After Bris Care

In 24 hours after the bris, the baby should be given a sponge bath using baby soap. You should soak the penis for 15 minutes or at minimum 8 minutes the day after the bris. Make sure water does not touch the umbilical cord if it has not fallen off yet. It is of paramount importance to keep the penis and diaper area as clean as possible to prevent any bacterial infection and to expedite the healing process.  For the next 7 days bathe your baby and let his penis soak for 5 minutes in water at a temperature that is comfortable for his skin. After 7 days, you no longer need to let the penis soak however continue to bathe him every day.

Following particularly large bowel movements, the baby should be cleaned in a sponge bath (you can use a sponge or soft cotton washcloth) in warm water mixed with a couple of drops of non-detergent and hypoallergenic soap. Brands like Johnson’s Baby Bath, Ivory or Dove fit this description. After the bath, wipe and dry the baby’s bottom very carefully and gently dry it, without touching the affected area. Use this washing technique for the next 10 days. Urination on the affected area is completely fine.

Following the bris, your  baby should be changed every two hours until the night. At night, it’s sufficient to change him every three to four hours. At every diaper change, apply a sterile “4 by 4” gauze pad with Vaseline and a bit of Triple Antibiotic Ointment (Bacitracin or Neosporin) and place it like a tent on the penis. This provides lubrication and prevents the penis from sticking to the diaper.  Never use Desitin or similar pastes and creams as they have drying agents and will not effectively lubricate the area.  Anesthetic creams for pain relief as EMLA can be dangerous and are not necessary, so do not use them.

There will be some blood present when taking off the gauze the first number of times following the Bris, it is normal. If there is any blood flow, contact the Mohel. Then apply pressure to the bleeding area for a full five minutes and do not release the pressure to check if the bleeding stopped until a complete five minutes have passed. Redness and swelling in the days following the procedure are normal. If the swelling has extended onto the abdominal wall, you should call your Mohel and your physician. Infection is a rare outcome of modern circumcision practices. Typically, the penis should return to a normal (healed) appearance in about a month.

If the gauze ends up sticking to the wound, soak the baby’s bottom in warm water and you will be able to remove the gauze easily. A circumcision wound usually heals fast. Remember that this wound is similar to a cut and there are some things that influence its healing quality and time. Immediately after the foreskin removal, the cut edges will seal up and bleeding will stop within a few minutes. Within the next twenty-four hours, the affected area will swell up and then shrink to normal size in two weeks. In the few days following the circumcision, the glans may appear to be blue or purple; this is normal. Over the next few days, some minor residual bleeding is normal and expected. As white, beige, or yellow crusting will form at the circumcision area, do not tamper with that. This is a normal scabbing that will heal on its own. These patches are a type of scab similar to the scab that forms around the umbilical cord after the umbilical cord has fallen off. It is important to understand that they are neither pus nor a symptom of an infection. They must be left alone to ensure proper healing. Also, you may note that the glans is red and glossy. The glans of an uncircumcised penis is covered by a more sensitive skin layer called mucous membrane, which will keratinize and take on a normal appearance given enough time.

Although it is very normal for a baby to be irritable after a circumcision, do your best to keep your baby as comfortable as possible. It is perfectly appropriate for the baby to lie on his back, stomach or the either side and the penis can remain in any position. Do not change around the baby’s sleep or eating schedule. Some change may occur naturally, due to the baby’s irritability or loss of appetite but this is not detrimental, in the short term, and should not be cause for any alarm.

It is normal for the baby to take around two cycles of sleeping and eating to get back on his normal schedule. When feeding the baby, keep him in a flat position. Even when burping, don’t sit him up. Burp the baby on your shoulder. When a baby is healing, it is important to minimize stimulation to promote healing.Being constantly agitated by visitors or passed around causes stress, and can result in slower healing or even aggravation of your baby’s wounds.

If your baby is sent home with a dressing, it is important for parents to leave the wound dressed until the Mohel instructs otherwise. The Mohel will instruct you, in detail, on how to carefully remove the dressing from the phallic area. Once the dressing is completely removed, or in the event that it fell off, continue applying the gauze pad with antibacterial ointment for the next 48 hours.

Your Mohel is open to questions and should always be consulted when concerns arise. You should also be in contact with your pediatrician in the rare case of any health complications. They are both there to help and provide support in this period of your child’s and your life.