Info Sheet: Neonatal Circumcision
Routine circumcision has gone from the absolute norm in the US a generation ago to being a hotly debated topic. In this information sheet, I will give you the basic facts about circumcision. As always, please do your own research and educate yourselves about this topic before making a decision regarding your baby. In any case, I do not perform circumcisions as this surgery is beyond the scope of my practice, so you will need to consult your doctor or pediatrician if you want your baby boy circumcised.
What Is Circumcision?
Circumcision is the cutting away of the foreskin on a male penis. (Female circumcision is practiced in some parts of the world, but this info sheet will deal only with male circumcision.) A medical circumcision involves cutting the entire foreskin away; sometimes a ritual religious circumcision will remove only the tip of the foreskin or simply nick the tip symbolically.
How Is It Performed?
In a hospital or doctor’s office, the baby is strapped down so that he cannot flail and move away from the practitioner, and also so that he does not contaminate the sterile field. Some doctors will administer a local anesthesia. A metal bell-shaped tool is placed over the head of the penis to protect it. The foreskin is pulled away from the head, tearing away the adhesions that are formed between the foreskin and head. The foreskin is then cut away, and the cut flesh is clamped. The head of the penis will be red and tender for several days.
Why Is It Performed?
There are many reasons given for performing circumcision. One reason for circumcision is religion. Judaism and Islam are two religions that require circumcision for its faithful. This info sheet will not address the religious validity of circumcision; I will leave this important decision to you and your religious advisors if applicable.
The main reason for circumcision historically in the US is societal norms. Circumcision became popular in the US only after World War II, when it was found that men who served in swamplands came home with a higher rate of infection for those who were uncircumcised. It was decided that circumcision made for a cleaner, more hygienic penis, and most baby boys were circumcised after this.
Studies have been conducted that show both sides: both that circumcision prevents and doesn’t prevent STIs, penile cancer, and other infection. The American Academy of Pediatrics has stated that the jury is still out on the subject, but that at this time there is no compelling medical reason to circumcise.
Other reasons for circumcision are to make the baby look like his father, family tradition, and social norms.
Are There Complications?
Complications of surgical circumcision are, thankfully, rare, but do exist. There have been incidences of complete or partial accidental removal of the penis. Hemorrhage can occur because of unknown blood clotting disorders combined with the surgery. There can be a reaction to the anesthesia. Infection, ulcers, and other complications can arise. Again, the purpose of this info sheet is not to be a comprehensive fact sheet, but just to cover the highlights, so educate yourself on the risks of circumcision before you decide on it.
The Uncircumcised Penis
Much misinformation exists on how to care for the uncircumcised penis. All that is necessary is to clean the penis, just as you would any other body part. You do not have to retract the foreskin and wash under. Retracting the foreskin should not be done, as it can tear the adhesions that may be present for several years. When the foreskin is ready to retract, it will. For an excellent discussion on this topic, see Mothering Magazine’s excellent article by Dr. Paul Fleiss at http://www.mothersagainstcirc.org/fleiss.html. A quote from the article: “The natural penis requires no special care. A child's foreskin, like his eyelids, is self-cleansing. For the same reason it is inadvisable to lift the eyelids and wash the eyeballs, it is inadvisable to retract a child's foreskin and wash the glans. Immersion in plain water during the bath is all that is needed to keep the intact penis clean.” [1]
For More Information
Please ask if you need more information on any aspect of circumcision. You can also check out these resources:
Mothering Magazine http://mothering.com/
http://patiented.aap.org/content.aspx?aid=5273
http://en.wikipedia.org/wiki/Circumcision
http://en.wikipedia.org/wiki/Religious_male_circumcision
[1] Fleiss PM. The case against circumcision. Mothering Magazine. Winter 1997: 36-45.
