Whether you're expecting a baby boy or have just welcomed your new little guy into
the world, you have an important decision to make before you take your son home: whether
to circumcise him.
For some families, the choice is simple because it's based on cultural or religious
beliefs. But for others, the right option isn't as clear. Before you make a circumcision
decision, it's important to talk to your doctor and consider some of the issues.
Boys are born with a hood of skin, called the foreskin, covering the head (also
called the glans) of the penis. In circumcision, the foreskin is surgically removed,
exposing the end of the penis.
Approximately 55% to 65% of all newborn boys are circumcised in the United States
each year, though this rate varies by region (western states have the lowest rates
and the north central region has the highest). The procedure is much more widespread
in the United States, Canada, Africa, and the Middle East than in Asia, South America,
Central America, and most of Europe, where it's uncommon.
Parents who choose circumcision often do so based on religious beliefs, concerns
about hygiene, or cultural or social reasons, such as the wish to have their son look
like other men in the family.
Routine circumcision is usually performed during the first 10 days (often within
the first 48 hours), either in the hospital or, for some religious ritual circumcisions,
If you decide to have your son circumcised at the hospital, your pediatrician,
family doctor, or obstetrician will perform the procedure before you bring your baby
home. The doctor can tell you about the procedure and the possible risks. Circumcision
after the newborn period can be a more complicated procedure and usually requires
In some instances, doctors may decide to delay the procedure or forgo it altogether.
Premature babies or
those who have special medical concerns may not be circumcised until they're ready
to leave the hospital. And babies born with physical abnormalities of the penis that
need to be corrected surgically often aren't circumcised at all because the foreskin
may eventually be used as part of a reconstructive operation.
The Pros and Cons
On the plus side, circumcised infants are less likely to develop urinary
tract infections (UTIs), especially in the first year of life. UTIs are about
10 times more common in uncircumcised males than circumcised infants. However, even
with this increased risk of UTI, only 1% or less of uncircumcised males will be affected.
Circumcised men also might be at lower risk for penile cancer, although the disease
is rare in both circumcised and uncircumcised males. Some studies indicate that the
procedure might offer an additional line of defense against sexually
transmitted diseases (STDs) like HIV
in heterosexual men. For HIV in particular, the findings come from studies done on
populations of African men, and some experts feel that these data might not be as
relevant to men in other areas of the world, like the United States.
Penile problems, such as irritation, inflammation, and infection, are more common
in uncircumcised males. It's easier to keep a circumcised penis clean, although uncircumcised
boys can learn how to clean beneath the foreskin once they're older.
Some people claim that circumcision lessens the sensitivity of the tip of the penis,
decreasing sexual pleasure later in life. But none of these subjective findings are
Although circumcision appears to have some medical benefits, it also carries potential
risks — as does any surgical procedure. These risks are small, but you should
be aware of both the possible advantages and the problems before you make your decision.
Complications of newborn circumcision are uncommon, occurring in between 0.2% to 2%
of cases. Of these, the most frequent are minor bleeding and local infection, both
of which can be easily treated by your doctor.
One of the hardest parts of the decision to circumcise is accepting that the procedure
can be painful. In the past, it wasn't common to provide pain relief. But the American
Academy of Pediatrics (AAP) recommends it and studies show that infants undergoing
circumcision benefit from anesthesia, so most doctors now use it. But because this
is a fairly new standard of care, it's important to ask your doctor ahead of time
what, if any, pain relief your son will receive.
Two main types of local anesthetic are used to make the operation less painful
for a baby:
a topical cream (a cream put on the penis) that requires at least 20 to 40 minutes
to take its full effect
an injectable anesthetic that requires less time to take effect and may provide
a slightly longer period of anesthesia
In addition to anesthesia, acetaminophen is sometimes given. This helps reduce
discomfort during the procedure and for several hours afterward. Giving a pacifier
dipped in sugar water and swaddling a baby also can help reduce stress and discomfort.
Caring for a Circumcised Penis
Following circumcision, it is important to keep the area as clean as possible.
Gently clean with warm water — do not use diaper wipes. Soapy water can be used
If there is a dressing on the incision, apply a new one (with petroleum jelly)
whenever you change a diaper for the first day or two. Even after the dressing is
no longer needed, put a dab of petroleum jelly on the penis or on the front of the
diaper for 3 to 5 days. This can help avoid discomfort from rubbing and sticking to
It usually takes between 7 to 10 days for a penis to heal. Initially the tip may
appear slightly swollen and red and you may notice a small amount of blood on the
diaper. You also may notice a slight yellow discharge or crust after a couple of days.
This is part of the normal healing process.
If you notice any of the
following problems, call your doctor right away:
persistent bleeding or blood on the diaper (more than quarter-sized)
other signs of infection, such
as worsening swelling or discharge, or the presence of pus-filled blisters
not urinating normally within
12 hours after the circumcision
However, with quick intervention, almost all circumcision-related problems are
Caring for an Uncircumcised Penis
As with a penis that's circumcised, an uncircumcised one should be kept clean.
Also, no cotton swabs, astringent or any special bath products are needed —
just warm water every time you bathe your baby will suffice.
Initially, do not pull back the foreskin to clean beneath it. Over time, the foreskin
will retract on its own so that it can be pulled away easily from the glans toward
the abdomen. This happens at different times for different boys, but most can retract
the foreskin by the time they reach puberty.
As your son grows up, teach him to wash beneath the foreskin by gently pulling
it back from the glans, rinsing the glans and the inside of the foreskin with warm
water, then pulling the foreskin back over the head of the penis.
The Circumcision Decision
After reviewing multiple studies on circumcision, the AAP reports that "the health
benefits of newborn male circumcision outweigh the risks." But at the current time,
the scientific evidence is not strong enough for the AAP to recommend
routine circumcision of all newborn boys. Instead, the AAP advises parents to learn
the facts about circumcision and weigh the pros and cons.
In addition to considering the medical factors, religious and cultural beliefs
might play a role. If these are important to you, they deserve to be seriously considered.
Talk to your doctor to help you make the choice that's right for your son.