One of the first questions your pediatrician may ask after your son’s birth is whether you plan to have him circumcised. It’s a relatively common surgical procedure where your baby’s foreskin -- the hood of skin that covers the head of his penis -- is removed. If a baby is going to have the surgery, it’s usually done before he leaves the hospital, 2 or 3 days after birth. If you’re considering it, here’s what you need to know.
What Is It?
The foreskin of the penis covers the glans, or head, of the penis. By cutting it off, the surgery exposes the end of the penis.
The practice of circumcision dates back to ancient Egypt. It was believed to help males keep the area clean. While that’s true, circumcisions today are done mainly for religious or cultural reasons. In the U.S., about 55% of newborns are circumcised shortly after birth. Others have the surgery later, but some never have it.
Preparing for Circumcision
If you want to circumcise your baby, talk it over with the doctor who will do the procedure. That can be a pediatrician, family doctor, urologist, neonatologist, or even a pediatric surgeon.
While most babies can be circumcised within 2 days after birth, you may need to wait if your baby is premature, born with a problem to his penis, or has bleeding problems or his family has a history of them.
Your doctor will explain the risks and benefits of the surgery. This is your chance to ask any questions you have about the procedure. Once you’re satisfied, you’ll sign an informed consent form giving your permission for the surgery.
What Happens During Circumcision
If the procedure happens when your son is a newborn, he’ll be awake during his circumcision. It most likely will happen in the hospital. He’ll be placed on his back, with Velcro bands or other restraints used to keep his arms and legs still.
The doctor will clean the penis area with antiseptic, then inject an anesthetic to the base of the penis to ease the pain. Sometimes doctors apply the pain reliever as a cream instead. Your doctor will also recommend swaddling him after the procedure by wrapping him up tightly with a blanket or having him suck on a pacifier dipped in sugar water. Your baby also may be given acetaminophen for pain.
Three different kinds of clamps or plastic rings are used for circumcision: the Gomco clamp, the Plastibell device, and the Mogen clamp. But the procedure is similar for all. The clamp or ring is attached to the penis and the doctor clips off excess foreskin. The ring stays on and will fall off later. The doctor then applies an ointment like petroleum jelly to the penis and wraps it in gauze. It’s usually over in about 10 minutes. If it’s done in the hospital, your baby should be ready to go home in a few hours.
What to Expect Afterwards
After his circumcision, your baby may be fussy and irritable. Hold him carefully so you don’t put pressure on his penis. The tip may be sore, and the penis itself may look red and swollen. You may see a yellow crust on the tip as well. This is normal and should go away on its own in a few days. It will take a week to 10 days for your son’s penis to heal completely.
It’s fine to wash his penis as it heals. You should change his bandage with each diaper change, applying a dab of petroleum jelly first so it doesn’t stick to his diaper. Around 48 hours after the procedure, the bandage is usually not put back on once it comes off. Lubricant, though, should still be used to keep the penis from sticking to the diaper. If stool gets on his penis, gently wipe it away with warm, soapy water. To ward off infection, change his diaper often and fasten it loosely.
When to Call Your Doctor
Most of the time, babies recover from circumcision without problems. Only about 1% have complications. Contact your doctor if:
- Your baby doesn’t pee within 12 hours of the circumcision.
- You see blood on his diaper larger than the size of a quarter.
- Redness or swelling around his penis gets worse, not better.
- You see signs of infection, like pus.
- Foul smelling, cloudy drainage comes from the tip of his penis.
- The plastic ring used during circumcision hasn’t fallen off after 2 weeks.