Infant Circumcision
Circumcision of the male newborn is a surgical procedure in which the foreskin of the penis, including the inner foreskin is removed, exposing the glans (head of the penis). The decision of whether or not to have a male infant circumcised is up to the individual parents.
Circumcision is the oldest planned operative procedure in the history of human civilization but there continues to be a lack of consensus and strong opposing views on whether universal neonatal circumcision should be adopted as a public health measure. The American Academy of Pediatrics (AAP) 2012 guidelines on male circumcision (MC), reversed its prior stand stating that the “ health benefits of newborn male circumcision outweigh the risks” and justify access to the procedure if the parents so choose [1]. This recommendation was primarily based on the impressive results from African trials demonstrating the protective effect of MC against Human Immunodeficiency Virus (HIV) and sexually transmitted infections.
We consider that the Mogan clamp circumcision method is an effective and relatively painless way to circumcise infants, and older babies up to 13 pounds.
Choosing not to Circumcise
At birth the foreskin is tightly attached to the head of the penis and normally it cannot be pulled back. Retraction of the foreskin usually develops naturally and the process can be aided by gently pulling back on the foreskin after a bath when it is the most pliable. This can be started after one year of age. Pushing the foreskin back too forcefully or too soon may result in further tightening of the foreskin around the head of the penis (phimosis).
Choosing to Circumcise
Circumcision should be performed by and experienced physician who is familiar with the use of penile blocks for local anesthesia. Contrary to some beliefs infants do experience pain is local anesthetic is not used. Although some bruising may develop at the site of the anesthetic injection, other complications are very rare.
Ideally this procedure should be performed within the first few weeks of life, and after its determined that the infant is feeding well. The maximum weight for this procedure in our office is 13 lbs.
Complications of circumcision are very rare (0.5%) with experienced physicians and most of these are minor. Complications can include bleeding, infection, and recurrent adhesions of the remaining foreskin to the head of the penis.