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1. Apply firm direct pressure using a sterile gauze to any area of continued oozing of blood for a period of 10-15 minutes. Do NOT examine the wound while applying the pressure. If the bleeding is persistent, or if one square gauze is completely soaked, or if the diaper begins filling with blood call me, or your physician, or take the baby to the hospital! (This instruction is precautionary only, NOT to be routinely used.)

2.Wash the genitals gently after each large bowel movement (large = stool on the penis), using either a soft cotton cloth, cotton balls, or a sponge with a few drops of nondetergent soap (such as Ivory, Dove or Johnson's Baby Bath) in warm water, rinse, then gently dry. Continue to wash for a period of 10 days. (it is absolutely OK to wet & touch the penis) Do NOT use abrasive cleaning wipes on the circumcision wound!

3. When the baby urinates, simply change the dressing if soaked, washing is not necessary. The baby will NOT experience pain with urination... he cries because he is wet.

4. Apply a copious amount of neosporin-plus ointment to the center of a sterile gauze, and then gently place it onto the penis for the first day, The second day, use a 50% ointment mix (1/2 Neo/Myci-Plus + 1/2 vaseline). The third day, use just the vaseline. Continue with pure vaseline for the remaining 8 days of ointment treatment for a total of ten days of care. The penis may remain in any position and the baby may sleep on his back or side. Do NOT tie anything around the wound... ever!

5. To reiterate, apply some type of ointment for the first 10 days after the circumcision. I recommend: Day 1 (24hrs) of pure neosporin-plus ointment, then Day 2 (24hrs) of a 50% ointment mix, then Days 3-10 of pure vaseline, again for a grand total of 10 days of care.

6. If the gauze sticks to the wound, simply soak the baby's bottom in a basin of warm water. The baby may be fully bathed 10 days after the circumcision, if the cord is off. ( i.e. when you have finished with the 10 days of dressing changes you may bath the baby.)

7. Be alert to the signs of infection, such as increases in redness, pain or swelling. The baby may be irritable for 3-4 days and will heal in 12-14 days with residual swelling up to three weeks (3 wks) after the circumcision.

8. If the wound appears to be attaching or sticking to the head (glans) of the penis, firmly retract shaft skin 2 times per day, by grasping immediately beneath the healing wound and firmly pulling down toward the penile base on Days 2-10. Q-Tips may be used instead of fingers to grasp the adhering site. The head should always remain completely visible, i.e., exposed. If in doubt, bring the baby to a pediatrician for a quick examination.

9.If the baby is irritable you may dispense one single dose (0.4 ml or 1/3 of the eyedropper) of Infant Tylenol or Tempra drops 4 hours after the circumcision. Again, this is a one time dose of Tylenol or Tempra.

10. NOTE: The glans or head of the penis will be beefy red in color; the area immediately behind the glans will be quite swollen for several days. Small yellowish-white firm plaques, moist crusts or a whitish filmy material may occur near the wound or head of the penis, Days 3-10. This plaque formation is normal and will eventually disappear. The plaque is not foreskin... foreskin does not grow back!

11. Please feel free to call me at any time with further questions or problems and relax, the baby will heal just fine!

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