By Kari Osel © 2016 Peaceful Parenting
Each newborn baby arrives into the world with a prepuce organ protecting his or her glans (head) of the penis or clitoris. In baby girls this organ is commonly referred to as the 'clitoral hood' and in baby boys it is often called the 'foreskin.' In some parts of the world girls or boys are circumcised, which removes some or all of this natural protective organ. In the United States, the circumcision of baby girls is illegal by federal law (FGM Bill), though many North American girls are still circumcised each year in 'underground' operations. The two most common forms of infant circumcision of baby boys are by Plastibell and Gomco.
Because a circumcised baby boy’s urethra and sensitive glans (head of his penis) are exposed to the elements, special care must be taken when diapering and tending to this surgical wound. Cloth diapers are easily stained by blood from a baby’s genitals post-circumcision. Vaseline and similar products that are used in an attempt to protect the wound and allow for healing may cause cloth diapers to repel urine. Parents whose babies were circumcised at birth often wonder what the best course of action is at this point to prevent this from happening while using cloth. The following are solutions that have been effective for other families.
1) A strip of fleece or a receiving blanket cut to the appropriate length and width, laid into baby's diaper as a liner between the cloth and Vaseline treatment.
2) A large cotton makeup pad with a dollop of Vaseline on it, applied to your baby's wound and left in place until the next diaper change. This serves as a barrier between the ointment and the diaper. Be sure to use a fresh cotton pad with each change.
3) An ointment called CJ’s BuTTer is sometimes used instead of Vaseline, which is said to be cloth-diaper safe.
4) Cotton prefolds or flats are easiest to launder and care for, to treat stains on, and may be boiled if needed. The downfall is that they do not wick away moisture as pockets (which some babies are sensitive to - leading to rash and irritation). Watching your little one and his/her skin response to different diapering methods is key.
5) Many parents who circumcise their baby use disposables until the time comes when blood stains are no longer a risk factor for their cloth stash. However, if you opt for this means of diapering your baby, be vigilant to check the amount of blood loss during any given hour, and call emergency services immediately if you notice more than a few drops of blood. Hemorrhage post circumcision happens every year in the United States, and a newborn baby only needs to lose 1 ounce of blood to hemorrhage, and 2.3 ounces to die from blood loss. Disposable diapers are designed to hide moisture (including blood) well, and will not show actual amounts lost as clearly as cloth does.
Another important point to consider is your baby’s comfort during the healing weeks. When a baby is born, the prepuce (foreskin/clitoral hood) is tightly adhered to the glans (head) of the clitoris or penis, like your fingernail is tightly fixed to your finger. No matter which method of infant circumcision is used, the prepuce must be probed and ripped apart from the glans. Next, using various methods, an amount of the prepuce is cut off (how much varies according to the individual who is cutting). This is understandably a very painful procedure, and as is the case in many surgeries, the recovery period is often just as painful (if not more so).
Because newborn babies cannot have adequate anesthesia due to their tiny, immature organs, it is especially important for care-givers to make recovery as comfortable as possible. The clitoris or penis is an area of the body that deserves special care as it is the richest part of the human body in terms of nerve endings (and feeling). Cloth diapers are often more comfortable for babies in general than are disposables, and this remains true in the case of those with wounds.
As mentioned above, cloth does not absorb as disposables do (which has the benefit of showing clear blood volume lost), and also is less likely to allow the circumcised genitals to stick to the material of a diaper (causing further pain when a healing wound must be ripped away during diaper changes). Because cloth diapers do not contain chemicals, they are also less likely to irritate sensitive skin.
It is important to change your baby's diaper promptly after urination, and most definitely after defecation, no matter the type of diaper you use post-circumcision. Urine sitting in a diaper is no longer sterile, and a diaper with urine and/or feces in it is not a healthy environment for an open wound. The number one cause of urinary tract infections (UTIs) in babies is fecal matter being pushed into an exposed urethra - whereby bacteria moves up the urinary tract. Be gentle with your little one, give pain medication as your doctor advises or according to weight, nurse often around the clock, sleep safely within an arm's reach of your baby, and change diapers frequently with ample ointment for protection and healing.
Because all babies arrive with a prepuce to naturally protect and keep things out of the urethra, and because there is no open wound while your baby is intact, you do not need to worry about infection or protection at birth when using cloth. For an intact baby (male, female or intersex) the prepuce is a self-sustaining organ and will do all the covering, protecting, and 'cleaning' that is necessary. If you opt to keep your baby intact, simply wipe the outside of the genitals with your choice of wipes, and do not allow anyone to retract your baby's prepuce (not on girls, not on boys). Intact care involves leaving everything alone (no 'cleaning' and no special care). Learn more on intact care here.