Newborn Circumcision

Newborn and Infant 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 child 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 5-15 minutes. Your baby will be returned to you shortly thereafter. Care instructions are provided, usually standard, but they may vary by provider.

Aftercare

Normal hygiene using baby soap and water is usually recommended by all. Your child will urinate and stool onto the circumcision often. This does not necessarily increase the risk of infection and should not increase your anxiety about care. Cleaning the penis after circumcision is typically only for general hygiene. Further instructions may include applying petroleum jelly (Vasoline) or antibiotic ointment and gauze to the site. Some care providers stress sponge baths, while others approve normal submersion in baths.

Many institutions and care providers require that your child urinates after the procedure prior to discharge.  Gentle retraction of the shaft skin after the circumcision can be encouraged to avoid adhesions (foreskin sticking to the head of the penis Рsee Outcomes). However, this recommendation varies widely among providers, since adhesions will resolve over time on their own.

Typically, you will be encouraged to follow up with your child’s physician or care provider if further concerns arise regarding the circumcision. Rarely does the individual who performs the circumcision follow up and check on the site later.

Healing

Regardless of the technique used, your baby may have some swelling, redness, and slight bleeding. These are all normal healing responses in most cases. Because the penis has a considerable blood supply, the inflammatory response can be remarkable, but the likelihood of infection is very low. If a plastic ring (such as Plastibell) is used, temporary swelling around the ring is expected until it comes off, usually within 3-7 days. Local tenderness is also common. If it is significant, you should consider giving your child occasional infant acetaminophen if not contraindicated by your child’s health. Complete healing typically occurs 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. Again, because of the increased blood supply to the penis, it swells easily but improves quickly, with a low risk for infection or injury due to manipulation.

We are not providing medical advice; if you need advice, please consult with your child’s physician or care provider regarding personal concerns, risks, and outcomes.