Post-Circumcision Advice:

GUIDELINES

Short-Term Care:

  1. Please read and follow all instructions. Prepare for a fussy baby. Primary healing time is 24 - 48 hours.
  2. There are risks, benefits and alternatives to this or any other surgical procedure. They are bleeding, infection, changes in appearance and sensitivity and/or damage. Cosmetic results will vary from child to child and cannot be guaranteed (i.e. adhesions, scar tissue, curvature, asymmetry, unevenness etc.)
  3. There may be some swelling or puffiness. It may occur on one side (often the right side) or both, on the underside where the skin was bunched together or if there is scar tissue. Over time, this will decrease and become cosmetically less significant. Bear in mind that skin is elastic and the penis is not a perfect circle; there may be some unevenness. This is normal.
  4. After each diaper change, apply a sterile gauze pad treated with a healthy amount of ointment for 3-5 days. If the gauze pad sticks, leave it alone until it comes off by itself. Put the new gauze pad with ointment on top of the old one, and after a few diaper changes, both should come off. If the gauze pad is still stuck, you may soak the baby in a shallow tub of warm water (ten to fifteen minutes) to remove it. It may take several soakings until the gauze pad comes off.
  5. Any bleeding will stain the gauze pad and the diaper. The size and intensity of the stain will decrease after each diaper change. If bleeding persists, page me immediately and apply direct pressure with a sterile gauze pad for 15 – 20 minutes. This should stop the bleeding. If you are unable to reach me, call your pediatrician.
  6. If there is a bandage (which is not the same as the gauze pad--the gauze pad covers the bandaged penis), the pediatrician, nurse or the parents should remove it after 24 hours. If it comes off by itself at anytime—great; if you accidentally remove it, don't worry. If the bandage unravels, you may re-wrap it. If the bandage sticks, soak the baby in a shallow tub of warm water (ten to fifteen minutes) to remove it. (It may take a few soakings.) After the bandage comes off, continue to apply gauze pad with ointment for a few more days. Your baby should have a wet diaper within a few hours of the circumcision.
  7. If there is no bandage (not to be confused with the gauze pad), no follow-up visit is needed. Parents may wish to schedule the first pediatrician’s visit within a week of the circumcision. A follow-up visit by the mohel may be requested at any time. Most pre- and post-circumcision questions can be addressed by emailing one or two digital photos of the area in question. There is a $150.00 charge for a separate follow-up in-home visit. Email me immediately if there is any question about the healing.
  8. Following the circumcision, resume the baby's regular routine and treat him normally.
  9. Sponge bathe the baby until the penis is healed. When the area is sufficiently healed (about one week after the bris) you may bathe the baby (assuming the umbilical cord is healed, as well). The swelling and redness may take several weeks to subside.

Longer-Term Care

No further bandaging is necessary. One may continue to apply ointment as needed to enhance further healing. Each child is unique and the techniques of performing circumcisions vary. Cosmetic results will vary from child to child and cannot be guaranteed (i.e. adhesions, scar tissue, curvature, asymmetry, unevenness, etc.) Siblings or twins may not look the same even if the bris was done with the same technique or by the same mohel. During the healing process, the head (glans and corona) should remain completely revealed. The following may occur during the healing process:

  1. The redness and swelling may last several weeks.
  2. Sometimes a whitish or yellowish waxy-like coating (granulation) will occur on some babies. This is normal and part of the healing process; it is not an infection.
  3. During the healing process, the tip of the penis may turn a bluish/purple color or
  4. A blister may develop along the circumcision line—this, too, is normal. Technically it is displaced lymphatic fluid usually due to friction against the diaper.
  5. After a few days, the skin can separate causing a blood spot. This is normal and is usually a one time event.

For babies who gain a lot of weight quickly, if the weight is located in the thighs and/or abdominal areas, the fat may cause the head of the penis to retract completely. Slide or gently push the skin back and apply ointment to avoid adhesions. This may need to be done for many months in order to prevent adhesions. If there is any question about the healing process or appearance of the circumcision site, DO NOT WAIT—email me immediately at cantorsherman@gmail.com. You may email me one or two digital pictures of the area or arrangements will be made to see the baby.

 

Some General Guidelines

  1. Once again—please read and follow all instructions.
  2. In the event of an emergency, email me immediately at cantorsherman@gmail.com. If I don't get back to you right away, please call your pediatrician.
  3. If a question or emergency arises on Friday night or Saturday (Shabbat) or a Jewish holiday, you will not be able to reach me. Please call your pediatrician immediately. After the Shabbat or holiday has concluded, please call to apprise me of the situation. If I am unavailable at any other time and you need assistance, please call your pediatrician.