1. Beal, Judy A. DNSc, RN, FNAP, FAAN

Article Content

Parents of newborn baby boys are faced with a decision about circumcision. For most, it is the first major decision about a procedure for their child. Some parents decide well in advance of the birth, whereas others have not given circumcision much thought prior to being asked to sign a consent for the procedure. For some parents, religious or cultural norms and expectations guide their choice. Parents rely on nurses to offer information about circumcision that is founded on the best evidence and recommendations from professional organizations such as the American Academy of Pediatrics (AAP). Although neonatal male circumcision is one of the oldest and most commonly performed surgeries worldwide, many parents for whom the decision is not based in religious or cultural practices struggle with resolving concerns over benefits and risks. According to the most recent policy statement on circumcision from AAP (2012), current evidence suggests health benefits for neonatal circumcision far outweigh risks. The AAP policy statement summarizes the health benefits and risks while stressing that the procedure should be performed by trained medical professionals. They conclude that ultimately parents must make their decision based on the evidence presented by their provider.


Sabzehi, Mousavi-Bahar, and Bazmamoun (2013) reviewed 43 research-based articles on male neonatal circumcision. They presented historical and epidemiological evidence as well as a detailed summary of the indications for, benefits of, and risks associated with neonatal circumcision and concluded that, although the majority of male newborns are circumcised for religious or cultural reasons, there are numerous other medically related benefits. Specifically, uncircumcised males under 6 months of age have a slightly higher risk of urinary tract infections, although after 6 months, the difference is negligible. Infant circumcision has been found to be preventative and curative for phimosis, which is a rare complication. Penile cancers and cervical cancers of adult partners were found to be somewhat less common with uncircumcised adult males. There is strong evidence to suggest that circumcised men are somewhat less likely to contract sexually transmitted diseases, in particular HIV, HPV, trichomonas, and HSV. Penile hygiene may be less difficult in circumcised boys and men. Although risks to neonatal male circumcision are less than 1.5%, bleeding and infection are the most common. Meatal stenosis, meatitis, insufficient or excessive foreskin removal, phimosis, and skin bridges where the remaining pieces of the removed foreskin adhere to the penis are significantly less likely to occur. Contraindications to neonatal circumcision include prematurity, blood dyscrasias, and hypospadias (Sabzehi et al.).


Neonatal circumcision should be performed by a trained medical professional and within 24 hours of birth but no later than 10 days of age (AAP, 2012; Sabzehi et al., 2013). In a more recent post on a popular parenting Web site subsequently picked up by the Huffington Post, (2015) concluded that as "with so many other parenting decisions, everyone has a strong opinion about whether or not to circumcise. It can be hard to shut out the background noise, but remember that this is a highly personal decision with little evidence on either side that provides a clear right or wrong answer." The bottom line is that nurses can offer the evidence that seemingly points to greater benefit than risk, listen to parental concerns, and acknowledge the highly personal nature of the decision. Nurses have a vital role in providing information for parents. They can answer questions about how the procedure is done and what to expect when caring for their baby following circumcision. Nurses can suggest resources that offer more information such as AAP's information for parents Parents should be fully informed when making the decision about newborn male circumcision.




American Academy of Pediatrics Task Force on Circumcision. (2012). Circumcision policy statement. Pediatrics, 130(3), 585-586. doi:10.1542/peds.2012-1989 [Context Link]


Kidsinthehouse. (2015). The Blog: The circumcision controversy: The risks and the benefits of circumcision for babies. Retrieved from risks. Accessed December 7, 2017. [Context Link]


Sabzehi M. K., Mousavi-Bahar S. H., Bazmamoun H. (2013). Male neonatal circumcision: A review article. Journal of Comprehensive Pediatrics, 4(1), 50-53. doi:10.17796/compreped-6543 [Context Link]