How do you circumcise a newborn

Circumcision (for Parents) - Nemours KidsHealth

What Is Circumcision?

A hood of skin, called the foreskin, covers the head (or glans) of the penis. In circumcision, the foreskin is surgically removed, exposing the end of the penis.

Some families choose to circumcise based on cultural or religious beliefs. Others choose to for hygiene or appearance. And some choose not to circumcise. 

Most circumcisions are done during the first 10 days (often within the first 48 hours) of a baby's life. They're done either in the hospital by the pediatrician, family doctor, or obstetrician, or, for some religious ritual circumcisions, at home. The doctor will discuss the procedure and the possible risks with the baby's parents.

Premature babies or those who have special medical concerns may need extra time until they can be circumcised. Some babies are born with physical problems affecting the penis that will be fixed with surgery. They may not be circumcised because doctors use the foreskin as part of the reconstructive operation.

Sometimes, families decide to wait to circumcise so that they or their child can make the choice later. Circumcision after the newborn period usually is done in an operating room with the child getting general anesthesia, and comes with some additional risks.

What Are the Benefits of Circumcision?

Those who are circumcised have a lower likelihood of:

• getting HIV and other sexually transmitted diseases (STDs) when they are older
• developing urinary tract infections (UTIs), especially in the first year of life
• getting cancer of the penis, which is rare in those who are both circumcised and uncircumcised. It is not yet clear if the decreased risk is related to circumcision itself or differences in hygiene.
• developing irritation, inflammation, or infection of the penis, because it is easier to keep a circumcised penis clean

What Are the Risks of Circumcision?

Like any surgical procedure, circumcision has some risks. These are rare but include:

• bleeding, which is usually a small amount. Be sure to tell the doctor know about any bleeding disorders in the family, as these can cause more significant bleeding after a circumcision.
• infection, which is usually mild and easy to treat 
• more skin or less skin removed than planned
• scar tissue forming

Some people feel that circumcision may lessen the sensitivity of the tip of the penis, decreasing sexual pleasure later in life. This has not been proven in studies to date.

One known downside of circumcision is pain. In the past, it wasn't common to give pain relief to infants for a circumcision. But now pain medicine is recommended to help keep them comfortable. This can be a cream put on the penis beforehand, or medicine injected into the area to numb it for the circumcision. Both types wear off soon, so you can give acetaminophen to keep your baby comfortable after the procedure. Giving a pacifier dipped in sugar water and swaddling also can help babies be calmer and more comfortable.

How Do We Care for a Circumcised Penis?

Following circumcision, it is important to keep the area as clean as possible. Gently clean with warm water — do not use diaper wipes. Soapy water can be used if needed. The doctor may recommend only sponge baths until the area is healed. Newborns should only have sponge baths until their umbilical cord has fallen off.

If there is a dressing on the incision, apply a new one (with petroleum jelly) whenever you change a diaper for the first day or two. Even after the dressing is no longer needed, put a dab of petroleum jelly on the penis or on the front of the diaper until the penis is healed. This can help avoid discomfort from the penis rubbing on or sticking to the diaper.

If a plastic ring (called a plastibell) was used for the circumcision, it should be allowed to fall off on its own. This usually takes 5 to 10 days.

It usually takes between 7 to 10 days for a circumcised penis to heal. Initially the tip may appear slightly swollen and red, and you may notice a small amount of blood on the diaper. You also may notice a slight yellow discharge or crust after a couple of days. This is part of the normal healing process.

 If you notice any of these problems, call your doctor right away:

• lasting bleeding or blood on the diaper (more than quarter-sized)
• increasing redness
• fever
• other signs of infection, such as worsening swelling or discharge, or pus-filled blisters
• not peeing normally within 8 hours after the circumcision
• the plastic ring (plastibell) does not fall off after 10 days

How Do We Care for an Uncircumcised Penis?

As with a penis that's circumcised, an uncircumcised one should be kept clean. Also, no cotton swabs, astringent, or any special bath products are needed — just warm water every time you bathe your baby is enough.

Initially, do not pull back the foreskin to clean beneath it. Over time, the foreskin will retract on its own so that it can be pulled away easily from the glans toward the belly. This happens at different times for different boys, but most can retract the foreskin by the time they reach puberty.

As your son grows up, teach him to wash beneath the foreskin by gently pulling it back from the glans, rinsing the glans and the inside of the foreskin with warm water, then pulling the foreskin back over the head of his penis.

