Newborn Care: To Circumcise Or Not To Circumcise

Newborn Care

That Is The question!

It was a typical day in a pediatric office.  Ear infections, well-child checks and a few circumcisions to perform.  For this particular family, this beautiful boy was their first and the parents were still contemplating whether they wanted him circumcised or not.  This comes up more often lately because a few insurance companies have decided to not cover the cost of a circumcision.  We discussed their options as stated below.

What Have Been The Medical Reasons to Circumcise?

A circumcision remains a cosmetic procedure.  It has been shown to reduce the risk of sexually transmitted infections in adult males, reduce risk of urinary tract infections (UTI) and penile cancers.  However, as of December 2020, these diseases do not happen enough to recommend this procedure for all boys.  In fact, the American Academy of Pediatrics (AAP), American Academy of Family Physicians (AAFP), and American College of Obstetrics and Gynecologists (ACOG) each have statements explaining the medical benefits of the procedure and therefore, should be available for families to decide but, ultimately, remains parent choice.

According to the AAFP statement one would have to perform a circumcision on 140 boys to prevent one UTI and almost 200 to prevent a hospitalization due to a UTI.  In addition, one would have to perform 300,000 circumcisions to prevent one case of penile cancer.

Are There Different Methods?

There are a few ways to perform a circumcision.  The two most common are called Plastibell and Gomco.  At our office we use the Gomco procedure.  After we receive the families written consent we take the newborn boy to the procedure room.  If families are comfortable, they may join us for the procedure.  We use a special board called a “circumstraint” board to keep their legs still.  We also use injectable lidocaine to numb the foreskin and oral “sweeties” a sugar mixture that they suck to soothe them.  It usually takes about 20 minutes and your baby will go home with you that day with Vaseline in the diaper to prevent the penis from sticking to the diaper as it heals.  It usually takes about a week to heal and plenty of Vaseline.

What Are The Risks?

There are two main, but rare, risk factors with a circumcision including bleeding and infection.  However, the procedure is clean and sterile and we make sure there is no bleeding before you leave the office.

Who Can I Talk To?

If you have other questions regarding whether or not you should circumcise your baby boy, please don’t hesitate to call to speak to one of our providers.  We are Thrive Pediatrics, caring for Idaho’s future today.

 

Source: https://pediatrics.aappublications.org/content/130/3/585