Is this your child’s symptom?
- Recent circumcision (removal of the male foreskin)
- Mainly circumcision of newborns
Normal Circumcision Healing
- A circumcision is the removal of most of the male foreskin.
- The incision starts off red and tender. The tenderness should be much less by day 3.
- The scab at the incision line comes off in 7 to 10 days.
- If a Plastibell (plastic ring) was used, it should fall off by 14 days. 10 days is the average. While it can’t fall off too early, pulling it off can cause bleeding.
Complications of Circumcision
- Wound Infection (Serious). This is the most common complication. It occurs in less than 1 out of 200 circumcised boys. The main finding is spreading redness up the shaft of the penis.
- Bleeding (Serious). Normal bleeding from the incision site should be a few drops. More than that suggests a bleeding problem. Very rare.
- Urine Retention (Serious). Can’t pass urine or just dribbles urine. Defined as no urine in 8 hours. Very rare.
When to Call for Circumcision Problems
Call 911 Now
- Large blood loss and baby is pale or cold
- Not moving or very weak
- You think your child has a life-threatening emergency
Call Doctor or Seek Care Now
- Age less than 1 month old and looks or acts abnormal in any way
- Bleeding is more than a few drops
- Head of penis is dark blue or black
- Severe swelling of penis
- Can’t pass urine or can only pass a few drops
- No urine for more than 8 hours
- Crying and your child can’t be comforted after trying this advice for more than 2 hours
- Age less than 12 weeks old with fever. Caution: do NOT give your baby any fever medicine before being seen.
- Looks infected (redness is spreading or pimples occur)
- Tiny water blisters occur on skin
- Plastic ring has moved on to shaft of penis
- Your child looks or acts very sick
- You think your child needs to be seen, and the problem is urgent
Contact Doctor Within 24 Hours
- Bleeding is a few drops, but happens 3 or more times
- Swelling (without redness) gets larger after day 3
- You think your child needs to be seen, but the problem is not urgent
Contact Doctor During Office Hours
- Plastic ring stays on more than 14 days
- Penis looks well-healed but not normal to you. (It looks strange or has an extra tag of skin.)
- You have other questions or concerns
Self Care at Home
- Normal circumcision
Care Advice for Circumcisions
- What You Should Know About Circumcisions:
- The tip (head) of the penis can be red after the foreskin is removed. This is normal.
- The rest of the penis should not be red.
- The penis will be swollen for a few days. There may be some bruises or dried blood on it.
- Most circumcisions heal quickly.
- Infections are rare.
- Here is some care advice that should help.
- Plastic Ring Type Circ:
- Gently wash the area with warm water twice a day.
- Also, do this if it becomes dirty with poop.
- Incision (No Plastic Ring is Present) Type Circ:
- The dressing is gauze with petroleum jelly. Take this off 24 hours later. Sometimes, it will fall off on its own. If you need to remove it, use a warm wet washcloth.
- Gently wash the area with warm water twice a day. Also, do this if it becomes dirty with poop.
- Ointment for Pain:
- Put a layer of ointment on the incision line. This should lessen any pain and crying.
- To prevent pain, use petroleum jelly (such as Vaseline). Put it on the incision line and head of the penis. Do this after each cleansing for the first 4 days. Other option: You can also use an antibiotic ointment (such as Polysporin). No prescription is needed.
- Reason: Helps keep it soft and stops the diaper from sticking during healing.
- Crying – Don’t Give Pain Meds:
- Circumcisions are usually not that painful.
- Covering the wound with an ointment often is all that is needed.
- Do not give pain medicine (such as Tylenol).
- If your baby is crying a lot, he may need to be seen. Call your doctor if you think your baby is in pain.
- Your baby’s doctor will decide if pain meds are needed.
- Bleeding – How to Stop:
- The circumcision wound can normally bleed a few drops. Most often, this is caused by the diaper rubbing on the wound.
- Will stop on its own or with a few minutes of direct pressure.
- Can stop bleeding by keeping the area soft with an ointment.
- What to Expect For A Plastic Ring:
- The plastic ring will normally fall off between 7 and 14 days (average 10).
- It often hangs by a small piece of tissue for a few days.
- It will come off on its own.
- Pulling it off can cause bleeding.
- It can’t fall off too early.
- Prevent Infections:
- Fasten the diaper loosely to prevent friction against the penis.
- Avoid tub baths for 7 days after the circ. Just clean the penis with a wet cloth.
- If the cord is still on, wait longer. Avoid tub baths until 2 days after cord falls off.
- Call Your Doctor If:
- Looks infected
- Bleeding occurs
- Plastic ring moves onto shaft of the penis
- Plastic ring does not fall off by day 14
- You think your child needs to be seen
- Your child becomes worse
And remember, contact your doctor if your child develops any of the ‘Call Your Doctor’ symptoms.
Disclaimer: this health information is for educational purposes only. You, the reader, assume full responsibility for how you choose to use it.
Copyright 2000-2020. Schmitt Pediatric Guidelines LLC.