Newborn circumcision: Caring for your child at home after the procedure

Your child has had a circumcision​. It is important to know how to care for your child at home after the procedure and when to call for help.

Circumcision

Circumcision involves removing the foreskin that covers the glans, or head of the penis.

What to expect as your child heals after a circumcision

Once your child is circumcised, the surgeon will apply a lubricant gauze dressing to the area. The lubricant helps to prevent the dressing from sticking to the glans. The gauze usually falls off on its own within 24 hours.

Over the following days, your child will heal from the surgery in stages. Every child heals differently; it can take up to a month for the penis to appear fully healed.

Bleeding

Within minutes, hours or an entire day, the cut edges of the glans close up and bleeding stops.

​Colour changes

​Immediately after the circumcision, the glans may appear red and glossy or even purple. This occurs because the skin covering the glans of an uncircumcised penis is a mucous membrane. Once the membrane is exposed, it thickens and becomes darker.

Your child’s glans may have off-white or yellowish patches in the first few days after surgery. These are a type of scab and are completely normal. Two or three days after the circumcision, the skin may look green and yellow. This is a sign of normal healing, not pus.

Swelling

You may notice some swelling behind or under the head of the penis and believe it looks like a blister. The swelling is simply another sign of healing and will disappear within a week or two.

​Changes in size

​The penis may appear smaller after circumcision. This is mostly because the skin surrounding the penis is relaxed, while before circumcision it usually held the penis more erect.

How to care for your child after a circumcision

Check for bleeding

Blood staining of the diaper is common after circumcision. During the first 24 hours, check your child’s diaper at every diaper change for active bleeding. It is normal to see spots of blood no bigger than a two-dollar coin (about an inch wide), but you should see a doctor if there is more blood.

Ease swelling

Point your infant’s penis up in his diaper to ease any swelling of the area behind the glans.

Bathe your child frequently

After circumcision, your infant should have a warm bath every day for one week. You can allow the lubricant gauze to come off by itself, unless you are instructed to remove it. If the gauze does not fall off on its own within 24 hours, soak it off in the bath.

When the gauze comes off, it is normal for the penis to be discoloured with drops of blood and pieces of skin at its tip.

Prevent skin sticking

Gently push back the edges of the penile skin from the glans after the first two weeks of healing. This will prevent the skin from sticking to the glans as healing continues.

Apply a barrier ointment

Apply a topical barrier ointment (such as petroleum jelly) on the end of the penis after every bath and with each diaper change until the penis has healed completely. A topical barrier prevents the penis from sticking to the diaper.

Give pain relief if needed

Infants may be fussy and in pain for some hours after a circumcision, but this usually does not last more than a couple of days.

Signs of pain can include crying and problems with sleep and feeding. During the first 24 hours after circumcision, you may give acetaminophen regularly to manage your child’s pain. Be aware of how much acetaminophen your child has received in the hospital.

When to see a doctor after a circumcision

Go to the nearest emergency department (ED) right away if your child has excessive bleeding (small pools of blood or spots larger than a two-dollar coin on the diaper). To help slow down any bleeding before you go the ED, use your thumb and index finger to create a ring around the top of the penis and squeeze for five minutes.

Also go to the nearest emergency department if your child has:

  • redness of the skin spreading to abdomen and legs
  • fever
  • poor feeding and/ or vomiting
  • yellow liquid draining from the incision
  • difficulty with urinating (peeing) after circumcision, for example if diapers are less wet than usual.

​Key points

  • ​Leave your infant’s dressing (lubricant gauze) on for 24 hours after the circumcision.
  • While your child is healing, apply a petroleum-based ointment (such as Vaseline) to the end of the penis after every bath and with each diaper change.
  • Give your child acetaminophen for pain as instructed.
  • Go to the nearest emergency department if your child has excessive bleeding, fever, worsening redness or swelling, yellow liquid draining from the incision or difficulty with urinating.

At SickKids

The Urology Clinic is at 555 University Avenue, the Atrium, Fifth Floor, Unit D. Use the Atrium elevators (near the cafeteria), exit at the 5th floor and look for the unit D. Working hours are 8.30 am to 4.30 pm, Monday to Friday.​

If your child is healing normally, he does not need a follow-up visit with the Urology clinic. You can follow up with your family doctor or paediatrician within a week of the circumcision.

If you have any concerns, however, you can call the Urology clinic during working hours at (416) 813-6661 and ask to speak to a Urology nurse. If you have concerns after working hours, see your family doctor or go to the nearest emergency department. If you need to leave a message with the clinic, you can expect a call back within 24 hours.

​​

Dalia Bozic MN, RN(EC), NP-PHC​

Joana Dos Santos, MD

6/10/2016
 




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