The whats, whys, and hows about newborn circumcision.
What It Is
When boys are born, they have a piece of skin that covers the end of the penis, called the foreskin. Circumcision is the surgical removal of the foreskin to expose the tip of the penis.
A newborn must be stable and healthy to be circumcised. If a parent decides to have her baby circumcised, the procedure is usually performed in the baby's first few days of life (assuming the procedure will not be taking place during a religious ceremony). To perform the procedure, the doctor places the baby on a special table and cleans the baby's penis and foreskin. A special clamp is attached to the penis, and the foreskin is removed. Finally, ointment and gauze or a plastic ring are placed over the cut to protect it from rubbing against the diaper.
The procedure is done quickly. The baby may cry during the procedure and for a short while afterward. Local anesthesia can greatly reduce your baby's discomfort. If you decide to have your son circumcised, talk with your child's doctor about anesthesia options.
Making the Decision
Circumcision is an elective procedure. It's your choice whether to have your son circumcised. In most cases, there is no medical need for a circumcision. It is not required by law or by hospital policy. Scientific studies show some medical benefits of circumcision, but these benefits are not sufficient enough for the American Academy of Pediatrics (AAP) to recommend that all infant boys be circumcised. The AAP does recommend, however, that parents discuss the benefits and risks of circumcision with their pediatrician and then make an informed decision.
Ask yourself why you may or may not want your son to be circumcised. Some parents may want their sons circumcised for religious, social, or cultural reasons. Followers of the Jewish and Islamic faiths have circumcised their male newborns for centuries. Although many newborn boys in the United States are circumcised, it is much less common in Northern Europe and other parts of the world. Ask yourself if it matters whether your son looks like other men in the family or his peers.
Whether or not to circumcise your newborn is an important decision. Circumcision could be riskier if done later in a boy's life, so if you have any questions or concerns, talk with your doctor about them during your pregnancy. Then you'll have enough time to make an informed decision.
Benefits and Drawbacks
According to the AAP, research suggests that there may be some medical benefits to circumcision. Boys who have been circumcised are at reduced risk for:
- Foreskin infections
- Urinary tract infections
- Penile cancer
- Sexually transmitted diseases
- Phimosis, a condition in uncircumcised males that makes foreskin retraction impossible
Here are some of the reasons parents may decide not to have their baby circumcised:
- Surgical risks: As with any surgery, circumcision has some risks. Complications are rare and usually minor. The most common complications are bleeding and infection.
- Penile damage: Very rarely, the foreskin may be cut too short or too long. Equally unlikely is improper healing from the circumcision. These complications may require another circumcision or -- in extreme cases -- penile reconstruction.
- Alteration of penile sensitivity: Some people claim that circumcision may lessen the sensitivity of the tip of the penis, decreasing sexual pleasure later in life. However, this hasn't been proven to be true.
- Fear of pain: Some parents choose not to circumcise their sons because they are worried about the pain the baby may feel.
- Protection of the tip of the penis: When the foreskin is removed, the tip of the penis may become irritated, causing the urinary opening to become too small. This could lead to urination problems that may need to be surgically corrected.
Care of the Circumcised Newborn
After the circumcision, the tip of the penis may seem raw or yellowish for seven to ten days. Keep the area as clean as possible by washing your baby's penis with soap and water every day. Change his diapers often so that urine and stool do not cause infection.
If doctors have dressed the penis in gauze, apply a new bandage each time you change his diaper. Coat the gauze with petroleum jelly to keep it from sticking.
Some doctors apply a plastic ring instead of a bandage. This will drop off by itself within five to eight days.
Complications from a circumcision are rare. However, every surgery carries some risk. The AAP reports that complications occur in 1 in 200 to 1 in 500 circumcised newborn males. The most frequent complications are minor bleeding and local infection, both of which can be easily treated by your child's doctor. Call your pediatrician right away if:
- Your baby does not urinate normally within 6 to 8 hours after the circumcision.
- There is persistent bleeding.
- There is redness around the tip of the penis that gets worse after 3 to 5 days.
Care of the Uncircumcised Newborn
It is important to keep the uncircumcised penis clean. Gently wash the genital area while bathing your baby. You do not need to do any special cleansing, such as with cotton swabs or antiseptics.
The foreskin does not fully retract for several years and should never be forced. Once the foreskin fully retracts, around age 3, boys should be taught how to wash underneath the foreskin every day. The American College of Obstetrics and Gynecology recommends that you teach your son to clean his foreskin by:
- Gently pulling it back away from the head of the penis.
- Rinsing the head of the penis and inside fold of the foreskin with soap and warm water.
- Pulling the foreskin back over the head of the penis.
Sources: American Academy of Pediatrics; American College of Obstetrics and Gynecology; The Nemours Foundation
All content here, including advice from doctors and other health professionals, should be considered as opinion only. Always seek the direct advice of your own doctor in connection with any questions or issues you may have regarding your own health or the health of others.