Circumcision

Circumcision is a procedure where the foreskin (the skin that covers the tip of the penis) is removed. Circumcision isn’t required. But if parents choose this for their baby, the procedure is usually performed on the first or second day after birth in a healthy baby. However, it can be done within 10 days of birth. Circumcision is riskier and more complicated in infants older than 2 months of age, and in older boys and men.

Circumcisions are done by a doctor in a hospital or outpatient office. They also can be done at home by a hired professional as part of a religious or cultural ceremony.

During the procedure, the doctor will numb the area around the penis with a local anesthetic (medicine that numbs only a specific part of the body). This makes the procedure less painful for the baby. The anesthetic may be given as an injection or applied as a cream. The procedure takes about 20 minutes.

Making the decision about circumcision

Circumcision is a personal choice for you and your family. You will need to consider the benefits and risks of circumcision. Factors such as your culture, religion, and personal preferences may affect your decision. Talk with your doctor about the benefits and risks. He or she may be able to help you decide. You may want to make a decision about circumcision before your son is born. That way, you’ll know what to do about it while in the hospital.

The American Academy of Family Physicians (AAFP) recommends that parents talk to their family doctor about the potential benefits and risks of circumcision when making their decision.

The American Academy of Pediatrics (AAP) says the health benefits of circumcision outweigh the risks. However, the AAP does not think the benefits are great enough to recommend that all male newborns should be circumcised.

Path to improved health

If you decide to have your baby circumcised, you’ll need to follow some steps to help the penis heal.

  • Gently clean the area with water every day when your baby needs a fresh diaper.
  • Use mild soap and water to clean stool off of the penis. This will help prevent infection.
  • If there is a bandage on the penis, it will probably fall off the next time your baby urinates. Ask your doctor whether you should leave the bandage off or if you should put a new bandage on each time you change your son’s diaper.
  • Sometimes, your baby’s urine and the pressure from his diaper will irritate the newly exposed skin on the tip of the penis. This can be treated by putting petroleum ointment (brand name Vaseline) directly on the area. It will usually get better after a few days.

Healing usually takes about 7 to 10 days. Some swelling of the penis is normal. It’s also normal for a yellow discharge or coating to form over the tip of the penis. Don’t try to take this off. It will go away on its own.

If you decide not to have your son circumcised, you’ll need to take some steps to care for his penis. Keep it clean with soap and water to reduce the risk of problems or infections. When your son gets older, his foreskin will separate from the tip of his penis. This is called retraction. It happens at different times for different boys. Most boys can retract their foreskin by the time they are 5 years of age. Don’t try to force the foreskin to retract before it is ready. This can damage the penis and cause pain and other problems. Once the foreskin is ready to retract, you can teach your son how to gently pull the foreskin back and clean the skin underneath. He should wash beneath his foreskin every day while bathing or showering.

Things to consider

Studies have shown some limited health benefits of circumcision.

  • It offers some limited benefit in preventing urinary tract infections (UTIs) in infants. Overall, UTIs are not common in circumcised or uncircumcised males.
  • Newborn circumcision also offers some benefit in preventing cancer of the penis in adulthood. However, this cancer is rare in all men, whether or not they have been circumcised.
  • Circumcision may reduce the risk of certain sexually transmitted infections (STIs). Know that preventing STIs has more to do with a man’s sexual practices (for example, using condoms, limiting the number of sex partners) than with whether or not he is circumcised.

Like any surgical procedure, circumcision does have some risks. However, the rate of problems after circumcision is quite low. Bleeding and infection in the circumcised area are the most common problems. Both of these can be treated by your doctor.

When to call your doctor

After the circumcision, you may notice a small amount of blood on your baby’s diaper. If the bloodstain is larger than the size of a quarter, call your doctor right away. You should also call your doctor if:

  • The wound doesn’t stop bleeding.
  • Your baby doesn’t have a wet diaper within 6 to 8 hours after the circumcision.
  • Redness and swelling around the tip of the penis doesn’t go away after 3 to 5 days, or it gets worse.
  • The yellow discharge or coating on the tip of the penis doesn’t go away after 7 days.
  • A Plastibell device was used and it doesn’t fall off within 10 to 12 days.
  • Your baby has a temperature of 100.4°F or higher.

Questions for your doctor

  • What are some reasons I should have my baby circumcised?
  • What are some reasons I should not have my baby circumcised?
  • Will my baby feel any pain during circumcision?
  • Before circumcision, will you apply the anesthetic as an injection or a cream?
  • How will I know if my baby’s penis is infected?
  • What soap do you recommend for washing the bandaged area?