This is obviously a very important aspect of circumcision and one that causes the most concern amongst parents.
It is of vital importance for doctors performing circumcisions to make every effort to minimise any pain felt by the baby.
I advise a combined approach of topical and injection anaesthetic together with paracetamol and a sugar pacifier. I have found that this combination of measures is the most effective way to keep babies calm and out of pain.
When I arrive, I will apply an anaesthetic cream which helps numb the surface of the skin before giving the injection.
Whilst this cream is working, I will spend time with you going through the procedure, obtaining your consent and answering any last minute questions.
Just before the circumcision, I will transfer your son to a special changing mat with gentle restraints and give him a local anaesthetic injection. The injection takes about 7-10 minutes to become fully effective.
Once he is anaesthetised, the brit milah can start.
I suggest that you also give your son some paracetamol before the procedure. Paracetamol is only available for purchase over-the-counter for babies over 2 months old. It is however, safe under medical guidance to give for newborn babies as well. When you buy it, I suggest you buy a bottle rather than the sachets, and don’t say it is for a newborn baby, otherwise the pharmacist may not sell it to you.
Do not give your son any paracetamol until I arrive, I will help you give it to him.
During the procedure
The use of sugar during medical procedures for newborn infants is common in paediatric hospitals. I will bring special sugar ‘pacifiers’ which can be dipped in sweet wine such as Kiddush wine or grape juice, as you prefer. This is something that a family member or other guest can be ‘nominated’ to do and that way be more involved and honoured on the day.
After the procedure
Most boys do not need any further pain relief, but I will give you advice on the day about what you can do if needed. For example, if the Kiddush wine has helped, this can be given again during the day if required. Alternatively a further dose of paracetamol (eg Calpol) can be used. I will advise you on the day how this should be done.