Circumcision: What Parents Should Know

The health benefits of this procedure and what to expect on the day

Are you ready to welcome a baby boy into your family, or not yet sure of baby’s sex? Have you considered whether to circumcise your son or not? By considering the options for the procedure now and talking to your partner and healthcare provider, you can make an informed choice. The procedure for newborns is usually done within a day or two after your baby’s birth, and it is best to consider this beforehand, rather than make a sudden decision right after baby’s birth.

The term ‘circumcision’ refers to the surgical removal of the foreskin of the penis, the layer of skin that covers the glans, or head of the penis. There are a number of reasons why parents choose to have their baby boy circumcised. For many, it’s a cultural or religious rite, practiced traditionally for thousands of years. A newborn may be circumcised, or in some religions or cultures, it is done when the baby is older, or even when the boy is a teenager or adult. Some parents make the decision to circumcise their son based on whether the baby’s father is circumcised or not.

Health Benefits

Extensive research has been done on the health benefits of circumcision and more parents are considering these before making the decision to circumcise. These include the following:

• It’s easier to keep the head of the penis clean – and therefore, a reduced risk for inflammation or infection of the glans, called balanitis.
• A reduced risk for urinary tract infections (kidney, bladder and urethra, the tube that removes urine from the body).
• A reduced risk for sexually transmitted infections (STIs), including HIV.
• Prevention of conditions where the foreskin is unable to retract or return once retracted.
• Reduced risk for penile cancer, although it is very rare.

There are some risks to circumcision. These include bleeding after the skin is removed and possibly, a later infection (which can be treated). In rare instances, there may be injury to the penis. The baby will feel some pain but the healthcare provider will make him as comfortable as possible. Newborn circumcision is generally considered a safer option to a later procedure for older boys and men, especially if it is done by a trained and experienced healthcare provider in a sterile environment.

What to Expect

• Plan

Discuss circumcision beforehand with your healthcare provider. You can also call the hospital where you plan to have your baby and ask who will perform the circumcision. In some cases, the attending paediatrician does the procedure, or a paediatric surgeon or urologist may be called in. The procedure may be scheduled for the day before, or the day you go home. If your baby is born premature or with special needs, you will need to postpone the circumcision to a later date when your baby is well enough.

• Procedure

In most cases, you will be allowed to stay with your son during the procedure. An anaesthetic (numbing) cream may be applied to the penis about 20 to 30 minutes before the procedure. Then later, a local anaesthetic is injected into the base of the baby’s penis. The area is carefully cleaned. Your healthcare provider will decide on which method to use – a clamp or plastic ring. The clamp is removed after the procedure but the plastic ring will be left in place and will fall off in about a week. In both methods, the foreskin is removed with a scalpel. The procedure takes about 10 minutes. Your son should pass urine within six to eight hours of the procedure. If you haven’t seen a wet nappy, let your healthcare provider know.

• After care

Healthcare providers will explain how you should care for your baby after the procedure.

He may be fussy but gentle swaddling and offering him a dummy or your breast to nurse will usually soothe him. Take care not to put pressure on the penis area. A little blood after the procedure is normal, but if bleeding continues, contact your healthcare provider.

The penis may look red and swollen for a few days, with a yellowish crust. This is normal. However, if the redness worsens, or the swelling or discharge increases and/or there is a notable smell, let your healthcare provider know. Initially, your son’s penis will be wrapped in gauze. Your healthcare provider will let you know if you should replace it or not – some doctors prefer that it isn’t replaced once it falls off. You will be given an ointment to apply to prevent the penis from sticking to the nappy. Healing is usually within seven to 10 days.

Final Word

Making the decision to have your newborn son circumcised can be a difficult one for some parents. You may feel pressured to follow a family tradition but unsure of what you want for your child. Some parents may decide to wait to allow the child to make the decision when he is older. Your healthcare provider is best placed to discuss the risks and benefits with you. Contact your medical aid if this will be covered and from which benefits.

Contact your midwife or healthcare provider for support, advice and counselling.

Resources:  https://www.medicinenet.com/; https://www.ucsfhealth.org/;  https://www.webmd.com/; https://kidshealth.org/;https://www.parents.com/; https://www.pedsurologyassociates.com