Circumcision of baby boys: Information for parents

 

Circumcision of baby boys is an optional surgical procedure to remove the layer of skin (called the foreskin or the prepuce) that covers the head (glans) of the penis. It is most often done during the first few days after birth.

Parents who decide to circumcise their newborn boys often do so for religious, social or cultural reasons. If you are trying to make a decision about circumcision, talk to your baby’s health care provider. Ask for up-to-date information about the potential medical benefits and risks of circumcision.

Potential benefits of circumcision

A few studies suggest that boys who have been circumcised may be:

• Less likely to develop cancer of the penis later in life – although this form of cancer is extremely rare.
• Less likely to get HIV and HPV infections.
• Less likely to get a urinary tract infection during childhood.

Female partners of men who have been circumcised are less likely to get cervical cancer.

Potential risks of circumcision

Circumcision is a painful procedure.
Problems resulting from the surgery are usually minor. Although serious complications are very rare, they do occur. These can include:

• Too much bleeding or infection in the area.
• Too much skin removed.
• Side effects from the method or medicine used for pain relief.

The risk of complications is lower in young babies than in older children. To minimize the risks, the procedure should be done by a trained and experienced practitioner using a sterile technique. Someone should follow up with you in the days after the procedure to make sure that bleeding has not increased.

Caring for an uncircumcised penis

The foreskin covers the head (glans) of a boy’s penis. During the early years of a boy’s life, the foreskin starts to separate from the glans, but may not be fully retractable (meaning it can be pulled back) until a boy is 3 to 5 years old, or even until after puberty. This is a natural process that occurs over time. You do not need to do anything to make it happen.
An uncircumcised penis is easy to keep clean and requires no special care:

• Keep your baby’s penis clean by gently washing the area during his bath. Do not try to pull back the foreskin. Never force it.
• When your son is old enough, teach him to keep his penis clean as you’re teaching him how to keep the rest of his body clean.
• When the foreskin separates, skin cells will be shed and new ones will develop to replace them. These dead skin cells will work their way down the penis through the tip of the foreskin and may look like white, cheesy lumps. These are called smegma. If you see them under the skin, you don’t need to force them out. Just wipe them away once they come out.
• When the foreskin is fully retractable, teach your son to wash underneath it each day.

If you decide to have your baby boy circumcised

In Canada, most circumcisions are done by medical practitioners or skilled traditional providers.
Talk to your baby’s health care provider about the issues involved in circumcision:

• Cost: Circumcisions for non-medical reasons are not covered by any provincial and territorial health plans.
• Possible complications, such as the ones described above.
• Pain relief:
  • Newborn babies feel pain. The practitioner performing the circumcision should use some type of local anesthetic, given by a needle in the area where the circumcision is done.
  • Additional methods of relieving pain include sucking on a pacifier dipped in a sugar solution, topical anesthetic cream and  acetaminophen.
  • Anesthetics do carry risks and the needle can cause bruising or swelling. Creams may cause redness or swelling.
• Contraindications (a condition that makes a particular treatment or procedure not recommended): Sometimes, babies have health problems. which increase the risk of complications after circumcision.

Caring for a circumcised penis

• After the circumcision, you can comfort your baby by holding him and nursing him often.
• The penis will take 7 to 10 days to heal. The area may be red for a few days and you may see some yellow discharge, which should decrease as it heals. Talk to your baby’s health care provider about what to expect.
• Follow the instructions given by the practitioner who did the circumcision about caring for the dressing, using petroleum jelly, keeping the area clean and bathing.
• Call your health care provider if:
  • You see persistent bleeding at any time during the healing process.
  • The redness and swelling around the circumcision do not start to go down in 48 hours.
  • Your baby develops a fever (rectal temperature of 38.0° C or higher).
  • Your baby seems to be unwell.
  • Your baby does not pass urine within 12 hours of the procedure.
  • There is a greenish or foul smelling discharge from the penis.