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Newborn Services

Circumcision

Circumcision is a procedure to remove the foreskin of the penis to expose the glans permanently. Around 20% of boys in Australia are circumcised while, around the world, the number sits at around 30%. This is mostly the result of religious and cultural practices. There are a number of reasons you may want your son circumcised. It’s important to note this is your decision, and we respect your right to choose what’s right for your son. It is a simple operation which can be performed in the first few weeks after birth with local anaesthetic.

Guy has performed hundreds of neonatal circumcisions over twenty years. He prefers to use the plastibel ™ technique. This method avoids the use of scalpels and involves a specially-formed plastic bell being placed around the glans and a ring then placed around the base of the foreskin. This then cuts off the blood supply to the foreskin and allows the foreskin to drop off naturally after seven to ten days.

To Circumcise Or Not

There are arguments for or against circumcision, and it’s fair to say even the medical profession has quite differing views. 

In the USA the Centers for Disease Control and College of Paediatrics both suggest a distinct health advantage to circumcision. In the UK, the College of Physicians don’t support this view.  

It comes down to your preference and what you believe is right for your son.

Guy is able to talk you through all the reasons for and against circumcision and can provide perspectives based on his extensive experience with the surgery and with other families who have been faced with the same experience.

Circumcisions For Older Boys

Circumcisions can be performed at any age although, the older the boy is, this is usually only done for health reasons. For example, a small percentage of boys require it due to complications from infections, or dues to scarring of the meatus (the hole at the end of the penis).  

If the boy is older, he will require a general anaesthetic.

Please note: Guy does not perform circumcisions on older boys, but can recommend a highly skilled paediatric surgeon should you require one.

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Tongue Tie

The Frenulum Lingua is a small piece of skin which attaches the bottom of your tongue to the bottom of your mouth. It helps stablise the tongue, making it easier to swallow and plays a role in eating as well as helping us shape sounds and words.

A small percentage of babies (around 3%) have a shorter than normal frenulum which ties their tongue more tightly to the mouth, making it more difficult for the baby to move their tongue. This can influence how well they can breast feed. Tongue tie varies from baby to baby and can be moderate to severe.

There are a number of signs your baby might have a tongue tie, but it is always best to confirm any observation with an assessment by a qualified Lactation. They will be able to determine if your baby has a tongue tie and if it is contributing to feeding issues. 

The Signs

  • Not being able to poke their tongue out
  • The tip of the tongue has a v shape 
  • The tip of the tongue looks heart shaped
  • The baby makes a clicky sound when trying to breast feed
  • Your baby comes off the nipple often during feeding
  • Your baby swallows a lot of air if you’re bottle feeding
  • Has little weight gain
  • Your nipple looks creased after feeding

Tongue tie can be addressed quite easily

It involves a simple snip of the frenulum to free up the tongue. There is no need for a local anaesthetic. And it has a very low risk of complications.

Guy will consult with a lactation specialist to determine the severity of the tongue tie and to identify the best way to address the issue.

If you’d like further information – the Australian Breastfeeding Association has a very informative page which will help. (https://www.breastfeeding.asn.au/bf-info/tongue-tie)

FAQ’s

A circumcision is the removal of the foreskin. The foreskin is the skin at the end of the penis forming a hood over the head of the penis (the glans).

Boys are circumcised for medical, religious or cultural reasons.

While circumcision used to be more frequent, in Australia, since the 1970s the rates of circumcision have declined with more and more boys remaining uncircumcised.

In most cases, the decision comes down to your preference. Guy can talk you through the reasons why your baby may or may not need a circumcision. These mostly boil down to one of two reasons.

  • Medical
    • If your son has a tight foreskin or keeps getting infections of the foreskin and the head of the penis, Guy may recommend a circumcision. 
    • In older boys and men, a circumcision may be needed if the foreskin continually contributes to infections or blocks the head of the penis. Please note. Guy does not perform circumcisions on older boys – but can recommend a trusted surgeon for you.
  • Religious or cultural 
    • There are a number of different religions and cultures that circumcise their sons. These include Jewish, Islamic and many African communities.

Again, it depends on individual circumstances, however, in general, there are some health benefits associated with circumcision. These include: 

  • It’s easier to wash
    • While circumcision does make washing easy, uncircumcised boys can be taught proper hygiene and washing beneath the foreskin quickly becomes an easy habit
  • Less risk of infection
    • Urinary tract infections occur more frequently in uncircumcised males
    • Circumcised men also have a reduced risk of contracting some sexually transmitted diseases
  • Prevention of some penile problems
    • Circumcision removes the risk of phimosis – which is the condition which makes it difficult to retract the foreskin and often results in an inflammation of either the foreskin or the head of the penis
  • A reduced chance of some cancers
    • Penile cancer is rare, but much less common in circumcised males
    • Cervical cancer is seen less often in wives and partners of circumcised men

Dr Guy Skinner uses the plastibel for all circumcisions. This is a plastic bell which is fits under the foreskin and over the glans. A rubber ring is then inserted over the head of the penis which cuts off blood supply to the foreskin causing it to drop off after around 10 days.

Your son might be a little unsettled immediately afterwards, but this will settle down within 24 hours.  

Any risks are either complications due to surgery or anaesthetic.

Guy will talk through any risks with you before any circumcision. These include the risks involved if your son has, or your family has a history of, a blood slotting disorder. Or if your baby has been born premature.

The tongue is attached to the floor of the mouth by a small piece of connective tissue called a frenulum.

If the frenulum is too short, or too close to the front of the tongue, your baby might have problems extending their tongue – which is needed to create a strong suck during feeding.

A very quick and painless procedure, best performed by a trained obstetrician or doctor, involves simply snipping the frenulum. This can be performed in our rooms or while you and your baby are still in the hospital. 

The only real risk is bleeding. And this will usually only be a risk if there is a congenital blood-clotting issue. Again, while the risk is minimal, we recommend this procedure be done by your obstetrician or a doctor familiar with your family’s health history.