Circumcision Is Unnecessary; There Are Very Few Benefits to Newborn Males
Question: I am pregnant with our first baby. Lately my husband and I have been discussing, if we have a boy, whether we should have him circumcised. Every boy in his family is circumcised, and he said that this is the best way to keep the penis clean. My family doesn't have that tradition. I am trying to do the best for our son. Can you tell me the benefits of circumcision and whether there are problems?
I am glad that you are having this discussion with your husband before your baby is born. It is always better to make the decision together. Let me try to explain about the structure of a newborn penis and then talk about the benefits and problems of circumcision.
Every newborn baby boy has a piece of skin, which is called the foreskin, that surrounds the tip of the penis (also called the glans). At the very end of the penis, there is a little hole where urine comes out, and the urine passes through a similar small opening in the foreskin.
The foreskin of a newborn baby is attached to the glans by some tissue. That is why it is difficult to pull back the foreskin of a young child. When the tissue finally dissolves, then the foreskin can be pulled back easily. However, this usually does not happen until the boy is three to five years of age.
You may ask, “why is the foreskin there, and what is it for?” We don’t have the perfect answer, but most likely the foreskin is there to protect the delicate glans when the baby is small and in diapers.
One of the benefits of circumcision is to allow cleaning of the glans. This is very true. However, during the first few years of life, the glans is attached to the foreskin, and there is no need to clean the glans at all. Actually we do not advise parents to pull back the foreskin of uncircumcised babies during the first few years of life. Doing that can actually damage the opening of the foreskin and cause a condition called phimosis (which is narrowing of that opening).
As a child gets older, it is necessary to teach the child to pull back the foreskin every time he has a shower or bath. This way he can keep his glans clean and prevent infection of the glans and foreskin.
Another benefit for circumcision is to prevent infection of the bladder (also called urinary tract infection or UTI). However, UTI is very, very uncommon in males, and circumcision will only reduce the chance of a very uncommon disease. The benefit is small.
Some parents want their child circumcised because they have relatives with children who had foreskin infection, and required surgery later. They wanted to prevent this in the first place. I don’t think this is the right approach. It is like removing the appendix from every small child because there is a chance of appendicitis later on in life. It is possible to prevent foreskin infection by teaching proper cleaning of the glans and foreskin. If repeated infection still occurs, then circumcision can be done at that time.
In some families, every male was circumcised and the family wants the newborn baby to be circumcised also. I have a different opinion: every person is unique, that is why each has his or her own name, and the newborn child does not need circumcision to become part of the family. If the family has Jewish faith, then their religion dictates the ritual, and it is a totally different situation.
You can probably sense that I am not in favour of circumcision. This is because I was trained in United States during the 1970s. As a paediatric resident, one of my duties was to circumcise all newborn infant boys. As a result, I have done hundreds of these operations, and found it very traumatic to the babies and myself.
Most circumcisions are still done with inadequate pain control. Some babies cry to the point of passing out. I have also seen some serious surgical complications of circumcision. A few children required corrective surgery immediately or years later. Boys with Haemophilia (a bleeding condition) can bleed dangerously after surgery. You may have heard that, in rare situations, a boy’s penis had to be removed and surgically changed into a girl because of complications from circumcision. Of course this is very rare. In United States, there is a support group for men who have suffered from problems of circumcision as an newborn.
Yes, I am rather biased by my personal experience. But the benefit of circumcision is very small, and I cannot see why we should do unnecessary operation on newborn babies, no matter how minor or “safe” it is. I know this procedure is still being done routinely in many parts of this country, but there are more and more of my colleagues who are speaking up against this procedure.
I hope that both you and your husband take into consideration the pros and cons of circumcision, and make a conscious decision for your son. Well, if this is a girl, you don’t even have to worry.