Baby Circumcision Myths and Facts

Congratulations, it’s a boy! Do you want your baby boy circumcised or not? It’s one of the first questions you’ll get from the doctors and nurses in the hospital.

To some parents, there’s no doubt what they want to do. Others are on the fence. And some parents simply cannot agree with each other. No matter the decision, though, it’s often a very controversial topic.

Circumcision: What You Should Know

Circumcision is the surgical removal of the foreskin of the penis. It’s been happening for hundreds of years for various religious, social, cultural, and medical reasons.

What do the current societies say about it?

Most, including the American Academy of Pediatrics (AAP) and the American College of Obstetricians and Gynecologists (ACOG), recognize the potential health benefits, but they do not universally recommend the procedure.

The AAP policy statement says that the “preventive health benefits of elective circumcision of male newborns outweigh the risks of the procedure. Although health benefits are not great enough to recommend routine circumcision for all male newborns.”

So basically, you can do it or not. Either way is okay, medically. It’s a personal decision for each family to make. Even that statement is controversial, though. Some argue that it’s a form of genital mutilation that no one should make for an infant. This article is not for or against circumcision. It is simply meant to present some common myths and facts to help guide a new parent faced with this decision and unsure of what to do.

Myths of Circumcision

Most males are circumcised.

This is a myth. It depends on many factors. About one in three men are circumcised globally. In the past, up to 90% of all males born in the United States were circumcised, but today that number has dropped to 50-60%. And it varies widely by region, demographics, and religion in the US, according to the CDC. In Europe, Asia, and South America, circumcisions for nonreligious reasons are rarely done.

Circumcisions are always done for religious reasons.

This is a myth. Yes, it is often done for religious reasons. Circumcision has been a part of Jewish and Muslim practice for centuries, for example. However, some choose circumcision for health and cosmetic or social reasons.

Babies do not experience pain during the procedure.

This is a myth. Circumcision used to be done with only non-pharmacologic forms of pain control, but this is no longer the case. Pain relief is now provided in topical anesthetics (like a numbing cream) or nerve blocks (injecting a numbing medicine directly into the area). Techniques such as sucking on a pacifier, giving a sugar-water solution, or positioning can be added to the other forms of pain relief. (1)

Facts of Circumcision

  • Circumcision is an elective procedure. It should only be performed on healthy and stable infants.
  • Circumcised males have lower rates of urinary tract infections (UTIs) than uncircumcised males. The rate of a UTI in uncircumcised boys is about 1%, while in circumcised boys, it’s about 0.13%. (2)
  • Circumcised males have lower rates of some sexually transmitted infections than uncircumcised males, such as HIV and human papillomavirus (HPV). (3)
  • Circumcised males have lower rates of inflammation of their penis because the foreskin has been removed. (4)
  • All surgical procedures, including circumcision, carry risks such as excessive bleeding, infection, problems with anesthesia, and poor cosmetic results. Rarely, there can be an injury to the penis. These complications are all uncommon, and serious complications are infrequent. One study reported the adverse event rate was 1.5%, and the median frequency of any serious adverse event was 0%. (4)
  • If choosing circumcision, there are advantages to doing it in the newborn time versus waiting until the male is older. These advantages include a lower risk of complications and faster healing. Adverse events occur about four per 1,000 procedures for early infant circumcision, but that increases 10- to 20-fold in older boys. (5)

Uncertainties Regarding Circumcision

Some say it’s easier to maintain good hygiene for circumcised males than uncircumcised males, but this has not been shown to be true. Additionally, some say that circumcision decreases sensation in the penis, but there’s no good data on this.

Male circumcision potentially reduces the risk of penile cancer. However, the rate of penile cancer is very low, less than 1 per 100,000 males in the US. And the studies showing risk reduction for circumcised males were done before widespread HPV vaccination, which has further decreased the incidence of cancer. (6)

Whether to circumcise your newborn or not feels like a big decision. And it is. But the science supports whichever you choose. If you decide to do it, it’s a brief procedure that takes about 5-10 minutes. Depending on your state and hospital, it’s usually performed in the hospital after birth by an OBGYN or a pediatrician. If there’s any concern, the physician will consult with a pediatric urologist first. Once you leave the hospital, it is usually much more complicated to have the procedure done by a physician.

Religious officials can also perform circumcision in a newborn. In Jewish tradition, a mohel performs circumcision during a bris ceremony when the baby boy is eight days old.

Resources:
(1) Omole F, Smith W, Carter-Wicker. “Newborn Circumcision Techniques.” American Family Physician. 2020;101(11):680
(2) Singh-Grewal, J Macdessi, J Craig. Circumcision for the prevention of urinary tract infection in boys: a systematic review of randomised trials and observational studies. Arch Dis Child. 2005;90(8):853. Epub 2005 May 12.
(3) Siegfried N, Muller M, Deeks J, Volmink J, Egger M, Low N, Walker S, Williamson P. HIV and male circumcision–a systematic review with assessment of the quality of studies. Lancet Infect Dis. 2005;5(3):165.
(4) Weiss HA, Larke N, Halperin D, Schenker I. Complications of circumcision in male neonates, infants and children: a systematic review. BMC Urol. 2010;10:2. Epub 2010 Feb 16.
(5) El Bcheraoui C, Zhang X, Cooper CS, et al. Rates of adverse events associated with male circumcision in US. medical settings, 2001 to 2010 JAMA Pediatr 2014;168(7) 625-634
(6) Larke NL, Thomas SL, dos Santos Silva I, Weiss HA. Male circumcision and penile cancer: a systematic review and meta-analysis. Cancer Causes Control. 2011 Aug;22(8):1097-110. Epub 2011 Jun 22.


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