3) Most babies sleep quite well following the circumcision. The best sleeping position for your baby is on his side, supported by a blanket roll.
4) Healing is promoted by keeping the area clean and dry. Warm water and a cotton-ball or washcloth are preferred for cleaning the area around the penis. Avoid moistened baby wipes, alcohol, powders, and lotion since these may cause irritation.
5) Disposable diapers are strongly recommended for the first week since they tend to be less irritating, and they help keep the area dryer and cleaner.
6) For about three days following the circumcision to restrict the handling of your baby to just a few people. Also, avoid unnecessary travel as car seats can be irritating to the new circumcision.
Healing Process Post Circumcision
Healing is usually rapid and occurs in several stages. Remember that a circumcision is like any other cut. There are many factors that influence healing; but most importantly, every child heals differently.
First, the cut edge seals and bleeding ceases within minutes, hours, or even over the course of an entire day. The area just behind the glans (especially the underside) will become swollen. This inflammation will subside within a week or two. In the first two days, 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.
After a few days the area where the skin was cut look green and yellow. This is NOT pus. It is healing tissue. It can take this color for up to two weeks after the circumcision.
You will also notice that the glans appears red and glossy sometimes purple. 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. It takes about a month for the penis to take on a normal, healed appearance.
Appearance of the penis during healing
A common concern for parents is aesthetics. Remember that penises come in all shapes and 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. Furthermore, although the penis may appear smaller after circumcision, it is not! This appearance is mostly due to the relaxation of skin surrounding the penis, which prior to circumcision holds the penis more erect.
After a few days to a week, some parents notice swelling of the mucosal tissue behind or under the head of the penis and believe it looks like a blister. This type of swelling is normal. It is not a blister, and it will gradually subside.
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. The latter is sometimes caused by the presence of a hydrocele or penile erections. In nearly all these cases, the penis will heal properly, and, in time, take on a normal appearance. If you are concerned in anyway about the appearance of your son’s penis, please call to consult with us immediately.
Common Concerns After the Circumcision
Q: The gauze is very sticky and hard to pull off.
A: It is normal to use some force to pull off the gauze bandage. To make this easier, you can soak the gauze with warm water and Vaseline before pulling it off. In the end, you just may have to pull a little more firmly to get it off.
Q: When you take off the gauze, there is some bleeding.
A: A small amount of bleeding is normal. Take some gauze with Vaseline on it and gently squeeze the bleeding area of the penis with your fingers for two minutes.
Q: The entire Vaseline gauze around the penis falls off before 24 hours.
A: This is not important. Reapply a gauze pad with Vaseline and place it on the penis until the 24 hours is up. Then, just use Vaseline as instructed for about four days.
Q: There is stool on the gauze around the penis or on the penis after the gauze is removed.
A: Try to clean it as best as you can using soapy water and then rinse it.
Q: There is a piece of skin still attached to the head of the penis, or you can’t see the entire head of the penis.
A: If you are concerned, come back to have the baby examined.