Tough decisions. That's what parents have to face every day. 

One of the first decisions for parents of male children is whether or not to circumcise. 

In 1989 the American Academy of Pediatrics issued a statement that newborn male circumcision had potential medical benefits and advantages, as well as risks. 

But after re-evaluating its position and reviewing previously published studies, the Academy has amended its 1989 policy. The Academy now concludes that the benefits are not significant enough to recommend circumcision as a routine procedure. 

"We encourage parents to discuss the benefits and risks of circumcision with their pediatrician, and then make an informed choice," says Carole Lannon, task force chair and clinical associate professor of pediatrics and internal medicine. "Parents may take into account cultural, religious, and ethnic traditions,
as well as medical factors." 

Research has suggested that males who are uncircumcised have a greater chance of developing urinary tract infections (UTI), penile cancer, and sexually transmitted diseases, such as syphilis and HIV. 

But while the risks may be greater for uncircumcised males, the overall risk is low. For instance, an uncircumcised male has a one in 100 chance of developing a UTI, while a circumcised male has a one in 1,000 chance. 

If parents do make the choice to circumcise their sons, the Academy recommends that pain relief be used. Studies have shown that newborns circumcised without analgesia experience pain and stress, which
can be measured by changes in heart rate and blood pressure. Other studies indicate that the experience may cause circumcised infants to respond more strongly to the pain of future immunizations. 

The recommendation was first published in Pediatrics, the journal of the AAP. Ann G. Bailey, associate professor of anesthesiology, is also a member of the task force.