If you have a baby boy, deciding to circumcise your child is something that might cross your mind, but circumcision is highly controversial.
Your mother might tell you circumcising your son will ensure he is clean. Your husband might want your son to be circumcised so that “he is more like dad” or so that “he looks like other boys”. On the other hand, you might be uncomfortable with the idea of inflicting pain on your child or removing a normal part of his body. You might also be asking yourself whether it’s even necessary.
Health measure? Circumcision is no longer considered to be a preventative health measure, and no medical association anywhere in the world recommends non-therapeutic, routine infant circumcision. The South African Medical Association (SAMA) has formally stated that there is no justification for routine circumcision of male babies or children. The American Academy of Pediatrics (AAP) and the Canadian Paediatric Society take the same position and classify infant circumcision as an “elective procedure to be performed at the discretion of the parents.” The Australasian Association of Paediatric Surgeons (AAPS) goes further, stating, “We do not support the removal of a normal part of the body, unless there are definite indications to justify the complications and risks which may arise.” The AAPS goes on to describe routine infant male circumcision as: “A traditional practice prejudicial to the health of children that should be abolished.” Routine male circumcision is also an ethical issue and The British Medical Association (BMA) states, “We do not believe that parental preference alone constitutes sufficient grounds for performing a surgical procedure on a child unable to express his own view.” Routine circumcision of baby boys is rare in Scandinavia and Europe, but common in the US, with around 55% of boys being circumcised. It’s also widely practised in Australia, with 10%-15% of Australian infant boys being circumcised. The prevalence of infant male circumcision in South Africa has been dropping significantly as awareness increases. It is still traditional in Jewish culture to circumcise male infants. But nowadays, Jewish naming ceremonies, the Bris Shalom or Covenant of Peace, are available without circumcision. Some African cultures in South Africa circumcise boys in their teens as a rite of passage. Recently Swaziland and Botswana have begun to prematurely encourage infant circumcisions in an attempt to prevent HIV infection, even though research contradicts this rationale. South African state hospitals do not routinely circumcise baby boys, but private hospitals still offer it. The procedure is excluded by most medical aids as elective circumcision is now classified as an unnecessary cosmetic procedure. The Children’s Act prohibits routine infant circumcision and makes the procedure a criminal act, unless it is performed for religious reasons. It is now recognised that in fact the foreskin has a useful function. It protects the meatus (the opening of the urethra) from trauma, infection and narrowing down (the most common complication after circumcision from the rubbing of the glans on the nappy). Secondly, the foreskin plays an important role in the sensory input necessary for satisfying orgasm for both partners. The foreskin also prevents meatitis, meatal ulceration and meatal stenosis – conditions seen only in circumcised boys, who are also more likely to get urinary tract infections. Research shows that men circumcised as adults report a significant loss of sensitivity. This means that the same is probably true for males circumcised in infancy, but they simply are not aware of it. It is also recognised that circumcision is painful, contrary to the idea that it is a quick, minor procedure and less painful for infants, hence the fact that it is often performed without anaesthesia. In addition, there are about 20 short-term complications associated with circumcision, such as bleeding, infection, botched circumcisions that require surgical attention, disturbed sleep patterns, reduced activity levels and disruptions in mother-infant interaction. The latest advice is to leave the foreskin alone. It requires water to keep clean and alkaline soaps can disturb the delicate balance, causing undue irritation. Do not try to retract the child’s foreskin to wash underneath, as this can be harmful.