Circumcision of baby boys: Information for parents

Circumcision of baby boys is an optional surgical procedure to remove the layer of skin (called the foreskin or the prepuce) that covers the head (glans) of the penis. It is most often done during the first few days after birth.

The Canadian Paediatric Society does not recommend routine circumcision of every newborn boy.

Parents who decide to circumcise their newborn boys often do so for religious, social or cultural reasons. If you are trying to make a decision about circumcision, talk to your baby’s health care provider. Ask for up-to-date information about the potential medical benefits and risks of circumcision.

Potential benefits of circumcision

A few studies suggest that boys who have been circumcised may be:

• Less likely to develop cancer of the penis later in life – although this form of cancer is extremely rare.
• Less likely to get HIV and HPV infections.
• Less likely to get a urinary tract infection during childhood.

Female partners of men who have been circumcised are less likely to get cervical cancer.

Potential risks of circumcision

Circumcision is a painful procedure.

Problems resulting from the surgery are usually minor. Although serious complications are very rare, they do occur. These can include:

• Too much bleeding or infection in the area.
• Too much skin removed.
• Side effects from the method or medicine used for pain relief.

The risk of complications is lower in young babies than in older children. To minimize the risks, the procedure should be done by a trained and experienced practitioner using a sterile technique. Someone should follow up with you in the days after the procedure to make sure that bleeding has not increased.

Caring for an uncircumcised penis

The foreskin covers the head (glans) of a boy’s penis. During the early years of a boy’s life, the foreskin starts to separate from the glans, but may not be fully retractable (meaning it can be pulled back) until a boy is 3 to 5 years old, or even until after puberty. This is a natural process that occurs over time. You do not need to do anything to make it happen.

An uncircumcised penis is easy to keep clean and requires no special care:

• Keep your baby’s penis clean by gently washing the area during his bath. Do not try to pull back the foreskin. Never force it.
• When your son is old enough, teach him to keep his penis clean as you’re teaching him how to keep the rest of his body clean.
• When the foreskin separates, skin cells will be shed and new ones will develop to replace them. These dead skin cells will work their way down the penis through the tip of the foreskin and may look like white, cheesy lumps. These are called smegma. If you see them under the skin, you don’t need to force them out. Just wipe them away once they come out.
• When the foreskin is fully retractable, teach your son to wash underneath it each day.

If you decide to have your baby boy circumcised

In Canada, most circumcisions are done by medical practitioners or skilled traditional providers.

Talk to your baby’s health care provider about the issues involved in circumcision:

• Cost: Circumcisions for non-medical reasons are not covered by any provincial and territorial health plans.
• Possible complications, such as the ones described above.
• Pain relief:
  • Newborn babies feel pain. The practitioner performing the circumcision should use some type of local anesthetic, given by a needle in the area where the circumcision is done.
  • Additional methods of relieving pain include sucking on a pacifier dipped in a sugar solution, topical anesthetic cream and acetaminophen.
  • Anesthetics do carry risks and the needle can cause bruising or swelling. Creams may cause redness or swelling.
• Contraindications (a condition that makes a particular treatment or procedure not recommended): Sometimes, babies have health problems. which increase the risk of complications after circumcision.

Caring for a circumcised penis

• After the circumcision, you can comfort your baby by holding him and nursing him often.
• The penis will take 7 to 10 days to heal. The area may be red for a few days and you may see some yellow discharge, which should decrease as it heals. Talk to your baby’s health care provider about what to expect.
• Follow the instructions given by the practitioner who did the circumcision about caring for the dressing, using petroleum jelly, keeping the area clean and bathing.
• Call your health care provider if:
  • You see persistent bleeding at any time during the healing process.
  • The redness and swelling around the circumcision do not start to go down in 48 hours.
  • Your baby develops a fever (rectal temperature of 38.0° C or higher).
  • Your baby seems to be unwell.
  • Your baby does not pass urine within 12 hours of the procedure.
  • There is a greenish or foul smelling discharge from the penis. 

More information from the CPS

Reviewed by the following CPS committees

• Community Paediatrics Committee
• Fetus and Newborn Committee

Last updated: February 2021

Boy circumcision - answers to important questions

Many parents are interested in the topic of child circumcision. Some are sure of its necessity, others doubt its usefulness.

