The Circumcision Decision
Learn about this procedure before your baby boy is born.
It’s a good idea to discuss circumcision—the surgical removal of the foreskin that covers the tip of the penis—with your obstetrician or pediatrician during your pregnancy. Families may have strong feelings, but medically there’s no wrong choice, says Andrew Satin, M.D., a professor of gynecology and obstetrics at the John Hopkins University School of Medicine in Baltimore. “Mostly I see parents deciding based on cultural tradition and whether daddy is circumcised or not,” he says. Here’s what prospective parents should know:
THE PROCEDURE Circumcision is commonly performed in the hospital 24 hours to 72 hours after birth, often by mom’s OB-GYN or a pediatrician, but sometimes by a midwife or, according to Jewish tradition, a specially trained rabbi. Parents are not typically present for the 10-minute procedure, which should always involve a local anesthetic, says Satin.
THE PROS Studies have shown slightly lower rates of urinary tract infection, penile cancer and certain sexually transmitted diseases, including herpes and HPV, among circumcised adult men. Statistically, the difference is small enough that the American Academy of Pediatrics (AAP) does not currently recommend routine infant circumcision. However, the AAP is reviewing its position in light of data from Africa showing that circumcision significantly reduces the risk of HIV infection.
THE CONS Risks include infection and bleeding, which are rare; tell your doctor if there’s a family history of bleeding disorders. Anti-circumcision advocates say the procedure is traumatic, but a local anesthetic can minimize pain. Occasionally, a circumcised boy will need to undergo a revision procedure when he is older.
IF YOU CIRCUMCISE Expect the penis to look raw, purply-red and swollen afterward. For the first two or three days, change the bandage after each diapering and dollop petroleum jelly on the diaper and tip of the penis to keep it from sticking. When the dressing comes off, continue this routine until healing is complete, in about a week. If your baby has a fever, discharge, bleeding (more than a quarter-size stain, Satin says) or difficulty urinating, call your pediatrician.
IF YOU DON’T An uncircumcised penis is easily cleaned with warm, soapy water. Don’t pull back the foreskin to clean under it, warns Russell Reiff, M.D., a pediatrician at Kaiser Permanente’s San Francisco Medical Center. Most boys’ foreskin will loosen on its own; forcing it may cause injury.