What Parents Need to Know Baby Circumcision

Circumcision is a medical procedure that removes the piece of skin that covers the end of the penis, called the foreskin. Once the foreskin is removed, it will not grow back and the procedure permanently exposes the tip of the penis.

Circumcision has been done as a part of some religions and customs, including in many Jewish and Islamic families. It's also performed for other reasons, such as personal beliefs, a matter of hygiene, or family preference.

While circumcisions are the most common surgical procedure performed in the U.S., the actual prevalence of circumcisions among people with a penis varies widely based on geographical location, race, and culture. If you give birth to a baby with a penis, your healthcare team will most likely ask your preferences regarding circumcision, so you can do your research now to decide what is best for your family.

Learn more about this procedure, including the potential benefits, side effects that may happen, and how to care for a circumcised penis if your family decides to choose circumcision.

The Circumcision Procedure

A newborn must be stable and healthy to be circumcised, and the procedure is usually performed in the first few days of life (assuming it will not happen during a religious ceremony), often before a baby even leaves the hospital. As the parent, you will need to sign a consent to allow the doctor to perform a circumcision on the baby. Most parents elect not to watch the procedure, although you can ask your hospital what their policy is if you'd like.

“Most male babies are circumcised after birth/delivery and prior to discharge from the hospital,” explains Vanessa Elliott, M.D., a urologist at UCP Urology of Central PA, Inc.

There are a few different ways a doctor can perform a circumcision, but the most common method involves using a clamp. The doctor places the baby on a special table and cleans the penis and foreskin. Some kind of medication is used to ward off pain, such as a local numbing cream or a local anesthetic injection. A clamp is then attached to the penis, and the foreskin is removed to expose the head of the penis. Finally, ointment and gauze are placed over the cut to protect it from rubbing against the diaper.

The circumcision procedure is done quickly. The baby may cry during it and for a short while afterward, although infants typically experience minimal distress, says Dr. Elliot.

Local anesthesia can greatly reduce your baby's discomfort. If you decide to have your son circumcised, talk with your child's doctor about pain relief options. When your baby comes back from the procedure, it may comfort them to nurse or be cuddled by you, although many times, babies are also very tired and sleep right after too.

Circumcision Rates

Globally, circumcision is not a popular choice. Firm statistics on worldwide circumcision rates don't exist, but it's estimated that about one-third of males worldwide are circumcised. It's most common in North Africa, West Africa, the Middle East, and some parts of Southeast Asia. On the other hand, circumcision is rare in Europe, Latin America, and the majority of Asia.

In the United States, the Centers for Disease Control and Prevention (CDC) says 58.3% of males were circumcised in 2010, the most recent year for which figures are available. Hospital discharge data shows that circumcision rates vary significantly by region. In 2010, 71% of boys in the Midwest were circumcised; 66.3% in the Northeast; 58.4% in the South; but only 40.2% in the West.

"The regional differences may be due to varying rates among ethnic groups," says Mary Jones, an NCHS spokeswoman. Jones adds that Hispanic families are less likely to choose circumcision when compared to white and Black families.

Overall, though, circumcision rates have been declining in the United States over the past few decades. Specifically, the CDC reports a 10% overall decline between 1979 and 2010.

This might be partly attributed to task force reports from the American Academy of Pediatrics (AAP). The latest report in 2012 recognizes some medical benefits of circumcision, but it doesn't routinely recommend the procedure. Instead, it encourages parents to make the decision based on “religious, ethical, and cultural beliefs.”

The Benefits of Circumcision

According to the AAP, research suggests that there may be some medical benefits to circumcision. The AAP's official policy statement is that the benefits of circumcision do outweigh the risk.

Parents should still make the decision that is best for them and know that people with a penis who have been circumcised are at reduced risk for:

• Foreskin infections
• Urinary tract infections
• Penile cancer
• Sexually transmitted diseases, including HIV/AIDS—According to the CDC, the risk of acquiring HIV can be lowered by up to 50% in males having unprotected sex with females who have HIV
• Phimosis, a condition in uncircumcised people that makes foreskin retraction impossible

The CDC also explains that the circumcision procedure is far easier and comes with less complications when it's done on someone when they are a baby vs. as an adult. In other words, if you know you would like your baby to be eventually circumcised or know they will choose circumcision later, it may be easier to have it done earlier rather than later.

Circumcision Considerations

While there may be some potential benefits to circumcision, there are also some things to consider before making the decision. Here are some of the potential risks of circumcision.

Surgical risks

As with any surgery, circumcision has some risks. Complications are rare and usually minor. The most common issues 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, the AAP notes that studies haven't proven this to be true.

Procedure discomfort

Some parents choose not to circumcise their babies 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.

Should My Baby Get Circumcised?

Only you can make the decision of having your baby circumcised, but you can certainly gather input from research and talk to a trusted health care provider to see what they may recommend as well. Circumcision is an elective procedure that’s usually not required by medical need, law, or hospital policy. You can also talk with your partner about the best course of action for your child.

Some parents may want the procedure for religious, social, or cultural reasons. For example, followers of the Jewish and Islamic faiths have circumcised their male newborns for centuries, but it’s much less common in Northern Europe and other parts of the world. Ask yourself if it matters whether your child's penis looks like others in the family or potential peers.

Whether or not to circumcise your newborn is an important decision. Circumcision could be riskier if done later in 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.

Baby Circumcision Care

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 your baby's diapers often so that urine and stool do not cause infection. Dr. Elliot says you can also apply Vaseline or Neosporin to the incision so diapers do not stick to the area.

“The specific physician performing the circumcision would instruct the parents on care to avoid adhesions,” she adds. Your baby care nurse will also go over all the care instructions you need for your baby is you choose circumcision.

If doctors have dressed the penis in gauze, apply a new bandage each time you change the baby's diaper. Coat the gauze with petroleum jelly to keep it from sticking. Also note that some doctors apply a plastic ring instead of a bandage, which will drop off by itself within five to eight days.

Complications from circumcision occur in 1 in 200 to 1 in 500 circumcised newborn males, according to the AAP. 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.
• There is any drainage from the penis.
• Your baby seems to be in any distress.