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Canadian Paediatric Society Updates Circumcision Advice

To snip or not to snip

Everyone knows there are three topics you never talk about in polite conversation among parents: politics, religions, and... circumcision. But when the Canadian Paediatric Society (CPS) updates its position about the surgical removal of a newborn boy's foreskin for the first time since 1996, then you have no choice but to talk about it.

“It’s a very emotionally laden topic,” says associate pediatrician-in-chief at Toronto's Sick Kids Hospital, Dr. Jeremy Friedman, stating the obvious. “There’s a few topics in pediatrics that whenever you talk with parents, it’s never a mild conversation. People seem to have very, very strong feelings.”

And the reason parents have such strong feelings is that for many people, circumcision is connected to their culture or religion (see above). 

For the longest time, there was no other good reason to circumcise a newborn, which is typically done in the first week after birth.  

“There is a lot of good research these days that suggests there is definitely the ability [for a newborn] to perceive pain," claims Friedman, "and therefore pain control is essential if you’re going to do a procedure like a circumcision.” 

So while the CPS does not "recommend" the procedure per se for every baby boy, it does cite some health benefits to removing the foreskin of the penis, such as helping to prevent HIV, the herpes simplex virus and human papillomavirus, as well as urinary tract infections. It may even offer some protection against penile cancer. However, Friedman notes that HIV is something of a moot point in Canada, where the risk of contracting the virus is "very, very low."

And it goes without saying scrupulous hygiene goes a long way. Many boys grow into "intact" men without issue.

The fact remains, for some families the decision to cut or not to cut is an obvious one. For others, it's more complicated. Some parents may even opt to circumcise one child yet not another.

While newborns in this country used to be circumcised as a matter of course, over the past century the rates of circumcision have declined to about a third of all boys. It's still largely considered a cosmetic procedure, therefore the average $300-500 cost isn't covered by most provincial health plans.

“My advice to most of those families tends to be there really isn’t a good medical reason to convince you to do it or convince you to not do it,” says Friedman.

In other words: when in doubt, do whatever the heck works for you and your family.

 RELATED: Study Re-Opens Circumcision Debate