Baby Care After CircumcisionMarwan Nasr2020-05-29T10:53:22-04:00
We understand that parents will have concerns and questions in the days after a baby boy’s circumcision. The staff in our Vancouver clinics is here to help.
Please see the detail below for information on how to care for your baby post-circumcision, and do not hesitate to contact us with any concerns that you feel require our doctor’s attention.
How to care for your son in the first 24 hours following the circumcision:
Keep your son snugly swaddled (especially his legs). The more he kicks his legs, the less comfortable he may be.
This image shows initial application of the gauze with Vaseline. Replace it if it falls of in the first 24 hours.
There will be a square white gauze with Vaseline placed over the head of your son’s penis.Leave the gauze in place and remove it only after 24 hours. If it has fallen off, just replace it with a fresh 3×3 gauze with some Vaseline on it and put it over the penis then close the diaper.
Please check your son’s diaper every hour for the next 24 hours to look for any abnormal bleeding.
If the white gauze is soiled with urine or stool don’t worry just leave it alone. You may rinse his bum with warm water or use wipes on the bum, just not the penis.
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.
It is normal for your son to be a little irritable for the first 24 hours following the circumcision.
General care following the circumcision:
For the following weeks after circumcision, put a generous amount of Vaseline on your finger and rub it over the incision site placing a thick layer of ointment over the entire head of the penis.
Here you see a part of the mucosa attaching to the head of the penis. This is an example of mucosal adhesion that requires a simple adjustment by our doctors.
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. It is important to avoid mucosal adherence (see image) and/or skin bridging which results from the mucosa and/or skin respectively attaching to the head of the penis. If you are unsure of the appearance of your son’s penis, bring him to see our doctor, and we will adjust the skin for you if required.
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.
Most babies sleep quite well following the circumcision. The best sleeping position for your baby is on his side, supported by a blanket roll.
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 towelettes, alcohol, powders, and lotion since these may cause irritation. Don’t give your son a bath before the doctor has said that it is ok to do so (generally after 3 – 4 days).
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.
It is better both before and 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.
For your peace of mind, our doctors are available 24 hours a day on their personal cell phone. All clients are given contact information so they can reach our doctors directly 24/7 should any concerns arise.
Although the circumcision takes under 1 minute, you will be at the clinic for about one hour and fifteen minutes in total so that we can carefully review with you all post procedure care and answer any of your questions.
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 took 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.
You will notice yellow patches on the head of the penis as it heals. This is not infection and is in fact a normal part of healing
You will notice the head of the penis can often be purple, blue or red. This is all normal.
Circumcision Scar? – Appearance of the Baby’s Penis
.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. For example, there may be more mucosal tissue on one side compared to the other; this is a normal anatomical variation after circumcision that will resolve with time after your son grows older.
You will notice a mucosal ring at the base of the penis head. Sometimes it is more prominent on one side than the other. This is normal and no cause for concern.
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 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 one of our doctors immediately.
Frenulum – Band of skin underneath the penis
Sometimes parents come to us worried about a band on the bottom of the penis fearing that it needs to be cut. This band is called the frenulum which carries the frenular artery and is normal (see image). It is similar to the band under the tongue (the part that is cut in some babies with tongue-tie).
You may notice a band on the bottom of the penis after circumcision. This is normal and no reason for concern
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.