In the office: Try to be calm .Our experience had shown that babies can sense parent's feelings or behavior.
It is better that one person receive the baby and hold him after the procedure. Changing hands may disturb him. Stay calm, hug your baby and try to burp him for 2-3 minutes. He will feel comfort on your shoulder and would feel better if need to be burped.
Baby can be kept in his car seat. The area stay numb for the next 40-60 minutes.
Baby gets a local anesthesia and feels no pain during the procedure,most babies are calm and will stay as such after the procedure. However, a baby may feel uncomfortable and may cry for any reason including having gasses or by being unable to move for few minutes, and very few may continue crying for few minutes after the procedure for those same reasons.
At home on day of surgery ( day 0 ): Very few babies may continue be irritable and crying after the procedure , do not worry, he will calm down in few minutes. If he is crying, it is better not to enforce feeding, to prevent air swallowing while crying . Hold the baby, walk around, burp him, give time ( 30-60 min ) and then feed when mom and baby are calm.
Follow the instructions as given by the doctor and detailed also in the handout that will be provided in the office.
Our staff will call you in few hours to check on the bleeding and baby urination and to address any concern. Post surgery visit to the office is usually not necessary, however, Dr. Mati will tell you if a revisit is needed for any reason
Watch Bleeding: check your baby's diaper approximately every hour for the first 6 hours and then every 2-3 hours for the next 12 hours. First diaper may show slight fresh bleeding spots that will slowly lighten up or disappear on subsequent diapers.
Leave the bandage on for 24 hours. Removing the bandage prematurely may trigger bleeding.
Heavy bleeding is very rare, if you see heavy fresh blood soaking the dressing and part of diaper and continues with subsequent 1-2 diaper changes , do not panic , do not remove dressing, call Dr. Mati for instructions at 416 752 5426 or 416 499 8338. Most of such rare events can be controlled by simple pressure and dressing
Crying & Pain Management: Babies are very different in their responses, most babies would be calm and sleeping, or few may experience periodic discomfort when moving or peeing. It is normal for your son to be a little irritable in the first 24 hours. Give baby acetaminophen 0.5 ml every 6 hours as needed, or as instructed by the doctor
Avoid unnecessary baby travel during the first 2 days, as car seats can be irritating to the newly circumcised baby after the local freezing is off.
Nursing: Most babies like to nurse in a quiet place following the circumcision. Mom also need to be calm when nursing
Cleaning: Use warm water and a soft cloth to clean the area behind and around the penis. Avoid pre-moistened pads or alcohol, or any other products that may cause irritation. donot remove taped bandage on first day.
Sleeping: Most babies sleep well following the circumcision. The best sleeping position is on his side, supported by a blanket or a pillow
Day 1 ( next day ): After almost 24 hours post circumcision, remove the bandage by gently pulling off the edges of tapes and then all dressing will easily come off. If bandage fall off early by itself and no major bleeding is noticed, it is ok. You may use warm water to wet the bandage to make removing the bandage much easier
The penis will look red and may look swollen, a blood clot or a minor blood oozing may be seen. Gently apply petroleum gel (Vaseline) on the whole of penis. Remember that it is still a sensitive area and may cause some discomfort. No gauze or bandages required after the first 24 hours. Continue the cleaning using wipes.
Day 2: Give the baby a bath, the usual way. Apply Vaseline
In Day 2 and for the next two weeks, bath the baby every 1-2 days to keep area clean from infections, and apply Vaseline with every diaper change. Make sure every time that the glans is well exposed ( glans is seen and skin is not covering the glans) and apply a small amount of Vaseline over the glans and entire penis.
In rare instances, which may be seen in babies who are choppy with a short penis, the pubic fat or abdominal pressure may push the skin to the front and covers the glans. Dr. Mati will alert you and demonstrate to you when he does the assessment. If you notice that the skin has moved up and partially or completely covers the glans, follow this step: push the skin down by gently pressing on the pubic skin around penis base, this will stretch the skin down away from the glans. Make sure the glans is fully uncovered and free to the rim. Apply Vaseline on the exposed glans. Repeat this with every diaper change for the next 2 weeks, this is to ensure that the skin is retractable and is healing properly behind the back rim of the glans. It should be easy to stretch the skin backwards. If you see skin is covering the penis and difficult to retract, you need to bring the baby for check by Dr. Mati as soon as day 2.
After Day 2
Healing: Healing is usually rapid. When you take dressing off, the penis may look red & scabs may be seen on glans, the area behind glans may become swollen for a week or two, because the inflammation needs to settle and the mucous membrane covering penis needs time to toughen (whole process may take about a month time to take on a normal appearance)
The final appearance: Everyone's anatomy is different and penises and their skin are different in shapes and sizes and every child heals differently. The look of penis can also differ by age or weight or the presence of hydrocele or erection. The result of one circumcision cannot be completely identical to others
Delayed complications: Infections are rare and most can be treated with local care and antibiotic creams. Common signs of infection include: discharge, a foul smell, excessive swelling or redness, local warmth, rash in the penile area or fever. With development of any of these signs, please call us for instructions.