Newborn and Infant Circumcision
Circumcision is the removal of the tissue called the foreskin that covers the tip of the penis. There are several different techniques in common practice for circumcision.
Newborn and infant circumcision is usually performed in the hospital shortly after delivery. In the United States, circumcisions are performed most commonly by pediatricians, OB/GYN physicians, and family practitioners or their advanced care providers (nurse practitioners, physician’s assistants, and physicians in training).
Most newborn circumcisions are performed using sterile equipment while your baby is gently restrained on a procedure or restraint board. Local anesthesia (topical cream and/or injection) is typically provided to minimize discomfort for your child during the procedure. The procedure should take from 5 to 15 minutes, and your baby will be returned to you shortly afterwards.
Your provider will give you important care instructions to follow after the procedure. While the details may vary, in general, practitioners recommend normal washing using baby soap and water. Your baby will urinate and stool onto the circumcision often. This does not necessarily increase the risk of infection, and you shouldn’t worry about it. Cleaning the penis after circumcision is typically done only for general hygiene. You may be instructed to apply petroleum jelly (Vasoline) or antibiotic ointment and loose gauze to the site. Some care providers stress sponge baths, while others approve normal submersion in a bath.
Many institutions and care providers require that your baby urinates after the procedure before being discharged. After circumcision, you may be asked to gently retract the shaft skin from the site. This is to avoid adhesions (foreskin sticking to the head of the penis – see Outcomes). However, this recommendation varies widely among providers, since adhesions will resolve on their own over time.
Typically, you will be encouraged to follow up with your baby’s physician or care provider if you have any other concerns after circumcision. It is rare to have direct follow-up with the practitioner who actually performs the procedure (unless it’s your family doctor).
Regardless of the technique used, there may be some swelling, redness, and slight bleeding at the site. These are all normal healing responses in most cases. Because the penis has a considerable blood supply, swelling and redness can be remarkable. However, the likelihood of infection is very low. If a plastic ring (such as Plastibell) is used, expect temporary swelling around the ring until it comes off, usually within 3-7 days. The site may be tender, too. If it is significant, you should consider giving your baby occasional infant acetaminophen if your doctor or care provider approves. Complete healing usually happens in a few days or up to 2 weeks.
The newborn or infant penis is typically very resilient to manipulation and procedures. As a parent, you should not be afraid to clean or manipulate it to provide care or inspection. With a routine procedure and good aftercare, you can expect a fairly speedy recovery for your baby.