Should You Circumcise Your Son?

In the U.S., it is estimated that 61-65.3 percent of newborn males are circumcised (National Center of Health Statistics). This same organization notes that there was a substantial decrease of newborn male circumcision (NMC) in the western U.S. This is attributed to the large Hispanic population of that region. In South and Central America, circumcision is uncommon. With one in four children of Hispanic origin being born in the U.S., I feel safe in predicting that the rate of circumcision will decrease. One must recognize that Medicaid pays for this procedure in 33 states and 15 states are not covered by Medicaid. The other two states have some form of variable coverage.

NMC is the surgical removal of the foreskin (the skin that covers the tip of the penis). It is the most common surgical procedure in newborn males worldwide. Muslim boys account for the largest percentage of this global number. The reasons for NMC range from religious traditions, hygiene, family tradition, and the prevention of certain STD’s. The American Academy of Pediatrics does not have a policy recommending NMC because they feel that there is currently not enough information in support of this procedure.

According to the Mayo Clinic, the benefits of circumcision include the following:

1. Hygiene

2. A decrease in urinary tract infections

3. A decrease in penile cancers with less cervical cancers also noted in woman with circumcised partners.

4. Decreases in STD’s such as AIDS, Herpes and HPV.

NMC does not cause infertility or detract from the male sexual experience. Premature babies may be circumcised but doctors prefer the child as full term as possible.

Opponents to NMC suggest that it is an unnecessary procedure. Doctors and Human Rights advocates in the Netherlands have made the argument that NMC causes pain and disfigurement. They also state that the infant is given no choice when this body altering procedure is performed. This painful procedure is also seen as a human rights violation.

When a newborn is circumcised, a local anesthetic is either injected into the base of the penis or a topical anesthetic cream is applied to the penis. The procedure takes but a few minutes. The doctor will choose his instrumentation for the circumcision. Once performed, gauze with petroleum jelly is applied to the penis, in order, to avoid contact with the roughness of the diaper. New Vaseline gauze will be applied with each diaper change for the next few days. Healing takes about 7-10 days. Some doctors use a plastibell, which is a plastic ring that covers the head of the penis. It requires no gauze and it will fall off when the area is healed. This is a very convenient method.

Contact the doctor after the procedure for the following:

1. The baby does not urinate within 12 hours of the procedure.

2. Bleeding persists.

3. If the penis has a foul smelling drainage from the tip or the crusted healed area is filled with fluid.

4. The plastibell is still in place 2 weeks after the circ.

The incident rate of complication is unknown. According to the American Academy of Pediatrics, the rate is between 0.2 to 0.6 percent. Bleeding is the most common problem. In fact, some blood clotting illnesses are detected because of excessive hemorrhage.

NMC is a choice that parents make for their male children. With the rise of HIV disease in Africa, circumcision is being used as a way to decrease infection. It will be interesting to see if this intervention will become adopted practice for U.S. newborn males. More studies will be needed. Stay well.