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Newborn and Infant Care

Circumcision for newborn

11/16/2006

Question:

I am pregnant with a baby boy. Me and my husband are confused on whether to Circumcise our baby or not. I know it ia a personal decision but could you atleast give us some information on this and whether it is beneficial for the baby in the long run. I would also apprciate your personal opinion on this. Thanks

Answer:

The pros for circumcising include a decreased risk for urinary tract infections, prevention of potential problems with the foreskin in the future such as one that is too tight (acquired phimosis, about 1% of uncircumcised males) and prohibits urination or that rolls backwards away from the glans or head of the penis (paraphimosis, less than 1% of uncircumcised males) and could like a painfully tight rubberband, prevention of irritation and infection from poor cleansing, allergy or irritation (occurs in 4% of uncircumcised males) as the child gets older and the foreskin separates from the glans (you can always be sure to teach good hygiene), and reduction in the likelihood of cervical cancer in your son's future spouse and a reduction in risk for penile cancer for himself.

Cons are that there is no clear medical indication for the procedure, it is painful, and research shows that it increases the frequency of crying in the first month of life.

The most likely risks are first and foremost excessive bleeding. You would not want to refuse the Vitamin K injection routinely given all newborns if you select circumcision. Babies lack the intestinal bacteria that produce Vitamin K that is essential to support normal clotting. Damage to the penis requiring treatment and a longer hospital stay is the second most frequent problem, followed by infection. There is also the potential for the baby to be allergic to the lidocaine injection to block pain during the circumcision, but this is very rare.

A trade-off analysis done by University of Washington doctors in 2000 showed that for every boy with a complication, six boys were spared a urinary tract infection. They also showed that for every two complications from circumcisions, one little boy avoided penile cancer as an adult.

I don't think there is an easy choice. I really don't want to give you my own personal opinion, but rather questions to consider. Will you and your partner be comfortable cleansing your baby's genitals if he is uncircumcised? If he is uncircumcised, will you feel comfortable teaching him how to cleanse his genitals properly when he is older and the foreskin has separated from the glans? Do you live in an area where most boys are circumcised and where there is a good likelihood he would be teased about being different? If so, do you feel that you can help him deal with this? Does his father have any strong feelings about father and son both being circumcised or uncircumcised?

There is no right or wrong answer. I wish you an easy and safe delivery and much pleasure with your new son!

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Response by:

Mary M Gottesman, PhD, RN, CPNP, FAAN Mary M Gottesman, PhD, RN, CPNP, FAAN
Professor of Clinical Nursing
College of Nursing
The Ohio State University