ed before the baby leaves the hospital. Among the Jewish population, circumcision is performed on the eighth day. It is not a common practice in some areas of the world, such as Europe, Asia and South and Central America.
Physicians have varied opinions on the need for
circumcision in healthy boys. Some place great value on
the benefits of an intact foreskin, including a natural sexual response during adulthood. However, some studies suggest that uncircumcised males have an increased risk for urinary tract infections. Other studies show correlations between uncircumcised males and penile cancer and some sexually transmitted diseases including HIV, infections of the penis, and phimosis (tightness of the foreskin, not allowing it to retract over the head of the penis).
However, the overall increased risk for these conditions is
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thought to be relatively small. Proper hygiene of the penis and safe sexual practices can help prevent phimosis, penile cancer, AIDS and other sexually transmitted diseases. Proper hygiene is always important, but is thought to be especially important for an uncircumcised male.
The American Academy of Pediatrics revised its policy statement on circumcision in March 1999:
“Existing scientific evidence demonstrates potential medical benefits of newborn male circumcision; however, these data are not sufficient to recommend routine neonatal circumcision. In circumstances in which there are potential benefits and risks, yet the procedure is not essential to the child’s current well-being, parents should determine what is in the best interest of the child. To make an informed choice, parents of all male infants should be given accurate and unbiased information and be provided the opportunity to discuss this decision. If a decision for circumcision is made, procedural analgesia should be provided.”
Some form of pain relief should be provided to all male newborns undergoing circumcision. A local anesthesia is
recommended. It might be injected at the base of the penis, in the shaft, or applied as a topical cream. A sucrose (sugar) pacifier can be given to infants as well as Tylenol. The best course of action would be to provide a combination of all
the above mentioned pain relief. The old thinking that “
newborns do not feel pain” should not be considered
in this day of modern medicine.
If excessive bleeding, swelling, drainage or pain
occurs, call your pediatrician or surgeon immediately. Circumcision ultimately is the decision of new parents.
But if parents decide to have their newborn circumcised, they need to be an advocate for the use of proper analgesia and pain relief.
Dr. Brenker is medical director of Neonatal Intensive Care & Newborn Services at Boca Raton Community Hospital.
E-mail him at brenker@theparklander.com
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