Should You Have Your New Baby Circumcised?

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This is one of the more controversial topics in Pediatrics today. The American Academy of Pediatrics, in their Circumcision Policy Statement, concluded that "data are not sufficient to recommend routine neonatal circumcision" and that "parents should determine what is in the best interest of the child." Since the statement didn't really come out for or against circumcision, it left many parents still asking the question, "Should I have my son circumcised?"

Why Circumcise?

It may help to look at some of the reasons that parents use to have their sons circumcised. One common reason is because everyone else is circumcised. This is really not true at all. Worldwide, it is estimated that about 30%-40% of males are circumcised. Figures are higher, however, in the United States, where the World Health Organization estimates the circumcision rate to be between 76% and 92%.

Parents sometimes want their son circumcised because they think that the uncircumcised penis is too hard to take care of and keep clean. This is not true. The uncircumcised or intact penis is relatively easy to take care of. In fact, until the foreskin begins to retract, no special care is required. Once the foreskin does retract, you or your child once he is old enough, can just gently retract the foreskin, clean the head of the penis with soap and water, rinse, and then pull the foreskin back over the head of the penis.

Another reason is that there are medical benefits for being circumcised, including a lower risk of urinary tract infections, penile cancer, and sexually transmitted diseases. Most studies do show that uncircumcised male infants have about a 10 fold increase in UTIs, but the overall risk of an uncircumcised male infant getting a UTI is relatively low, only about 1%. Penile cancer is also more common in uncircumcised men, but this type of cancer is very rare anyway.

In fact, the AAP states that these "preventive health benefits of elective circumcision of male newborns outweigh the risks of the procedure." But, while these medical conditions seem to support circumcision, uncircumcised boys can be taught proper hygiene that can lower their risks of infection and disease.

Other conditions that only occur in uncircumcised males and which can sometimes require a later circumcision include infections of the foreskin, phimosis (inability to retract the foreskin) and paraphimosis (inability to pull the foreskin back over the head of the penis after it has been retracted).

It is also important to look at the reasons not to have a circumcision, including the risk of bleeding, pain from the procedure, infection, injury to the head of the penis, and penile sensation deficits. Children who are circumcised are also at increased risk of meatitis, or inflammation of the urethral opening.

Making a Circumcision Decision

In the end, one of the major reasons that many parents want to circumcise their child is because they want their son to look like their father, who is circumcised. Does it matter if a father is circumcised, but his children aren't? This is one area where some research is needed. There are many situations where a father and son aren't both circumcised. Premature infants are often too sick to be circumcised, and with all of the other medical issues that come up, circumcision is often not thought about. Step-fathers and adoptive parents also may not be 'the same' as their children. Does it make a difference to these children? A formal study that shows no difference would probably help to decrease the incidence of circumcisions even further.

With all that is known about the minimal medical benefits and the possible risks of circumcision, whether or not to have your son circumcision should be more of a cultural (ritual circumcision by the Jewish religion and Muslims, etc.) than a medical question.

A better question would be "Does my new baby boy need a circumcision?" The answer to that one is much easier. No, he doesn't need a circumcision.

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