Labor, Delivery, and Postpartum Care
FAQ039, September 2012



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Newborn Circumcision

What is circumcision?

Circumcision is the surgical removal of the layer of skin, called the foreskin, that covers the glans (head) of the penis.

When is circumcision performed?

Circumcision on infants may be performed before or after the mother and baby leave the hospital. It only is performed if the baby is healthy. If the baby has a medical condition, circumcision may be postponed. Circumcision also can be performed on older children or adults. However, recovery may take longer when circumcision is done on an older child or adult. The risks of complications also are increased.

Is circumcision a required procedure?

Circumcision is an elective procedure. That means that it is the parents’ choice whether to have their infant sons circumcised. It is not required by law or by hospital policy. Because it is an elective procedure, circumcision may not be covered by your insurance policy. To find out, call your insurance provider or check your policy.

Is circumcision a common practice?

Although many newborn boys in the United States are circumcised, the number of circumcisions has decreased in recent years. It is less common in other parts of the world.

Why do some parents choose to have their sons circumcised?

There are hygienic reasons for circumcision. Smegma is a thick white discharge containing dead cells. It can build up under the foreskin of males who are not circumcised. This can lead to odor or infection. However, a boy who has not been circumcised can be taught to wash his penis to get rid of smegma as a part of his bathing routine.

For some people, circumcision is a part of certain religious practices. Muslims and Jews, for example, have circumcised their male newborns for centuries. Others may choose circumcision so that the child does not look different from his father or other boys.

Why do some parents choose not to have their sons circumcised?

Some parents choose not to circumcise their sons because they are worried about the pain the baby may feel or the risks involved with the surgery. Others believe it is a decision a boy should make himself when he is older.

Are there any health benefits associated with circumcision?

Circumcised infants appear to have less risk of urinary tract infections than uncircumcised infants. The risk of urinary tract infection in both groups is low. It may help prevent cancer of the penis, a rare condition.

Some research suggests that circumcision may decrease the risk of a man getting human immunodeficiency virus (HIV) from an infected female partner. It is possible that circumcision may decrease the risk of passing HIV and other sexually transmitted diseases from an infected man to a female partner. At the present time, there is not enough information to recommend routine newborn circumcision for health reasons.

Are there any risks associated with circumcision?

Possible complications include bleeding, infection, and scarring. In rare cases, too much of the foreskin or not enough foreskin is removed. More surgery sometimes is needed to correct these problems.

How is circumcision performed?

Circumcision takes only a few minutes. During the procedure, the baby is placed on a special table. It is recommended that an anesthetic be used for pain relief. Various surgical techniques are used, but they follow the same steps:

  • The penis and foreskin are cleaned.
  • A special clamp is attached to the penis and the foreskin is removed.
  • After the procedure, a bandage and petroleum jelly are placed over the wound to protect it from rubbing against the diaper.

What should I expect after my baby boy has been circumcised?

If your baby boy has been circumcised, a bandage with petroleum jelly may be placed over the head of the penis after surgery. The bandage typically falls off the next time the baby urinates. Some heath care providers recommend keeping a clean bandage on until the penis is healed, while others recommend leaving it off. In most cases, the skin will heal in 7–10 days. You may notice that the tip of the penis is red and there may be a small amount of yellow fluid. This usually is normal.

How do I keep the circumcised area clean?

Use a mild soap and water to clean off any stool that gets on the penis. Change the diapers often so that urine and stool do not cause infection. Signs of infection include redness that does not go away, swelling, or fluid that looks cloudy and forms a crust.

If I decide not to have my son circumcised, how do I clean his penis and foreskin?

If your baby boy has not been circumcised, washing the baby’s penis and foreskin properly is important. The outside of the penis should be washed with a mild soap and water. Do not attempt to pull back the infant’s foreskin. The foreskin may not be able to pull back completely until the child is about 3–5 years old. This is normal.

As your child gets older, teach your son how to wash his penis. He should pull back the foreskin and clean the area with soap and water. The foreskin then should be pushed back into place.

Glossary

Anesthetic: A drug used to relieve pain.

Foreskin: A layer of skin covering the end of the penis.

Glans: The head of the penis.

Human Immunodeficiency Virus (HIV): A virus that attacks certain cells of the body’s immune system and causes acquired immunodeficiency syndrome (AIDS).

Sexually Transmitted Diseases: Diseases that are spread by sexual contact, including chlamydia, gonorrhea, genital warts, herpes, syphilis, and infection with human immunodeficiency virus (HIV, the cause of acquired immunodeficiency syndrome [AIDS]).

Smegma: A whitish, cheesy substance normally built up and shed from under the male foreskin.

If you have further questions, contact your obstetrician–gynecologist.

FAQ039: Designed as an aid to patients, this document sets forth current information and opinions related to women’s health. The information does not dictate an exclusive course of treatment or procedure to be followed and should not be construed as excluding other acceptable methods of practice. Variations, taking into account the needs of the individual patient, resources, and limitations unique to the institution or type of practice, may be appropriate.

Copyright September 2012 by the American College of Obstetricians and Gynecologists.