Approximately 55% to 65% of all newborn boys are circumcised in the United States each year, though this rate varies by region (western states have the lowest rates and the north central region has the highest). The procedure is much more widespread in the United States, Canada, and the Middle East than in Asia, South America, Central America, and most of Europe, where it’s uncommon.
Routine circumcision is usually performed during the first 10 days (often within the first 48 hours), either in the hospital or, for some religious ritual circumcisions, at home.
If you decide to have your son circumcised at the hospital, your pediatrician, family doctor, or obstetrician will perform the procedure before you bring your baby home. The doctor should prepare you by telling you about the procedure he or she will use and the possible risks. Circumcision after the newborn period can be a more complicated procedure and usually requires general anesthesia.
Circumcised infants are:
- Less likely to develop urinary tract infections (UTIs), especially in the first year of life. UTIs are about 10 times more common in uncircumcised males than circumcised infants.
- Circumcised men also might be at lower risk for penile cancer, although the disease is rare in both circumcised and uncircumcised males. Some studies indicate that the procedure might offer an additional line of defense against sexually transmitted infections (STIs) like HIV in heterosexual men.
- Penile problems, such as irritation, inflammation, and infection, are more common in uncircumcised males. It’s easier to keep a circumcised penis clean, although uncircumcised boys can learn how to clean beneath the foreskin once the foreskin becomes retractable (usually some time before age 5).
Although circumcision appears to have some medical benefits, it also carries potential risks — as does any surgical procedure. These risks are small, but you should be aware of both the possible advantages and the problems before you make your decision. Of these, the most frequent are minor bleeding and local infection, both of which can be easily treated by your doctor.
One of the hardest parts of the decision to circumcise is accepting that the procedure can be painful. In the past, it wasn’t common to provide pain relief. But the American Academy of Pediatrics (AAP) recommends it and studies show that infants undergoing circumcision benefit from anesthesia, so most doctors now use it. But because this is a fairly new standard of care, it’s important to ask your doctor ahead of time what, if any, pain relief your son will receive.
Two main types of local anesthetic are used to make the operation less painful for a baby:
- a topical cream (a cream put on the penis) that requires at least 20 to 40 minutes to take its full effect
- an injectable anesthetic that requires less time to take effect and may provide a slightly longer period of anesthesia.
- In addition to anesthesia, an acetaminophen suppository can be inserted into the baby’s rectum. This helps reduce discomfort during the procedure and several hours afterward. Giving a pacifier dipped in sugar water also can help reduce a baby’s stress and discomfort.
After reviewing multiple studies on circumcision, the American Academy of Pediatrics (AAP) reports that “the health benefits of newborn male circumcision outweigh the risks.” But at the current time, the scientific evidence is not strong enough for the AAP to recommend routine circumcision of all newborn boys. Instead, the AAP advises parents to learn the facts about circumcision and weigh the pros and cons.
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