Focus on Pediatrics
Just the facts, ma’am!
Provide parents with pros and cons of circumcision
Like breastfeeding, having a baby boy circumcised is a choice that parents must make. "When a woman comes in for labor and delivery, two of the first questions that are asked are, Will you be breastfeeding?’ and if the baby is a boy, Will you be having him circumcised?’" says Lynn A. Galuska Elsen, RN, CCE, resource coordinator at The Alberto Culver Women’s Health Center, which is part of Northwestern Memorial Hospital in Chicago.
Because the baby usually is circumcised before discharge, it helps to know the parents’ decision as soon as possible. Parents who attend the prenatal classes at Northwestern Memorial are well-prepared to answer the question because the topic is part of the curriculum.
In 1999, the Elk Grove Village, IL-based American Academy of Pediatrics (AAP) issued new recommendations on circumcision stating even though there were some potential medical benefits to the procedure, they were not compelling enough to warrant routine circumcision of newborn male babies. For example, studies show that developing a urinary tract infection during the first year of life is greater for boys who are uncircumcised.
What is recommended by the AAP is that health care professionals give parents adequate information and encourage them to discuss the procedure with their physician. To help in the education process, the organization published a brochure. (For more information on this brochure, see resource item at the end of this article.)
Dispelling misconceptions
Many times, parents have misconceptions about circumcision that must be dispelled in order for them to make a wise decision, says Galuska Elsen. For example, some believe that the foreskin protects the tip of the penis and if it is removed, the penis can become irritated causing the opening to become too small. Many also believe that circumcision can hamper sexual pleasure during adulthood. "Parents should be informed of the possible risks because this is a surgical procedure," she says.
What do parents need to know once the decision is made? Following is some of the information that should be covered:
• When the choice is circumcision:
Following circumcision, the tip of the penis may seem raw. Usually a small gauze bandage with petroleum jelly is used for two to three days following the procedure, and medical staff should show parents how to change the bandage during each diaper change to prevent infection. Parents must know to call their pediatrician if the baby doesn’t urinate within six to eight hours following the procedure; there is persistent bleeding; or there is redness around the tip of the penis that gets worse within three to five days.
• When the choice is not to circumcise.
If parents choose not to have the child circumcised, they need to be taught how to keep the penis clean. The foreskin may not be fully retracted for several years, but it should not be forced back. Instead, the genital area should be gently washed during bathing.
Sometimes the decision on whether or not to have a male child circumcised is based on religious, social, or cultural reasons vs. medical, says Galuska Elsen.
Resource
For more information on educating parents about circumcision or to obtain a brochure on circumcision, contact: American Academy of Pediatrics, 141 N.W. Point Blvd., Elk Grove Village, IL 60007-1098. Telephone: (847) 434-4000. Fax: (847) 434-8000. World Wide Web: www.aap.org. (Note: an educational brochure can be located at: www.aap.org/family/circ.htm.)
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