Circumcision: A decision you have to make for your baby boy

Circumcision is a surgical procedure to remove the layer of skin (foreskin) that covers the head (glans) of the penis and part of the shaft. It has been practised for centuries for religious, cultural or hygenic reasons. It is most often done in the first few days after birth or later to correct a medical problem.

Circumcision is not medically necessary, and the Canadian Paediatric Society does not recommend routine circumcision for baby boys. After reviewing the medical evidence, including whether circumcision helps prevent health problems such as urinary tract infections, penile cancer, and sexually transmitted diseases, the CPS concluded that the benefits of circumcision do not outweigh the risks and costs. Good hygiene should provide the benefits of circumcision without the risks of surgery.

In Canada, recent statistics show a continuing decline in circumcision for baby boys. Costs aren't covered by most provincial health plans. If you decide to have your baby circumcised, it's helpful to talk to your doctor about the issues involved.

Parents sometimes request circumcision to avoid the possibility that it may become necessary later in life, but this is rare. Only 10 out of every 1,000 uncircumcised boys will need to have a circumcision later for medical reasons such as phimosis. Phimosis is when the opening of the foreskin becomes scarred and narrow due to recurring infections.

• Problems after circumcision are usually minor. Serious complications are rare but do occur, such as too much skin removed, too much bleeding, infection or poor result.
• Without pain relief, circumcision is painful. Your baby will need a local anesthetic plus EMLA cream to reduce the pain of the needle for the anesthetic. He should receive ibuprofen or acetaminophen when the local anesthetic wears off, given for 48 hours or longer. You can help comfort your baby by holding and nursing him often.
• Keep the area as clean as possible, changing the bandage each time you change his diaper. Use petroleum jelly to keep the bandage from sticking. Call your doctor if: you see more than a few drops of blood during healing (about seven to 10 days), redness and swelling persist after 48 hours, your baby develops a fever or seems to be sick.

An uncircumcised penis is easy to keep clean and requires no special care. Gently wash the area during your baby's bath. Do not try to pull back the foreskin. Never force it. When the foreskin is fully retractable, usually at three to five years of age, teach your son to wash underneath it each day.