Parenthood brings with it many challenges and choices. As a pediatrician at The University of Kansas Health System, Whitney Pressler, MD, spends much of her time educating new parents on healthcare decisions they need to make for their child. And for parents of baby boys, one of the first decisions is whether to circumcise.
Circumcision can be a painful topic. Parents are often unsure what the procedure entails, if it will cause their baby pain and if it's even necessary. And with tons of misinformation online, it can be hard to separate fact from fiction.
If you're considering this elective procedure for your child, read on. Below are the top 5 things Dr. Pressler wants every parent to know about circumcision.
1. What happens during circumcision?
Circumcision is a surgical procedure that involves removing the foreskin of the penis. For a newborn, circumcision takes about 20 minutes and starts with administering lidocaine, a local anesthetic, to numb the baby's penis. A medical clamp or ring is then attached, which cuts off blood flow to minimize pain. After the device is attached, the foreskin, or the tip, is removed.
In most cases, there's little bleeding and babies don't need stitches. For additional comfort, physicians will often give newborns sugar water.
"The American Academy of Pediatrics says circumcision is safe and that babies tolerate it well if it's conducted in a sterile environment by someone who's properly trained," Dr. Pressler says.
2. Are only babies circumcised?
While most often done on babies, boys and men can also be circumcised. But Dr. Pressler says that the older a patient is, the greater the risk of complications. Additionally, older patients are more likely to need stitches and may take longer to heal.
However, the risk of complications doesn't increase immediately after a child is born. Dr. Pressler says parents have some time to decide what's right for their baby.
"I tell parents that once we cut it off, we can't put it back on. So, if they're unsure, they should wait," Dr. Pressler says. "Parents don't have to decide before they leave the hospital if they want their newborn to have the procedure. They have a little time."
3. Are there benefits to circumcision?
"The American Academy of Pediatrics found that circumcision lowers the risk of sexually transmitted diseases such as genital herpes, HIV, human papillomavirus and syphilis," Dr. Pressler says.
Some specific benefits the American Academy of Pediatrics mentions are:
- A 30-40% reduced risk of being infected with HPV
- A 30% reduced risk of contracting genital herpes
- Being 10 times less likely to have a urinary tract infection tthe first year of life
According to Dr. Pressler, the average rate of a urinary tract infection in the U.S. is 12 for every 1,000 uncircumcised babies, and 1-2 for every 1,000 circumcised babies.
"Circumcision essentially makes the risk of something that's already small in the U.S. even smaller," she says.
Some global health organizations advocate for every newborn boy to be circumcised to curb the contraction and spreading of HIV. However, Dr. Pressler says the U.S. doesn't have the high HIV burden the rest of the world does.
"We have access to contraception [condoms] in our country," she says. "This does a better job of preventing HIV than circumcision."
While there are medical benefits to circumcision, the American Academy of Pediatrics says that if parents have religious, cultural or aesthetic reasons they don't want their child circumcised, these preferences outweigh any medical advantages.
4. What are the risks of circumcision?
Like any medical procedure, circumcision is not without risk. The risk of side effects for babies is less than 1% when circumcision is performed by a qualified medical provider in a sterile setting. Dr. Pressler said infections, bleeding and reports of too much skin being taken are some of the complications that have been reported, but that these events are rare.
Some argue that circumcision may affect sexual satisfaction or sensitivity later in life, but there is little clinical data to support this.
5. Is there any reason my child shouldn't be circumcised?
Parents who don't want their child circumcised usually cite 2 reasons: They may believe it's a violation of their religious or cultural beliefs, or they don't want to alter their baby's body without their child's consent.
"It's a very personal decision and a pediatrician shouldn't try to talk you into it one way or the other," Dr. Pressler says. "Whatever a family decides is the right thing."