Circumcision

Getting ready for the birth of your baby involves many decisions.  One decision you need to make if your baby is a boy is about circumcision.  Circumcision is the cutting away of the foreskin, the skin that covers the head of the penis.  Many parents have strong feelings either for or against circumcision.  These feelings may be related to family custom or religion.   America is one of the few industrialized countries to routinely circumcise infants for non-religious reasons. If you are not sure about your decision, ask your doctor, nurse or midwife.

Reasons not to circumcise

• The procedure seems upsetting and painful for the baby
• The baby is restrained during the procedure and objects to the restraint
• Many babies are fussy for a while after the circumcision
• There are possible complications of the procedure
• Usually there is no medical reason to circumcise

Reasons to circumcise

• The circumcised penis is easier to clean
• There is less irritation or infection
• Boys who are not circumcised and do not do proper cleaning of the penis may develop a problem which required circumcision later in life when it is far more painful
• There are some reports which show that uncircumcised babies have a higher risk of urinary tract infections
• There are some reports which show a lower risk of HIV infection from a female partner if the man has been circumcised

Preparing for circumcision

If you decide to have your son circumcised, you will need to sign a consent form giving permission.  Circumcision is a short surgical procedure and is done by hospital staff before you leave the hospital after delivery.  The doctor will examine your son and decide if he is ready.  The baby will be taken to a special procedure room. When the baby is brought back to you, he may be fussy.  Cuddling and holding him should make him feel better.  Sometimes tylenol can be ordered.

Complications (less than 1%)

• Bleeding, usually easily controlled with pressure
• Local infection
• Cutting off too little or too much skin

Circumcision care

After circumcision, a piece of gauze with petroleum jelly will be put on the end of the baby's penis.  For the first few days after, continue to place a piece of gauze coated with petroleum jelly on top of the baby's penis.  The petroleum jelly prevents the penis from sticking to the diaper.  This should be done each time the diaper is changed until the penis is healed.  If you run out of gauze put petroleum jelly right on the baby's penis.  The penis usually heals within five days.

Watch for excessive bleeding

• A whitish, yellow covering will appear for 2 to 3 days.  This is normal healing tissue.  Do not try and remove it.
• Clean the penis with a damp cloth without soap and pat dry
• Keep the baby off his stomach until the circumcision heals

Delayed circumcision after hospital discharge

Circumcision is not done if the baby's condition is not stable.  If, for example, the baby is very jaundiced and is being treated with phototherapy, circumcision may be postponed until the problem is resolved. If circumcision is delayed, it may be done at 3-4 months of age by a urologist.  Talk to your baby's healthcare provider to make these arrangements.

Care of the uncircumcised penis

Make sure you clean all the folds and wrinkles of the genitals after each diaper change.  The uncircumcised penis requires no extra cleaning.  Just wash, rinse, and dry it along with the rest of the baby's bottom.  Wash away any whitish secretion (smegma) appearing on the outside of the penis, but don't try to wash or clean under the foreskin (skin over the top of the penis).  Do not pull back the foreskin over the glans (cone shaped tip) of the penis.  Separation of the foreskin from the glans usually takes a couple of years.  Your baby's healthcare provider will talk to you about this.