Newborn circumcision is a short procedure, usually lasting 10 to 15 minutes, in which a doctor removes the foreskin covering the tip of the penis. It’s typically performed within the first 10 days of life, most often before the baby leaves the hospital. Three different devices are commonly used, and each follows a slightly different sequence, but the basic steps are the same: the area is numbed with local anesthesia, the foreskin is separated from the head of the penis, and then the excess skin is removed.
Before the Procedure Begins
The baby is placed on a molded plastic restraint board that gently holds the legs apart and keeps the infant still. The doctor cleans the area with an antiseptic solution, then administers a local anesthetic, typically an injection at the base of the penis that numbs the foreskin and surrounding tissue. The numbing takes effect within a few minutes. Some providers also give the baby a sugar-dipped pacifier, which has a mild calming effect on newborns.
Once the area is numb, the doctor uses a small probe to gently separate the foreskin from the head of the penis. In newborns, these two layers of tissue are naturally fused together, so this step is necessary before any cutting can happen. The foreskin is then pushed back to expose the glans underneath.
The Three Common Techniques
Each method uses a different device to protect the head of the penis while the foreskin is removed. The choice usually depends on the provider’s training and preference.
Gomco Clamp
A metal bell is placed over the head of the penis, and the foreskin is pulled up and over it. A clamp tightens around the base of the foreskin against the bell, cutting off blood flow. After a few minutes, the doctor uses a scalpel to trim the foreskin along the edge of the clamp. The clamp and bell are then removed, leaving the circumcised penis exposed.
Plastibell Device
This method uses a small plastic ring instead of a metal clamp. The ring is placed over the head of the penis and under the foreskin. A tight string is tied around a groove in the ring, compressing the foreskin against it. The excess skin beyond the string is trimmed with a scalpel, and the handle of the device is snapped off, leaving just the plastic ring in place. The ring stays on the penis and falls off on its own, usually within five to seven days, as the skin heals underneath.
Mogen Clamp
The Mogen clamp is a flat, hinged device that looks a bit like a pair of pliers with a narrow slit. The foreskin is pulled forward through the slit, and the clamp is locked shut, crushing the skin to prevent bleeding. The doctor then runs a scalpel along the flat upper surface of the clamp to remove the foreskin. The entire process is the fastest of the three methods. One difference worth noting: unlike the Gomco and Plastibell, the Mogen clamp does not place a protective shield directly over the head of the penis during cutting. It was originally designed in 1954 for use in ceremonial circumcisions and remains the device most commonly used by mohels.
What the First Week Looks Like
Right after the procedure, you’ll notice some swelling on the penis. This is normal. Within a day, a thin yellowish film often forms over the exposed area. Parents sometimes worry this looks like pus or infection, but it’s actually granulation tissue, a sign that the skin is healing. It should clear up within a few days.
Your baby will likely be fussy for the first few days, and urinating may cause some discomfort. That pain typically improves within three or four days but can linger for up to two weeks. The appearance of the penis often looks worse before it looks better. Expect the area to start looking more normal around seven to ten days, which is when full healing usually occurs.
With each diaper change during the healing period, you’ll apply a small dab of petroleum jelly (or the ointment your provider recommends) to the tip of the penis or on the gauze dressing. This prevents the raw skin from sticking to the diaper. If a Plastibell was used, you’ll continue this routine until the ring falls off. For clamp methods, the dressing is typically needed for about a week.
Signs That Something Isn’t Right
Complications from newborn circumcision are uncommon when the procedure is performed under sterile conditions by a trained provider. Minor bleeding is the most frequent issue, and almost all cases are very mild. Infection is rare in a sterile setting. A less common long-term complication is a slight narrowing of the urinary opening, though this usually doesn’t require treatment.
Contact your baby’s doctor if you notice redness or swelling that isn’t improving after three days or is getting worse. Yellow discharge or a yellow coating on the penis that persists beyond seven days also warrants a call. Other reasons to reach out include active bleeding that doesn’t stop with gentle pressure, a foul smell from the area, or your baby not urinating within 12 hours of the procedure.
What Medical Guidelines Say
The American Academy of Pediatrics reviewed the medical literature and concluded that the preventive health benefits of newborn circumcision outweigh the risks. Those benefits include a lower risk of urinary tract infections in the first year of life and reduced transmission of HIV and other sexually transmitted infections later on. However, the benefits were not considered large enough to recommend circumcision as a routine procedure for every newborn. The AAP’s position is that parents should be given unbiased information about both the benefits and risks and make the decision themselves. Circumcision done in the newborn period carries considerably lower complication rates than when performed later in life.