Compassionate Newborn Circumcision Services at The Bercier Clinic

Preparing for the procedure

• Please give your newborn Tylenol or Tempra one hour prior to the appointment. Recommended dosage of either drug is 15 mg per kilogram of your newborn’s body weight (15 mg/kg of body weight).
• NOTE: If there is an acetaminophen shortage, it is acceptable to give ibuprophen as a last resort. The dose is 10mg/kg, every 8 hours, for a maximum of 48 hours, as needed if your child seems in pain.
• Do not give your child any other medications such as aspirin, as they may increase bleeding.
• Arrive at Dr. Bercier’s clinic with your child 15 minutes before the scheduled procedure.

Operation

• The analgesia procedure involves a dorsal penile block. We inject a solution of 1% lidocaine with the smallest needle possible.
• The circumcision takes place 5 minutes later. You are welcome to stay in or leave the room.
• Throughout the circumcision and the injection, which will be done within a few minutes, your son will receive a sugar solution to suck on to further alleviate any discomfort.
• Following the operation, we will show you how to take care of your son’s penis.

Recovery

A Vaseline-soaked gauze will be placed over the head of your son’s penis. Leave it in place for a full day.  You can remove it 24 hours later during the first bath. If the gauze falls off, replace it with a fresh Vaseline-soaked gauze, put it over the penis, and close the diaper.

If your baby still feels discomfort from the circumcision, give extra doses of Tempra, Tylenol or acetaminophen every four hours as needed.

If the white gauze is soiled with urine, there is no need to replace it. However, if it is soiled with stool, remove the gauze, rinse the buttock area with warm water, and apply a new Vaseline-soaked gauze. Use disposable diapers for the first week, as they cause less irritation and help keep the area drier and cleaner. There will undoubtedly be penis discolouration and light blood stains on the gauze and diaper during each diaper change. A yellowish membrane around the penis is part of the healing process*.

Post-circumcision Instructions

• Examine your son’s diaper every hour for the rest of the day to find signs of any new blood. Minimal amounts of blood are normal, but active bleeding is not. Active bleeding is rare, but when it occurs, the most common causes include overly aggressive cleanings, insufficient Vaseline applications, or too much pressure at the base of the penis for retraction. In these situations, grasp the penis with a room temperature wet cloth between your thumb and two fingers and maintain firm pressure for three to five minutes. Repeat as needed. If you are worried about active bleeding, call us.
• You can give a sponge bath 24 hours after the  circumcision. To remove the dressing, use some warm water. If some bleeding occurs, maintain firm pressure for three to five minutes. Gently clean the area around the penis with a warm washcloth. Do not use alcohol, powders or lotion, as these may cause irritation. Keep giving sponge baths for the next five days.
• It is not necessary to apply a dressing in the 24 hours that follow the first bath. However, keep applying generous amounts of Vaseline after every diaper change. Put a generous amount of Vaseline on your finger and rub it over the incision site, placing a thick layer of ointment over the entire head of the penis to prevent the exposed foreskin from adhering to the diaper or forming adhesions with the penis glans. Repeat procedure for two weeks.
• *In the first few days, there may be an off-white or yellowish patchy appearance or discolouration of the glans. This is not a sign of pus or infection; the glans may have this colour up to two weeks after the circumcision. Though rare, infection may occur. Common signs of infection include pus-like discharge, foul smell, severe inflammation or fever. If your son shows any of these signs, if he has not urinated in over 12 hours, or if you are unsure of the appearance, call us.
• If the skin has moved up slightly over the head of the penis, gently apply pressure on the SIDES of the penis to ensure it heals properly without any adhesions.  Do not push the skin at the margin where the foreskin was removed for the first 24 hours, for it will be swollen from the procedure.
• You will notice a spongier ring at the base of the penis head (the mucosal ring). It is sometimes more prominent on one side than the other. This is normal and should not be cause for concern.
• The area around the glans will become swollen, especially the underside. This is normal; swelling will subside within a few weeks.
• You may notice a band on the bottom of the penis after circumcision. This band is called the frenulum. This should not be cause for concern.
• Aesthetics are a common concern for parents. Like other body parts, penises come in all shapes and sizes. Although most penises return to their normal state following the circumcision, some penises do not take on a completely normal appearance until they start to grow, after the puberty.