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    Cutting to the Point on Circumcision

    Weigh the Options

    Vive la Difference continued...

    The biggest reason for the change is mounting evidence that the medical benefits aren't as compelling as once believed. In addition, anticircumcision groups have turned up the heat on the debate. They claim the practice is cruel and unnecessary and are spreading the word via web sites, mailings, bumper stickers, T-shirts, and international conferences.

    Circumcision rates are much lower in other parts of the world, including most of Europe, Asia, and Latin America. Only 48% of boys in Canada, 24% in the United Kingdom, and 15% of boys worldwide are circumcised.

    Probably the strongest cause for pause among parents, however, came in March 1999 when the American Academy of Pediatrics issued a policy statement saying it does not endorse routine circumcision.

    "There are potential benefits as well as risks, but the data wasn't sufficient for us to say every newborn male needs to be circumcised," says Carole Lannon, MD, clinical associate professor of pediatrics and internal medicine at the University of North Carolina, Chapel Hill, and chairwoman of the task force on circumcision. "Each parent needs to make that decision."

    To Snip or Not to Snip

    A circumcision is usually performed within 48 hours of birth by an obstetrician or pediatrician in the hospital, or on the eighth day after birth for the Jewish ritual, called brit milah or bris. The baby is restrained, then the layer of tissue that covers the tip of the penis is surgically removed. It should take no more than five minutes in skilled hands.

    When weighing the pros and cons of circumcising your baby, the most clear-cut medical benefits of circumcision are a four- to tenfold decrease in the risk of urinary tract infections during the first year of life, and a threefold reduction in the risk of penile cancer among adult men.

    However, UTIs and cancer of the penis are rare. The risk of developing a UTI in an uncircumcised male infant is no more than 1%, and breastfeeding has been shown to protect against these infections among this group, according to the AAP. Only 10 or fewer men per 1 million get cancer of the penis each year worldwide.

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