Canadian paediatricians revisit newborn male circumcision recommendations

In an updated statement released today, the Canadian Paediatric Society (CPS) continues to recommend against the routine circumcision of newborn males.

Recent evidence about the potential benefit of circumcision in preventing urinary tract infections and some sexually transmitted infections, including HIV, prompted the CPS to undertake a review of the current medical literature. The CPS reviewed the evidence to ensure that the recommendations were made as they relate to the needs and well-being of Canadian children.

"While there may be a benefit for some boys in high risk populations and the procedure could be considered as a treatment or to reduce disease, in most cases, the benefits of circumcision do not outweigh the risks," said Dr. Thierry Lacaze, chair of the CPS Fetus and Newborn Committee.

The CPS emphasizes that physicians and other health care professionals should provide parents of male newborns with the most up-to-date, unbiased and personalized medical information available about neonatal circumcision, so that they can weigh the benefits and risks.

"Families need to make the best decision for their child based on their own family, religious and cultural beliefs," said Dr. Lacaze.

The updated statement also recommends the following:

• Parents who choose to have their sons circumcised should be referred to a practitioner who is trained in the procedure.
• Neonatal male circumcisions must be performed by trained practitioners whose skills are up-to-date and strictly adhere to hygienic and analgesic best practices.
• Parents of circumcised boys must be thoroughly and accurately informed about post-procedural care and possible complications.
• At the time of hospital discharge, health professionals should ensure that the parents of the uncircumcised newborn boys know how to appropriately care for their son's penis.
• Quality Canadian data are required to understand the clinical and economic issues involved with neonatal male circumcision, including its potential risks, benefits and costs, in the Canadian context.