Circumcision is the surgical removal of the foreskin from the male penis, often performed electively during the newborn period in the United States. This decision is driven by cultural, religious, and perceived health reasons. Parents often ask which qualified medical professionals perform this procedure, which is generally considered low-risk for healthy infants. Understanding who performs the surgery helps parents navigate the decision-making and scheduling process.
Pediatricians and Newborn Circumcision
Many pediatricians are trained and credentialed to perform circumcisions, especially during the newborn period. The procedure is most frequently performed in the hospital before discharge or shortly after birth in an outpatient clinic. In the U.S., pediatricians perform approximately one-third of all newborn circumcisions.
A pediatrician’s decision to perform the surgery depends on individual training, hospital policies, and personal preference. Some maintain competency to offer the service, while others refer patients to specialists. Availability often aligns with the standard well-baby checkup phase.
The procedure is most commonly performed during the first 10 days of life, known as the neonatal period. This timing is preferred because it offers the lowest complication rates and often requires only local anesthesia. If a pediatrician does not offer the service, they facilitate a referral to an appropriate provider within this timeframe.
When Circumcision is Performed by Other Specialists
Other providers may perform the circumcision depending on the setting, the infant’s age, or medical status. In the hospital, obstetricians and gynecologists (OB/GYNs) frequently perform newborn circumcisions before discharge. Family practice physicians also perform the procedure in certain settings.
Referral to a pediatric urologist is necessary if the infant has specific anatomical concerns or if the procedure is delayed past the neonatal period. Delaying the procedure beyond the first month increases the risk of complications and may require sedation or general anesthesia. Pediatric urologists are trained to handle these complex cases or procedures on older infants.
Circumcision is not performed on premature babies or those with specific genital abnormalities, such as hypospadias, where the foreskin may be needed for reconstructive surgery. In these instances, the procedure is deferred. A pediatric urologist or surgeon will later evaluate the child for a specialized approach.
Understanding the Procedure and Parental Consent
Parents must provide informed consent before the procedure. This involves a discussion of the proposed procedure, potential benefits, risks, and the alternative of not performing the circumcision. The provider must disclose all relevant information, including minor complications such as bleeding, infection, or an unsatisfactory cosmetic result.
To minimize discomfort, a local anesthetic is administered, such as a topical cream or an injection like a dorsal penile nerve block (DPNB) using lidocaine. Non-pharmacological interventions, such as oral sucrose solution or a pacifier, are often used as supplementary measures. Combined pain management techniques are recommended to reduce the infant’s distress.
The actual removal of the foreskin is quick, typically taking less than 15 minutes. Providers generally use one of three common clamping devices: the Gomco clamp, the Mogen clamp, or the Plastibell device. The chosen method depends on the practitioner’s training and preference, but all are considered safe when used by an experienced provider.
Immediate Post-Procedure Care and Follow-up
Following the surgery, the medical team monitors the infant briefly to ensure there is no excessive bleeding. Parents receive instructions for at-home care, which includes applying petroleum jelly to the surgical site with every diaper change. This prevents the incision from sticking to the diaper and aids healing.
Parents should gently clean the area with warm water and mild soap, avoiding harsh chemicals or vigorous scrubbing. Healing usually occurs within seven to ten days. During this time, the area may appear red and swollen, and a yellowish film may form over the glans, which is a normal part of the healing process. Sponge baths are recommended for the first 48 hours.
Immediate contact with the pediatrician is necessary if the infant exhibits concerning signs:
- Fever.
- Continuous heavy bleeding.
- Worsening redness or swelling.
- Difficulty with urination.
The pediatrician monitors healing at subsequent well-baby visits. Parents may use infant acetaminophen, if recommended, to manage discomfort after the local anesthesia wears off.