Circumcision: What You Need to Know

What is circumcision?

At birth, males have skin that covers the end of the penis, called the foreskin. Circumcision is the surgical removal of the foreskin, exposing the tip of the penis. Circumcision is usually performed by a doctor in the first few days after birth. The surgery should be done under sterile conditions with adequate pain management. (See Is circumcision painful?) A newborn must be stable and healthy to safely be circumcised. Because circumcision may be riskier if done later in life, parents should decide before or soon after their baby is born if they want it done.

Is circumcision painful?

Yes. However, there are pain medicines that are safe and effective. The AAP recommends that they be used to reduce pain from circumcision.

What should I expect for my baby after circumcision?

After the circumcision, the tip of the penis may seem raw or yellowish. If there is a bandage, it should be changed with each diapering to reduce the risk of infection. Use petroleum jelly to keep the bandage from sticking. Sometimes a plastic ring is used instead of a bandage. This should drop off within 5 to 8 days. The penis should be fully healed in about 1 week to 10 days after circumcision.

Reasons Parents May Choose Circumcision

• Medical benefits. Scientific studies show the health benefits of newborn male circumcision outweigh the risks of the procedure, including

  • A markedly lower risk of acquiring HIV, the virus that causes AIDS.

  • A significantly lower risk of acquiring a number of other sexually transmitted infections (STIs), including genital herpes (herpes simplex virus), human papillomavirus (HPV), and syphilis.

  • A lower risk of urinary tract infections (UTIs). A circumcised male infant has about a 1 in 1,000 chance of developing a UTI in the first year after birth; an uncircumcised male infant has about a 1 in 100 chance of developing a UTI in the first year after birth.

  • A lower risk of getting cancer of the penis. However, this type of cancer is very rare in all males.

• Other medical benefits, including

  • Prevention of foreskin infections

  • Prevention of phimosis, a condition in uncircumcised males that makes foreskin retraction impossible

  • Easier genital hygiene

• Social reasons. Many parents choose to have it done because "all the other men in the family" had it done or because they do not want their children to feel "different."

• Religious or cultural reasons. Some groups, such as followers of the Jewish and Islamic faiths, practice circumcision for religious and cultural reasons.

Reasons Parents May Not Choose Circumcision

• Belief that circumcision should be a person's choice.

• Belief that if "it ain't broke, then why remove normal tissue?"

• Fear of the risks. Complications are rare and usually minor but may include bleeding, infection, cutting the foreskin too short or too long, and improper healing.

• Belief that the foreskin is needed. Some people feel the foreskin is needed to protect the tip of the penis. Without it, the tip of the penis may become irritated and cause the opening of the penis to become too small. This can cause urination problems that may need to be surgically corrected.

• Belief that it can affect sexual sensation. Some feel that circumcision makes the tip of the penis less sensitive, causing a decrease in sexual pleasure later in life.

• Belief that proper hygiene can lower health risks. Children can be taught proper hygiene that can lower their chances of getting infections, cancer of the penis, and STIs.

Are there any problems that can happen after circumcision?

Problems after a circumcision are very rare. However, call your child's doctor right away if

• Your baby does not urinate normally within 6 to 8 hours after the circumcision.

• Bleeding doesn't stop at the spot where the foreskin was removed.

• The redness around the tip of the penis gets worse after 3 to 5 days.

• Yellow discharge lasts longer than a week. It is normal to have a little yellow discharge or coating around the head of the penis in the first week.

What if I choose not to have my baby circumcised?

If you choose not to have your baby circumcised, talk with your child's doctor about how to keep the penis clean. Keep in mind that the foreskin will not fully retract for several years and should never be forced. When your child is old enough, they can learn how to keep their penis clean just as they will learn to keep other parts of their body clean.

What is female genital mutilation?

Female genital mutilation has sometimes been called female circumcision, although it has no known medical benefits and causes many known harms, both medical and psychological. It involves removing part or all of a female's clitoris. It may also include sewing up the opening of the vagina. It is often done without any pain medicine. The purpose of this practice is to prove that a female is a virgin before marriage, reduce the ability to experience sexual pleasure, and promote marital fidelity. There are many serious side effects, including

• Pelvic infections and UTIs

• Negative effects on self-esteem and sexuality

• Inability to deliver a baby vaginally

The AAP is absolutely opposed to this practice in all forms because it is disfiguring and has no medical benefits.

Visit HealthyChildren.org for more information.