• Ointment Schedule:
  • Days 1-4 (Day of procedure + next 3 days): Use antibiotic ointment.
  • Days 5-30: Use Vaseline or a generic equivalent — ask your pharmacist.
• Applying Ointment: The goal is to keep your son’s penis in contact with ointment, not the diaper, for the first 30 days.
  • For days 1-4, apply antibiotic ointment generously to a gauze and place it over the penis like a tent with each diaper change. An amount of ointment in the size of a one-dollar coin is enough.
  • For days 5-30, apply Vaseline generously to any healing/raw/cut area of your son’s penis OR generously to the front of the diaper anywhere his penis will rest.

This is crucial for preventing narrowing of the urethra (meatal stenosis) and trying to avoid adhesions.

• Please take your son to be assessed by his primary care physician (Family Physician/ Pediatrician) within 7-10 days after the circumcision.
• If you have concerns regarding adhesions or any other issues in the weeks/months following the circumcision, please reach out to us and we are happy to see you.

• NO diaper wipes, alcohol, lotions or powders directly on the penis.
• NO diaper rash creams (barrier creams) directly on the penis. If using them for the buttocks/groin then there is no problem with this. Place ointment on a gauze over the penis first to protect it prior to applying barrier cream to the groin or buttocks.

• No baths for the first 4 days. For example, if your son had his circumcision on Monday then no bath until Friday.
• Sponge baths are okay during the first 4 days, but keep the circumcision site dry.
• After 4 days, full baths with baby soap are acceptable.
• Do not submerge your baby’s circumcision site in water if his umbilical cord has not fallen off. Do not get the umbilical cord wet if it has not fallen off.

Some bleeding is normal, but know when to act.

• Normal Bleeding:
  • Some streaks of blood mixed with ointment in the diaper are normal for the first 24-48 hours.
  • You should see less blood with each diaper change over the first 24 hours.
  • By 24 hours, expect only some spotting.
  • Light bleeding between days 5 and 7 is also common due to scab separation. Manage this light day 5 to 7 bleeding, which is new, as outlined below with pressure.
• When to Apply Pressure: If a gauze placed over the penis becomes fully soaked with fresh red blood:
  • Remove the soaked gauze.
  • Apply a fresh gauze with ointment onto the end of the penis.
  • Apply gentle, steady pressure with your thumb and two fingers for a full 5 minutes (use a clock!).
  • DO NOT remove the gauze to check.
  • If bleeding stops, leave the gauze on until the next diaper change.
  • If bleeding continues after 5 minutes, as seen by blood being continuously absorbed by the gauze, place a second gauze over the first and apply pressure for another 5 minutes (10 minutes total).
• Go to the hospital if:
  • Rapid, active bleeding OR if you see blood is dripping from the penis.
  • 10 minutes of pressure has not stopped the bleeding.

It’s best to use disposable diapers for the first 4 weeks.

Follow steps demonstrated in clinic. Remember to clean front to back to clean groin/ buttocks. Do not touch the penis with a wipe for the first 4 weeks.

If stool gets on the healing penis from Days 1 to 4, gently wring/pour lukewarm water over the area. A damp cotton ball may be used VERY GENTLY if necessary to remove stool but try to avoid this, if possible. Let the penis air dry and you must ensure the umbilical cord does not get wet if it has yet to fall off. If stool gets on the healing penis from Day 4 onwards, you may readily submerge your baby’s circumcision site assuming the umbilical cord has fallen off. Urine on the dressing is not a concern. Do not scrub or use wipes directly on the penis as this can cause bleeding.

• Activity Restrictions: Minimize car seat travel for the first 24 hours, if possible

• Dressing Stuck: If the gauze sticks due to dried blood and does not come off with gentle traction, moisten it with lukewarm water and ointment prior to gently removing it. Do not rip it off. If bleeding occurs, see "Bleeding" section above.
• Fever (Temperature = 38° C or higher): A fever in a newborn is serious. Fever after circumcision is rare and usually due to other causes. Take your son to the emergency department immediately if he has a fever.
• Healing:
  • Every penis heals uniquely, but general norms apply. Redness on the glans is
    expected initially and can take on a purplish appearance at times.
  • Swelling: Significant swelling, sometimes uneven, can develop on the underside of the glans for 24-72 hours. It may look like a blister. Swelling resolves with time although some swelling can persist for months.
  • Yellowish/Whitish/Green Discolouration on the glans/head of penis: These “scabs”
    are normal and can appear 24-72 hours after the procedure. Crusts can also
    appear on the penis. DO NOT PICK THESE OFF. They signify healing. They will clear
    up within approximately a week or so. Golden/light amber coloured fluid can result
    from mixing with Vaseline and this is normal.
  • The overall healing process takes approximately 10-14 days with some changes
    persisting up to a month or longer.
  • For visual reference, you may consult: https://www.seattlechildrens.org/globalassets/documents/for-patients-and-families/pfe/pe2937.pdf
• Infection (Rare): Contact our physician or go to the emergency department immediately if you see any of these signs, especially with a fever:
  • Swelling that is increasing after it started to improve, or is excessive
  • Redness spreading on the shaft or scrotum
  • Warmth
  • Pus (greenish fluid) – not to be confused with normal healing crusts
  • Foul smell
  • Rash on the penis
• Pain Management:
  • The local anesthetic lasts 1-4 hours depending on which kind of local anesthetic was given.
  • Give infant acetaminophen, as prescribed, as soon as you get home or when your baby wakes.
  • This dose can be repeated up to three times, with a minimum of 6 hours between doses, if your baby is fussy or in pain. Most babies only need one dose.
  • Do not give ibuprofen/advil.

• Temperament: It’s normal for babies to be fussy or sleepy on the day of the procedure. Keep feeding in a quiet, calm environment.
• Urination: If your son has not urinated for 12 hours or more since the procedure, take him to the emergency department.