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The AAP's 2012 Guide for Parents

 

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Healthy Children > Ages & Stages > Prenatal > Unnecessary Decisions > Circumcision

Ages & Stages

Circumcision

[What is the foreskin?

The foreskin is a normal, healthy, functional, integral part of the penis. Throughout life it is protective, and in adult men it has erogenous functions. It has a unique rolling action and is richly innervated.]

 

Baby being circumcised

Circumcision is a surgical procedure in which the skin covering the end of the penis [no, the foreskin is the end of the penis - saying it "covers the end" defines it off the penis before we begin] is removed [cut off, to be precise]. Scientific studies show a number of [weak, debatable] medical benefits [and risks, and harms] of circumcision. Parents may also want their sons circumcised for religious, social, or cultural reasons. [Sons, in their turn, may grow up not wanting to have been circumcised. The AAP never considers this.] Because circumcision is not essential to a child's health, parents should choose what is best for their child by looking at the benefits and risks. [When it is not essential to a child's health, circumcision should not be done.] The following are [very biased] answers to common questions about circumcision.

What Is Circumcision?

At birth, boys [and throughout life, men, if they're lucky] have skin that covers the end of the penis, called the foreskin. Circumcision surgically removes the foreskin, exposing the tip [no, the glans, or "head"] of the penis. Circumcision is usually performed by a doctor in the first few days of life. [.. in the USA. In the Muslim world it is done before puberty. In most of the world it is not done at all.] An infant must be stable and healthy to safely be circumcised. [And even then, accidents can happen.]

Because circumcision may be more risky if done later in life [there is no evidence for this], parents should decide before or soon after their son is born if they want it done. [This is the old "Hurry! Buy now! This offer won't last!" shill.]

Is Circumcision Painful?

Yes. [Excruciatingly (of course). And the pain does not end with the operation.] However, there are pain medicines that are safe and [incompletely] effective. The American Academy of Pediatrics recommends that they be used to reduce pain from circumcision.

What Should I Expect For My Son After Circumcision?

After the circumcision, the tip of the penis may seem [Seem? No, it is] raw or yellowish. If there is a bandage, it should be changed with each diapering to reduce the risk of infection. [Infection can include MRSA.] Use petroleum jelly to keep the bandage from sticking. ["Sticking" can lead to the formation of skin bridges. And you thought circumcision made the baby's penis low-maintenance?] Sometimes a plastic ring is used instead of a bandage. This should drop off within 5 to 8 days. The penis should be fully healed in about 1 week to 10 days after circumcision.

Are There Any Problems That Can Happen After Circumcision?

Problems after a circumcision are very rare. [But when they happen to your son, that's too common.] However, call your pediatrician right away if

  • Your baby does not urinate normally within 6 to 8 hours after the circumcision. [This has led to death.]
  • [The plastic ring does not drop off within 5 to 8 days. This can cause serious damage. ]
  • Bleeding doesn't stop. [A newborn baby can afford to lose only two tablespoons of blood before his life is in danger.]
  • The redness around the tip of the penis gets worse after 3 to 5 days.
  • Yellow discharge lasts longer than a week. It is normal to have a little yellow discharge or coating around the head of the penis in the first week.
[Call your lawyer right away if
  • The tip of his glans is missing
  • His penis dies and falls off
  • He dies
  • You have turned 18 and are outraged that this was done to you.]

Reasons Parents May Choose Circumcision

There are a variety of reasons why parents choose circumcision.

Medical benefits, including:

  • A markedly lower risk of acquiring HIV, the virus that causes AIDS [from women, one of the rarer modes of transmission in the USA. This is debatable.].  
  • A significantly [statistically, but not greatly] lower risk of acquiring a number of sexually transmitted infections (STIs) [via unprotected sex with an infected person], including genital herpes (HSV), human papilloma virus (HPV), and syphilis. [The AAP actually found no signficant difference for syphilis, which is very rare.]
  • A slightly lower risk of urinary tract infections (UTIs). A circumcised infant boy has about a 1 in 1,000 chance of developing a UTI in the first year of life; an uncircumcised infant boy has about a 1 in 100 chance of developing a UTI in the first year of life. [So 99.1 percent of circumcisions for this purpose are wasted .]
  • A lower risk of getting cancer of the penis. However, this type of cancer is very rare in all males. [So why even mention it, except to frighten parents with the Big C?]
  • Prevention of foreskin infections. [Yes, cutting anything off prevents infection in it.]
  • Prevention of phimosis, a condition in uncircumcised males that makes foreskin retraction impossible [but can readily treated non-surgically or by other surgery when it occurs].
  • Easier genital hygiene.

Social reasons:

  • Many parents choose to have it done because "all the other men in the family" had it done or because they do not want their sons to feel "different." [With the rate around 55 percent, it is touch-and-go which group will feel more "different", but the ones who have had part of their penis cut off have more to learn. And what does genital surgery on infants for the purely social wishes of other people have to do with pediatrics?]

Religious or cultural reasons:

  • Some groups, such as followers of the Jewish and Islamic faiths, practice circumcision for religious and cultural reasons.

Reasons Parents May Choose Not to Circumcise

The following are reasons why parents may choose NOT to have their son circumcised:

[Nobody needs any reason to simply leave their baby's genitals alone.]
  • Fear of the risks. Complications are rare and usually minor but may include bleeding [which can cause death], infection [which can cause death], cutting the foreskin too short [which can seriously damage his adult sex life] or too long, and improper healing. [There are many more. See how they discount these legitimate fears. Anyone would think they were trying to push you into circumcising]
  • Belief that the foreskin is needed. Some people feel the foreskin is needed to protect the tip of the penis. Without it, the tip of the penis may become irritated and cause the opening of the penis to become too small. This can cause urination problems that may need to be surgically corrected. [This is a very common complication of circumcision.]
  • Belief it can affect sex. Some feel that circumcision makes the tip of the penis less sensitive, causing a decrease in sexual pleasure later in life. [It certainly makes the FORESKIN infinitely less sensitive!]
  • Belief that proper hygiene can lower health risks. Boys can be taught proper hygiene that can lower their chances of getting infections, cancer of the penis, and STIs.
  • ["Fear" "Belief" "Belief" "Belief" These legitimate objections are discounted before they are even expressed.]

What If I Choose Not to Have My Son Circumcised?

If you choose not to have your son circumcised, talk with your pediatrician about how to keep your son's penis clean. Keep in mind that the foreskin will not fully retract for several years and should never be forced. When your son is old enough, he can learn how to keep his penis clean just as he will learn to keep other parts of his body clean. [This advice, alone, is more-or-less accurate.]

 

Circumcision: Information for Parents (Copyrightę 2007 American Academy of Pediatrics, Updated 8/2012 [annotated 9/2012] )

The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. [Parents might be better advised to trust their own humane instincts than "medical advice" like this, and just leave their babies alone.] There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.

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