by Amy Crelly

Most medical professionals may consider it “a simple procedure,” but the controversy surrounding the question of circumcision makes the decision a pretty complicated one for many parents.

Religion holds the answer for some, and cultural tradition points the way for others, but the question of whether to circumcise or not has come down to a matter of personal beliefs and preference for almost all parents of baby boys. Some parents simply want their child to “look like Daddy,” while other parents can’t see how any reason could be reason enough to put a newborn under the knife.

In terms of health concerns, the arguments on both sides have still been pretty well balanced: According to the American Academy of Pediatrics’ policy statement, while circumcised newborns have a significantly lowered risk of developing a urinary tract infection (UTI) during the first year of life (about 1 in 1000, versus 1 in 100 for uncircumcised male infants), the risk is low regardless, affecting only ¾ to 1 percent of the overall population. And while studies conclude that circumcised males are also three times less likely to develop penile cancer than their uncircumcised counterparts, the AAP notes that the overall risk of a man developing this rare disease is extremely low (in the United States only 9 to 10 cases are diagnosed per year per 1 million men).*

But adding some heat to the debate, recent studies have concluded that circumcision may significantly reduce males’ risk of acquiring and spreading sexually transmitted infections, including HIV (the virus that causes AIDS). According to findings from a 25-year study conducted in New Zealand, and published in the November 2006 issue of Pediatrics, circumcision may reduce that risk by as much as 50 percent. The study’s conclusions were drawn after taking into account such factors as number of sexual partners and protected vs. unprotected encounters. Its results were similar to earlier findings based on studies conducted in Africa, the most notable published in 2000 and 2004.

The American Academy of Pediatrics maintains its neutral position amid the controversy, encouraging parents to weigh the benefits and risks of circumcision with their pediatrician in order to make an informed decision. The Academy has also been quick to caution that circumcision is no substitute for sound sex education and safe sex practices, reminding the public that these practices remain the best way to protect against infection.

Those opposed to circumcision (or simply indifferent to the procedure) make several points, including the fact that every circumcision procedure, no matter how routine, carries the potential for complications. According to Dr. Jeremy Friedman and Dr. Norman Saunders, authors of The Baby Care Book: A Complete Guide from Birth to 12 Months Old, “This procedure is relatively simple, with few complications, although it can be painful, and there is a small risk of bleeding, infection, and poor healing.” For parents concerned about the potential pain of the procedure, their book offers this advice: “To reduce the pain associated with [circumcision], an anesthetic cream can be applied to the foreskin or freezing injected around the nerve supplying the penis…” They add, “Many health-care professionals now feel that pain reduction should be a regular part of the circumcision procedure.”**

So, the circumcision question remains debatable. And, like so many other parenting decisions, parents will simply have to continue answering based on their own personal beliefs about what’s best for their child.

* http://aappolicy.aappublications.org/
** © 2007, The Hospital for Sick Children, excerpted with permission from The Baby Care Book: A Complete Guide from Birth to 12 Months Old by Dr. Jeremy Friedman and Dr. Norman Saunders, Robert Rose, Inc. 2007. Distributed by Firefly Book: www.fireflybooks.com.