Circumcision: Can your baby be circumcised at home?
My husband and I are expecting our first child. We know it is a boy and we are sure that we want to have him circumcised. We are having a homebirth and want to have him circumcised on the eighth day of life. We believe the Vitamin K level to be highest on this day. Since we are not going to a hospital, can he be circumcised in a doctor's office, or does it have to be done in the hospital? I am also concerned about a condition that can occur later in life -- pain with erection. Can you address this issue?Question:
Congratulations on your impending birth.
Let me answer your questions directly:
Most children born in the U.S. receive a shot of Vitamin K shortly after birth. Vitamin K facilitates the making and correct function of clotting factors. After searching extensively, I can find no information to support the idea that the peak level of Vitamin K occurs at eight days of age. However, even if the levels were at the peak at that time, it is not the level of Vitamin K which protects from bleeding problems but the Vitamin K's effect on clotting factors which may take days to occur. I tell you this only for your information because even if the Vitamin K levels were low at the time of circumcision, your boy would probably not experience complications from this due to how the procedure is done. However, I encourage you to have your son receive the injection of Vitamin K shortly after birth to prevent bleeding complications unrelated to circumcision.
Where to have the circumcision performed
This may be done anywhere the person performing the procedure is comfortable. This includes the home, office, or hospital.
Pain later in life with erection
Pain from erection may be caused from two things:
- Some boys are born with a band of skin which tethers the glans (head) of the penis to the shaft. This is called a chordae. The person performing the procedure should examine your boy for this condition, and not circumcise him if present. I generally refer those babies to a urologist to circumcise.
- The other way which also causes tethering occurs after the circumcision during the healing process. The healing skin will have a tendency to stick to itself and to the normal skin around it causing adhesions. To prevent this, 24 hours after circumcision, gently pull back the redundant skin, which overlies the glans, each time you change his diaper and during bathing until the skin is fully healed (about one week).
Special care after circumcision
I find using polysporin ointment seems to soothe the skin, keep it from infection, keep the healing skin from sticking to the diaper, and keep urine (which is irritating) off of the site. Apply this as needed. I also prescribe acetaminophen (Tylenol) to be given at least for the first 24 hours for pain.Answer: