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Newborn Circumcision

by Editorial Staff and Contributors

Definition

Reasons for Procedure

Possible Complications

What to Expect

Call Your Doctor

En Español

Definition

Circumcision is the surgical removal of the foreskin. The foreskin is a flap of skin that covers the tip of the penis.

Circumcision

Reasons for Procedure TOP

The procedure may be done for cultural or religious reasons. It is often done on babies in the first few days of life.

There may be some health benefits for circumcision. Many health professionals believe these benefits are small. Circumcision may be associated with a decreased risk of:

Urinary tract infection
Phimosis—tightening of the foreskin
Penile cancer
Certain sexually transmitted diseases, like HIV
Cervical cancer in female partners

Possible Complications TOP

Problems from the procedure are rare, but all procedures have some risk. Your doctor will review potential problems, like:

Infection
Bleeding
Reaction to drugs used for anesthesia
You may not be happy with the appearance of penis after circumcision
Decreased penile sensation
Damage to the tip of the penis

Factors that may increase the risk of complications include:

Bleeding disorders
Family history of bleeding disorders
Birth mothers taking blood thinners during pregnancy
Penile deformities requiring repair procedures
Prematurity
Infections or serious jaundice at the time of the circumcision

What to Expect TOP

Prior to Procedure

The doctor will carefully examine your baby. This is to make sure your baby is in good health. The penis will be examined for any abnormalities.
Blood and/or urine tests may be done.
Your baby may be given a pacifier to suck on. The pacifier will have some sugar water on it. This has been shown to decrease pain in infants.

Anesthesia

The type of anesthesia may depend on where the circumcision is done. There are 2 common approaches:

Cream—A cream may be applied to the penis. This cream will help to numb the area. It is often done about 60-90 minutes before the circumcision.
Nerve block—This is a medication injected near the penis. The medication will block the nerve that runs to the penis. This will make the entire penis numb. It may be used in a hospital setting.

Description of the Procedure TOP

The baby will need to be very still during the circumcision. The baby may be carefully restrained on an infant board or someone will hold the baby. The anesthesia will be applied.

Once the area is numb the procedure will begin. The foreskin will be pulled away from the penis. Some parts of the foreskin may still be attached to the penis. The doctor will sweep these attachments away. The extra foreskin will then be cut away. It can be removed with a scalpel or special clamp.

Stitches may be needed. They will be used to sew the remaining bit of foreskin into place. Petroleum jelly or an antibiotic ointment will be smeared on the penis. A bandage may be applied. A Plastibell device, if used, will be left in place instead of a bandage. The Plastibell will fall off on its own.

How Long Will It Take? TOP

About 15–30 minutes

Will It Hurt? TOP

Anesthesia prevents pain during the procedure.

Post-procedure Care TOP

Swelling and scabbing is normal, but the circumcision site should heal in about 10 days. The Plastibell should fall off on its own within this time frame.

Home care will include:

Changing the bandage and cleaning the area at every diaper change.
Applying petroleum jelly or an antibiotic ointment to the area to keep the diaper or bandage from sticking to the penis.

Call Your Doctor TOP

It is important for you to monitor your baby's recovery after you leave the hospital. Alert your baby's doctor to any problems right away. If any of the following occur, call your baby's doctor:

You find a bloodstain larger than the size of a quarter on the baby's diaper
The Plastibell device has not fallen off within 10 days
The penis or the area of the incision appears red, swollen, hot to the touch, or is oozing a yellowish discharge
The baby develops a fever or appears to be in pain
The baby does not have a wet diaper within 6–8 hours of the procedure
The head of the penis appears blue or black

If you think you have an emergency, call for emergency medical services right away.

RESOURCES:

Family Doctor—American Academy of Family Physicians
https://familydoctor.org

Kids Health—Nemours Foundation
http://kidshealth.org

CANADIAN RESOURCES:

About Kids Health—The Hospital for Sick Children
http://www.aboutkidshealth.ca

Caring for Kids—Canadian Paediatric Society
http://www.caringforkids.cps.ca

References:

Circumcision. Family Doctor—American Academy of Family Physicians website. Available at: https://familydoctor.org/circumcision. Updated November 2016. Accessed May 18, 2017.

American Academy of Pediatrics Task Force on Circumcision. Circumcision policy statement. Pediatrics.2012;130(3):585-586.

Brady-Fryer B, Wiebe N, Lander JA. Pain relief for neonatal circumcision. Cochrane Database Syst Rev. 2004;18(4):CD004217.

Circumcision. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T115571/Circumcision. Updated May 23, 2016. Accessed May 18, 2017.

Circumcision. Healthy Children—American Academy of Pediatrics website. Available at:
...(Click grey area to select URL)
Updated November 21, 2015. Accessed May 18, 2017.

Circumcision. Kids Health—Nemours Foundation website. Available at:
...(Click grey area to select URL)
Updated June 2016. Accessed May 18, 2017.

Leef KH. Evidence-based review of oral sucrose administration to decrease the pain response in newborn infants. Neonatal Network. 2006; 25(4):275-284.

Last reviewed May 2017 by Kari Kassir, MD
Last Updated: 9/30/2013

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