Circumcision Care and Caring for an Uncircumcised Penis

A choice for each family

• The AAP's most recent policy statement found that the health benefits of newborn circumcision outweigh the small risks but are were not large enough to recommend it for every baby. Families decide based on their own values, religion, culture and medical advice. Both choices are normal and common.
• Many families have the procedure done by a religious practitioner, sometimes days or weeks after birth. The aftercare below applies either way; follow the instructions you were given.

After a circumcision: the first 7-10 days

• The tip will look red and raw at first. Within a day or two a soft yellowish or white film often forms. That is normal healing tissue, not pus. Don't scrub it off.
• With each diaper change, put a dab of petroleum jelly on the tip, or on a gauze square placed over it, so it doesn't stick to the diaper.
• Clean gently with warm water. Mild soap only if there is stool on it. Pat dry.
• Fasten the diaper a little looser for a few days.
• A few drops of blood on the diaper in the first day are common.
• If a plastic ring was used, leave it alone. It usually falls off on its own in about 5-8 days.
• Sponge baths until it heals, which also suits a baby whose cord stump is still on.
• Healing is usually complete in 7-10 days.

After healing

• Wash during the bath like any other skin. No special care.
• Sometimes a little skin re-attaches to the head of the penis (adhesions). Gently easing the skin back during baths, once fully healed, can help prevent this. Ask at a checkup if you notice it.

Uncircumcised care: leave the foreskin alone

• At birth the foreskin is attached to the head of the penis and is not meant to pull back.
• Wash the outside with water during baths. Don't retract it, and don't use cotton swabs or cleaners underneath.
• The foreskin separates on its own over years. Some boys can retract it by age 5, many not until the teen years. All of that is normal.
• Small white lumps under the skin (smegma) are shed skin cells working their way out. Leave them.
• Once it retracts easily on its own, teach your child to slide it back, rinse, and always slide it forward again.
• Forcing it back can cause pain, bleeding and scarring.

Common mistakes

• Wiping off the yellow healing film.
• Pulling back a newborn's foreskin to clean it, sometimes because a relative suggests it.
• Using wipes with fragrance or alcohol on a healing circumcision.

When to check in

• Mention at a checkup if the circumcision looks uneven, skin seems stuck to the head, or the foreskin balloons a lot when your child pees.
• Contact the pediatrician the same day for bleeding that is more than a few drops, spreading redness, swelling, foul smell, fever, or no wet diaper within about 12 hours after the procedure.
• If a retracted foreskin is stuck behind the head of the penis and the tip is swelling, go to the emergency department.