Paul Berger August 27, 2012

The American Association of Pediatrics has doubled down on its position that the health benefits of infant male circumcision outweigh the risks. But the AAP’s new policy statement, released today, stops short of recommending routine circumcision of boys.

The report did warn against “mouth-to-penis contact during circumcision,” which has been linked to a seldom-performed, ultra-Orthodox Jewish practice known as metzitzah b’peh, which involves a mohel sucking blood away from the wound. A baby boy died in New York last year when a mohel infected him with herpes.

The AAP’s circumcision task force, an interdisciplinary panel of specialists, has worked since 2007 to comb through more than a thousand articles and studies to come up with its new guidelines.

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Previous guidelines, issued in 1999, also found that the health benefits of circumcision outweighed the risks.

But this latest study found even more evidence, gleaned from health studies during the past decade, showing that circumcision decreases the risk of urinary tract infections in infants and of sexually transmitted diseases in men.

The report found that circumcision was particularly effective in reducing a heterosexual man’s risk of contracting HIV. In recent years, a growing number of states have dropped Medicaid coverage for circumcision.

The report noted that HIV rates are highest among Blacks and Hispanics, but that these communities are most likely to rely on Medicaid. Therefore, the task force recommended that “financial barriers” to circumcision should be “reduced or eliminated.”

Dr Andrew Freedman, a pediatric urologist who worked on the policy statement, said he hoped the latest report gave “a little more clarity” than its predecessor to the issue.

“If somebody wants this, they should have it,” Dr Freedman said. “On the other hand, the benefits are not so strong that everybody needs to have it.”

Contact Paul Berger at [email protected] or on Twitter @pdberger

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