What You Should Know About Newborn Circumcision

Are you about to welcome a baby boy into your family? You might feel uncomfortable thinking about the decision to circumcise your baby or not. By getting as much information as you can now, you will be able to move forward feeling more comfortable with whatever you decide.

Circumcision is the surgical removal of the skin that covers the head of your baby’s penis, known as the foreskin. It can be performed by your ob-gyn before your baby leaves the hospital, or later by the baby’s pediatrician. It is performed only if the baby is healthy.

What is involved in a circumcision procedure?

A traditional circumcision procedure takes between 10 and 20 minutes. During the procedure, the baby is placed on a special table with soft restraints for the arms and legs. The penis and foreskin are cleaned, and a special clamp is attached to the penis. The foreskin is then carefully cut and removed. After the procedure, gauze with petroleum jelly is placed over the wound to protect it from rubbing against the diaper.

The Plastibell method

The Plastibell was invented in 1950 and is now one of the most widely-used circumcision methods. With the Plastibell technique, the doctor separates the foreskin from the penis head with a probe. A plastic ring is inserted underneath the foreskin and the foreskin is stretched over it. It is then secured with a suture to stop blood flow. The plastic ring remains on the baby’s penis until the foreskin falls off naturally in 7-10 days.

Will my baby need pain medication during the procedure?

An anesthetic (medicine to numb the pain) can be injected at the base of the penis with a needle or applied as a topical cream to the skin. Analgesia is also safe and effective in reducing the pain associated with newborn circumcision.

Why should I have my baby circumcised?

There is no “should” involved in the decision to have your baby circumcised. It’s a personal choice. Some parents choose circumcision because of their cultural practices or religious beliefs. For example, Jews and Muslims have circumcised their male newborns for centuries. There are other parents who choose circumcision simply because that is what the males of their families have always chosen.

Some parents choose to circumcise their newborn sons for certain health benefits:

• Circumcision reduces the bacteria that can live under the foreskin, including the bacteria that can cause STIs in adults and bacteria that can cause urinary tract infections. Circumcised infants have a decreased risk of urinary tract infections (UTIs), particularly in the first year of a child’s life. Severe or recurrent UTIs can result in kidney damage or lead to sepsis, a dangerous bloodstream infection.
• Decreased risk of skin conditions that can affect the penis, such as phimosis.
• Reduced risk of developing penile cancer.
• There is a decreased risk for cervical cancer in the female partners of circumcised men.
• Some research studies indicate that circumcision may decrease the risk of a man getting human immunodeficiency virus (HIV) from an infected female partner. However, additional research is needed.

The American Academy of Pediatrics (AAP) has stated that the health benefits of circumcision in newborn boys outweigh the risks of the procedure. However, the AAP has determined the benefits are not substantial enough to issue a recommendation that all newborn boys be circumcised. For this reason, parents will want to discuss the procedure with their baby’s healthcare provider and do their own research in order to determine if it’s the right option for their child.

It’s important to note that because circumcision is an elective procedure, it may not be covered by your health insurance. Parents should contact their insurance carrier to find out if their policy covers the procedure.

Why would I not have my baby circumcised?

Some parents are concerned about pain the baby could experience or the potential risks involved in the procedure. While all surgical procedures carry some risk, complications from circumcision are rare. Others may be concerned that circumcising their baby could negatively affect their child’s sexual function as an adult, penis sensitivity, or sexual satisfaction. However, studies indicate that these concerns are unfounded.

Occasionally, parents prefer to leave the decision to be circumcised to the child himself, once he is old enough to decide what he would like to do. However, it should be kept in mind that recovery from the procedure may take longer when circumcision is done on an older child or adult, and there is an increased risk for complications.

What are the potential complications involved in newborn circumcision?

• Bleeding
• Infection
• Scarring

Also, in rare incidents, too much of the foreskin or not enough foreskin is removed. However, when these complications do occur, they are generally very minor. Some complications specific to the Plastibell circumcision technique include incomplete circumcision due to inadequate bell placement or slippage of the Plastibell while tying the suture, injury to the penis head, or bleeding due to inadequate hemostatic suture placement.

Complications are less likely to occur if the circumcision is performed by a very experienced healthcare provider in a medical setting. When a circumcision is performed in a non-medical setting for religious or cultural reasons, the person performing the procedure should be well-trained in its execution, in how to relieve pain, and how to prevent infection.

When should circumcision not be performed?

Reasons to delay circumcision include the following:

• The baby is premature
• The baby has a blood disorder or a family history of bleeding disorders
• The baby has particular congenital abnormalities

If your baby is not circumcised, you can keep his penis clean by washing the exterior with a gentle soap and water. Do not try to pull back the infant’s foreskin, as the skin may not be able to pull back completely until he is older. During your baby’s appointments, Dr. Leung will check the area and let you know when the skin can be pulled back and cleaned.

After-care for a circumcision

After your baby has been circumcised, you will want to change his diaper frequently so that urine and feces do not cause infection. Each time you change your baby’s diaper, gently clean your baby’s penis. Remove any feces with a mild soap and water during diaper changes. After cleaning, place petroleum jelly on a gauze pad and apply it directly to the penis. You may also place the petroleum jelly on the diaper in the area the penis touches. The tip of the penis may appear slightly reddened. There may also be a small amount of yellow fluid. These are indications the wound is healing normally and in most cases, the skin will heal in 7–10 days.

Signs of infection include fever, redness that does not go away, swelling, or if the wound is weeping fluid that looks cloudy and forms a crust. Call our office right away if you notice any of these symptoms of infection.

Circumcising your baby is a very personal decision for each family. Hopefully, many of your concerns about circumcision have been addressed in this post. If you have questions about circumcision, Dr. Leung would be happy to discuss the benefits and risks with you.