AFTER CARE

 

The Brit Milah ceremony is both an exciting and a stressful time for most families. Here are a few guidelines to help you care for the circumcision in the first few days after the Brit Milah ceremony. Please read this information sheet carefully, as it will answer most of the frequently asked questions that are generally asked and alert you to potential complications that can occasionally arise following the circumcision

Care of the circumcision is quite simple. Circumcisions generally heal by themselves.  The object of care is to keep the area of the surgery as clean and comfortable as possible until the tissue heals.

Guests must not be permitted in the baby’s room for the first twenty four hours after the circumcision.

Anybody coming into contact with the baby should wash their hands carefully with an antibacterial soap before coming near the baby.

It is extremely important to keep the penis and diaper area as clean as you normally would. Following large bowel movements baby may be given a sponge bath using a sponge or a soft clean cotton washcloth, with warm water mixed with a few drops of non-detergent and non-allergenic soap (such as Ivory, Dove or Johnson’s Baby Bath), wipe baby’s bottom carefully, then gently dry being careful not to touch the circumcised area. Continue to wash like this for a period of 10 days.

It is completely OK for the baby to urinate on the circumcised area, simply change the baby’s wet diaper when soaked it is not necessary to wash the baby after each time he urinates.

At every diaper change, apply a sterile 3″ x 3″ gauze pad with either Bacitracin, Neosporin or Triple Antibiotic Ointment to the tip of the penis to completely lubricate the tip so as to prevent the penis from sticking to the diaper. Spread the prescribed ointment on the gauze, and if necessary directly onto the penis.

Do not use creams or pastes like Desitin they have drying agents and do not lubricate well. Never use anesthetic creams (EMLA) after circumcision for pain relief. They can be extremely dangerous and are not necessary.

If gauze sticks to the wound, simply soak the baby’s bottom in a basin of warm water to easily remove then gently pat baby dry with clean towel.

Healing is usually quite rapid. You should remember that this is like any other cut and there are many factors that influence healing, but most importantly, every child heals differently.

First, the cut edges seal and bleeding ceases within minutes. Within twenty-four hours, the area behind the glans will become swollen this inflammation will subside within a week or two.

One or two days after the circumcision there may be an off-white or yellowish, patchy appearance on the glans. Since part of the circumcision is on a mucous membrane, a yellowish or off-white area may

 

form at the site of the cut. Do not touch or pick at them. These patches are a type of scab and are associated with normal healing this may be similar to what you see at the site of the umbilical cord insertion. This is not pus and does not represent infection, but is normal for the healing process and will eventually disappear by itself.

You will also notice that the glans is red and glossy. This is because the skin covering the glans of an uncircumcised penis is mucous membrane (like the skin inside your cheek). Once exposed, the mucous membrane will toughen (or keratinize) and in time take on a normal appearance (like the skin outside your cheek).

There may be a small amount of blood on the gauze. This is normal. If there is a flow of blood, apply pressure to area for five complete minutes timed on a clock do not let up on pressure to check if it is working . If the bleeding persists, call your pediatrician or the Mohel.

There will be some redness and swelling at the area of the circumcision for a few days. This is normal. If the swelling extends down the shaft and onto the abdominal wall you should call your physician or the Mohel. Infection is extremely rare after circumcision.

Generally the penis should take on a ‘normal, healed appearance’ in about a month. On occasion, a poor aesthetic result may occur when too little or too much skin is removed or more likely when the cut edge of the skin attaches too high or too low along the length of the penis. In nearly all cases the penis will heal properly and in time take on a normal appearance.

During the first 24 hours after circumcision it is normal for the baby to be somewhat irritable. Try to keep him as comfortable as possible. It is OK for him to lie on his stomach, back, or side and the penis may remain in any position.

Feed your baby as usual, but do not get startled if he doesn’t have much of an appetite the first twenty four hours following the procedure. He may sleep more or less than usual. However generally by two cycles of eating and sleeping, he will be back to his usual behavior, and definitely by 24 hours afterwards. During feeding, keep the baby in a flat position. Do not sit him up, even to burp. Burp him on your shoulder.

Recovery can be delayed if your son is over stimulated by an abundance of visitors and passing him around from person to person less stimulation is better

Do not attempt to take off the dressing from the Brit until after the Mohel directs you to do so. The Mohel will call you with detailed instructions on how to remove the dressing from around the penis. After the dressing is removed, or in the event that it fell off by itself continue applying the gauze pad with the ointment for another 48 hours.

Please feel free to contact the Mohel or your pediatrician at any time with any questions you may have. 

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