As the majority of newborn circumcisions are elective and cosmetic, the American Academy of Pediatrics does not condone routine male circumcision. Although a relatively minor procedure, circumcision does pose risks to the patient and can cause significant complications. Therefore, the Vanderbilt Neonatology group and the VUMC NICU do not offer routine circumcisions.

Vanderbilt NICU staff perform only medically indicated circumcisions; for ex. the infant with recurrent UTI or structural renal anomalies. These NICU circumcisions can only be performed by several of the NNPs who have developed the skill and experience necessary to safely circumcise this high-risk population. Circumcisions should always be accompanied by local anesthesia for pain relief.

However, VUMC NICU recognizes that male circumcision is a very personal and important choice for some families. Therefore, the following options exist:

1. Term infants born at VUMC may be circumcised by the obstetrical housestaff prior to discharge.
2. Term infants born at VUMC (and former preterm infants grown to term age and size) who will see a VUMC Pediatric Resident as their follow-up care provider may be circumcised by the pediatric resident, IF that resident has completed the one month newborn nursery rotation, has had adequate experience with the procedure, and the newborn nursery attending agrees to be the supervising physician.
3. The obstetrical housestaff are often kind enough to circumcise outborn term infants by personal request.

However, the majority of outborn infants and all premature infants discharged at low birth weight have the following options:

1. They may be circumcised by their follow-up pediatrician in the office if the pediatrician offers this service.

OR

2. They may return to Vanderbilt at a later date for an appointment with VUMC Pediatric Urology.

Resolved at Nursery Policy & Procedure meeting 8/18/99; revisited at the Collaborative Pathways meeting 8/9/00.

Reference:

American Academy of Pediatrics. Circumcision Policy Statement. Pediatrics 1999; 103: 686-693.