Should You Get Your Son Circumcised?

Circumcision is the surgical removal of the skin covering the tip of the penis, called the foreskin. Circumcision is an option for most healthy, stable newborn boys, but there are medical reasons some newborns cannot be circumcised.

Circumcision is the surgical removal of the skin covering the tip of the penis, called the foreskin. Although this procedure is relatively common in the United States, deciding whether to circumcise often causes anxiety for parents and debate among medical experts.

Many people have passionate opinions on the subject of circumcision, and advice from professionals varies widely. Is circumcision a bad idea? No one can decide for you, but here are some answers to frequently asked questions.

Circumcision is a long-standing religious practice in many Jewish and Islamic faiths around the world as well as in some aboriginal tribes in Australia and Africa.

In the United States, male circumcision has been a cultural tradition for many years and is still relatively common — with the numbers being the highest in the Midwestern and Northeastern United States and the lowest in the Western United States. Though the popularity of male circumcision is declining, as of 2010, about 58% of American male infants were estimated to have been circumcised during their birth hospital stay.

In other regions of the world, the frequency of circumcision varies greatly. It's relatively common in Canada and the Middle East, but much less common in South and Central Americas, Asia, and most of Europe.

Circumcision is an optional procedure. In a 2012 statement, the American Academy of Pediatrics determined the benefits of circumcision outweigh the risks but didn't recommend circumcision for all male infants. 

Circumcision is an option for most healthy, stable newborn boys, but there are medical reasons some newborns cannot be circumcised. If your son was born very premature (too early), has an illness, was born with certain penis abnormalities, or your family has a history of clotting disorders, the doctors may recommend not circumcising.

Another factor you may want to consider is that circumcision is relatively safe and doesn’t affect your child's fertility or sexual pleasure or their partners later in life. 

Circumcision is usually done in the first few days or weeks after birth because it becomes much more complicated in older children and adult men. If done in a hospital, doctors usually circumcise within 48 hours, but if the baby is born at home or birth center, the family may wait two to three weeks and do it at the doctor's office or with a Mohel — as part of a Jewish religious ceremony, called a “bris”.

Methods vary greatly between individual care providers and between individual hospitals, medical offices, and religious officials (usually Mohels).

Usually, care providers will use a kind of clamp specifically made for circumcision procedures and cut the foreskin with a scalpel. This can take a few seconds to a few minutes. Some care providers will have the mother hold the baby and others will use a padded restraint chair.

It is recommended that circumcision be performed by trained professionals in sterile conditions with appropriate analgesia — or pain control. Be sure to ask your care provider how they plan to perform the procedure should you decide to move forward with circumcision.

There is some disagreement as to how badly it hurts, but pain control should always be used — preferably an injectable penile nerve block, a topical cream won't be enough. Newborns generally recover in 12 to 24 hours, but older babies can take a little longer.

Postoperative recovery can be complicated with irritation from urine and the diaper itself, so it's often recommended to keep the area clean and uses petroleum jelly to protect the penis while healing. All postoperative care should be discussed with your care provider ahead of time.

In general, many medical caregivers agree there are some health benefits to circumcision:

• Easier personal hygiene. Boys with a foreskin must learn how to gently pull it back and clean beneath it as they get older. Boys who have been circumcised don't need to learn that skill.
• Decreased urinary tract infection (UTI) risk. Though rare, UTIs can be dangerous for babies.
• Decreased risk of other problems related to the penis and foreskin. Circumcision may reduce the risk of inflammation of the head of the penis (balanitis) or the foreskin (posthitis) and the inability to retract the foreskin (phimosis).
• Decreased STI risk. Circumcision can reduce the risk of several STIs, including HIV, later in life — though safe sexual practices are still recommended. 
• Decreased cancer risk. Circumcision can reduce the risk of penile cancer later in life.

About 0.1% to 35% of the cases show some kind of complication after the procedure. Most of the complications are minor, including infection and bleeding. Also, if enough foreskin isn't removed during circumcision, your child may need surgery later in life.

Ethical concerns. Critics have argued that a boy has a right to decide for himself whether to change his own body when he is older and that circumcision — especially in the United States — has little to no medical basis and is a result of decades of cultural tradition and bias — when not associated with specific religious beliefs.

Health concerns. Some doctors argue that the health benefits of circumcision are exaggerated, saying that circumcision is unnecessary and, in some cases, even disfiguring. The foreskin is no more prone to disease than any other body part, and even a young boy can learn to take care of it and clean it like any other part of himself.

The decision to circumcise your baby or leave him intact shouldn't come lightly. It's a deeply personal decision that you and your partner should make before the baby arrives. Rest assured that billions of little boys have grown up happy and healthy, with or without a foreskin. If you still have questions and concerns, discuss them with your doctor.