What is circumcision, why and at what age is it done for boys, how is it carried out and what is the care of the child after the procedure?

Circumcision, or circumcisio - surgical excision of the foreskin of the male penis. The operation can be performed on men at any age. nine0003

WHY DO CIRCUMCISO

Perform circumcision for medical or religious reasons.

Medical indications:

• Phimosis. With phimosis, the opening of the foreskin is narrowed, which makes it impossible to expose the glans penis. Symptoms of phimosis are swelling of the foreskin during urination, a weak stream and urinary retention, a tendency to inflammation and infections. nine0003

• Balanitis. In young boys, balanitis is often observed - inflammation of the glans penis and foreskin (balanoposthitis). The disease is characterized by redness and swelling of the foreskin, pain during urination, purulent discharge. A doctor may recommend circumcision if the condition recurs frequently.

HOW CIRCUMMION IS MADE

• The child is first anesthetized. Usually circumcision is performed under general anesthesia and local anesthesia is additionally used. nine0003

• The surgeon then removes the foreskin around the glans penis with a scalpel. In this case, a special clip is used to protect the head of the penis from accidental damage.

• Stop bleeding by suturing with absorbable sutures.

• Bandaging.

The whole procedure takes no more than 15-20 minutes.

As with any operation, circumcision is performed after examination and elimination of contraindications. For example, a child should not be circumcised if he was born prematurely or has malaise, problems with blood clotting.

HOW TO CARE FOR A CHILD AFTER A CIRCUCIUM

On the first day after surgery, the patient may experience some pain, restless sleep is possible. In this case, the doctor may prescribe pain medication for the child. nine0003

Swelling in the area of ​​the operation and slight bleeding after circumcision is normal. The swelling will completely disappear in 7-10 days, but the general well-being of a small patient will improve after 3-4 days.

During this time, you need to see a doctor. After removing the bandage, you need to be especially careful about hygiene.

WHO DOES THE CIRCUMISSION

In the EMC, the circumcision is performed by a pediatric surgeon or pediatric urologist. nine0003

WHAT ARE THE RISKS IN CIRCUCIATION

Complications after surgery, subject to the high professionalism of the doctor, are minimized, but not excluded.

Approximately 2 out of 100 children may experience minor bleeding after surgery. This problem is short term. You should immediately consult a doctor if the wound does not heal for a long time or the child has a fever.

SHOULD A CHILD 9 BE CIRCUMIDED?0015

Physicians' views on circumcision vary. Some consider circumcision as an important measure in the prevention of diseases and recommend it. Others see it as devoid of scientific justification and offer to perform only if it is due to religion.

Circumcision benefits:

• procedure reduces the risk of narrowing of the foreskin - phimosis;

• after the procedure, the hygiene of the penis is greatly simplified; nine0003

• A number of studies have shown that cancer of the foreskin and penis is more common in those who have not been circumcised.

In the case of a positive decision, the operation should only be performed by an experienced professional surgeon in a reliable, well-established clinic. EMC has all the conditions for safe circumcision even for the smallest patients.

WHY EMC

when, how and where is it better to do it? — Healer Medical Center

Boy circumcision is a traditional surgical operation in which the foreskin is excised and removed to expose the glans penis. Such an operation is within the competence of the urologist and surgeon. For example, among Muslims, the rite of circumcision is part of the religious norm, and in some cases this procedure is carried out in order to release the head of the penis in order to eliminate signs of the disease (phimosis). nine0003

Why is a child circumcised?

In Dagestan, the surgical operation of male circumcision is carried out mainly according to religious traditions, for hygienic reasons. However, it is not uncommon for doctors to prescribe and perform circumcision on male representatives strictly for medical reasons, that is, when such a need is caused by the presence of a disease. This, for example, can be:

• phimosis, in which an insufficient opening of the foreskin does not allow the head of the male genital organ to be completely exposed. Accordingly, in such cases, problems with urination often occur, as well as the risk of developing inflammatory processes; nine0026
• postitis - an inflammatory process of the foreskin, often accompanied by purulent discharge;
• balanoposthitis - inflammation of the foreskin and glans penis in males.

You should know that according to the research of medical scientists, circumcision is one of the medical procedures that significantly reduces the likelihood of cancer of the foreskin.

When is the best time to do it and why?

