Traditionally religious circumcision of newborn boys has been performed without any form of painkillers or anaesthetics. Although the baby will experience pain during the procedure, a straightforward circumcision takes less than a minute and the baby usually settles down quickly afterwards. I am prepared however to use a combination of techniques to reduce the trauma of the procedure if the parents wish.
The possibilities are:
1. To give the baby sweet, red wine prior to the procedure. (Kiddush wine is ideal). This is very effective in calming the baby. Ideally it is given about 15 minutes before the circumcision and I will give it on arrival if you wish. You will need to provide the wine.
2. Local anaesthetic cream. EMLA cream is being increasingly used for circumcisions with good effect. Your pharmacist will be able to sell you a five gram tube of emla cream. Please give the pharmacist as much notice as possible as he/ she may well have to order the cream for you.
Apply the cream at least one-hour before the circumcision using no more than half of the 5g tube to the whole of the penis and two or three centimetres of skin around the base. When the cream is applied then point the penis upwards and cover with cling-film. It does not matter if the baby passes urine with the dressing on. I will remove the dressing when preparing the baby for the circumcision. The effect of the cream will last for five or six hours.
EMLA cream can on rare occasions make the baby’s skin sore. Some parents prefer to try the cream the day before to ensure the baby will not react to it. I would suggest applying it to a small patch on the baby’s calf and checking if there is a skin reaction an hour later. (Redness and swelling).
3. Local anaesthetic injections to block the nerves to the penis are effective but can hurt the baby when put in. I carry the anaesthetic with me and can use ten minutes or so before the circumcision if you wish. (The cream is as effective as the injection and would be my recommendation.)
The options can be combined as you wish. Please note the EMLA cream must be used an hour before I arrive. I will not able to wait for the hour while it works!
I hope that this note explains the options clearly, please contact me for clarification if you need to.
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