People often ask me, at what age is it better to have circumcision, how old should a child be? And I always answer that the sooner the circumcision is done, the better. In principle, of course, you can do it at any age. But preferably in the period from 10 days to 6 months, until the baby began to crawl, and even more so to walk and understand everything. And a child who eats breast milk is less sick. During the first 1.5 months, maternal antibodies are still present in his blood. They reliably protect against any diseases. That is, in this age period, the baby is under effective protection. nine0003

Moreover, the milk that the baby receives from the mother contains interferon. This is a protein that is synthesized by the cells of the child's body. It provides reliable protection of the baby's body from viral invasion from the outside. Therefore, circumcision of newborns by specialists is only welcome. The fact is that circumcision (circumcision) by breastfed babies is well tolerated. Mother's milk is also a good natural pain reliever and sedative, and is even often used by pediatric specialists during a surgical operation. nine0003

What are the other benefits of early circumcision?

Before the age of 1 month, the microflora has not yet fully formed in the child. To put it more clearly, in his body the pathogenic flora is present in small quantities. Therefore, a surgical operation to circumcise the foreskin is recommended before the baby is one month old. At this age, the infant is relatively sterile, and the risks of wound infections are very low.

From the position of a practicing surgeon who has considerable experience in working with young children, I would like to draw the attention of parents to another advantage of early circumcision - this is a relatively small throughput size of blood vessels. In a newborn, they are still very thin, and therefore surgical intervention does not threaten any serious bleeding. In addition, young children are characterized by little physical activity. They behave relatively calmly, do not disturb their body, due to which the wound heals faster. Infants differ from older ones and have higher regenerative abilities. nine0003

What are the methods of circumcision?

Pediatric specialists use a variety of surgical procedures for circumcision. The classical method of circumcision remains in demand, when an ordinary surgical scalpel and scissors are used. In recent years, the radio wave method of male circumcision is gaining more and more popularity.

Which option is still better and why?

With more than 35 years of practical surgical experience behind me, I can confidently say that today the radio wave method is considered the best. Currently, this modern method of surgical intervention is effectively used in our medical clinics "Healer" in Makhachkala. For these purposes, we use a modern American-made radio wave device "Surgitron", with the help of which our surgeons effectively perform male circumcision surgery for children and adults. nine0003

Why is the radio wave method preferred?

If we talk about the advantages of circumcision with a radio wave scalpel compared to the traditional method, then these are:

1. Less traumatic.
2. Accelerated wound healing.
3. The risk of blood loss is almost eliminated (not only for children who are very active physically, running and jumping, but also for older patients).
4. Powerful disinfection effect from the radio waves themselves. nine0026
5. There is no need for long-term supervision and care after surgery.

I think the most important advantage of the radio wave method is that the chance of bleeding decreases qualitatively and really tends to zero.

What are the contraindications for circumcision?

Despite the undeniable benefits of the procedure for men's health, circumcision is like a surgical procedure. still has some contraindications for medical reasons. There are situations when surgical intervention can cause significant harm to the health of the patient. In this case, it could be one of the following reasons:

• certain forms of cardiovascular disease;
• acute inflammation in the foreskin and head of the male genital organ;
• presence of purulent processes in the area of ​​operation;
• exacerbation of existing chronic diseases;
• a serious condition of a patient who needs constant monitoring.

In addition, surgeons may refuse to perform a circumcision if:

• insufficient blood clotting;
• birth defects and individual characteristics of the penis;
• diabetes mellitus;
• increased leukocytosis in urine;
• immunodeficiency, etc.

Where is the best place to have a male circumcision done in Makhachkala?

To sum up, I would like to strongly recommend all parents to circumcise the foreskin of boys as early as possible. The little man endures the operation much easier, there is no stress for him or his parents, the wound heals faster, at the same time, the likelihood of infectious complications is much lower. nine0003

Contact our medical clinic "Healer" in Makhachkala. The best pediatric surgeons work here, who will perform the circumcision of the foreskin of your child according to the canons of Islam without pain, tears and any complications.
At the request of the patient, the specialists of the Medical Center "Healer" can perform circumcision in children and adults in a traditional surgical way or with a laser. So the people call the procedure of circumcision using radio waves. As noted above, recently this technique has become very popular among our population. nine0003

Gadzhikuliev Nuri Babayevich, surgeon, urologist, specialist of the highest category, Excellence in Public Health of the Republic of Dagestan.

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