It is a controversial topic and hard to summarize here. My opinions are below. 

There is no medical indication for performing an "urgent!!" circumcision in the neonatal period (in the first week of birth). Circumcision is beneficial for babies with clinically proven recurrent UTI's with or without  vesicoureteral reflux or some other congenital genitourinary disorders. It is wisely to perform circumcision in the same setting with a cystoscopy and/or valve resection. 

If it is performed for traditional or religional purposes and if the family wants it to be done during the first year of life, it can be done after confirming that the baby has no other issues (icterus, coagulation disorders etc.) after the first weeks of life. Many of our colleagues prefer general anesthesia after the newborn period, however it can be easily performed under local anesthesia even if the baby is older than 3 months of age. It is preferred before the child begins to move, interact and walk (before 8-9 months of life)

We have to remember the basic rule of surgery. Do not operate a newborn unless there is an urgent or life-threatening situation. 

Best regards

I agree that It is a controversial topic. There are not any diseases in the newborn that require urgent circumcision, the circumcision is indicated in case of phimosis and recurrent UTI's because of the phimosis. 

In Mexico there are a lot of parents that ask the pediatricians about this procedure. When I am asked about it, I always talk to the parents and try to explain that it is not necessary but If they are convinced to do it  (because of cultural or religious matters),  I sincerely prefer to do it in the neonatal period,  because i know how to do it and I know the potential complications and their solution instead of them  looking for someone who is not a pediatric surgeon to do it. The American academy of Pediatrics accepts that the parents can choose to do this procedure to their sons if they want to.

When I perform a newborn circumcision in a healthy newborn, I do it at my office assisted by a nurse and always use regional anesthesia (xylocaine whitout epinephrine 1 or 2 %) 1 ml, in a suprapubic punction. Monitoring vital signs and in a fixed position of the baby with a 2 hours starving to avoid vomiting during the procedure. I usually perform the plasti-bell technique. I never use the Gomco technique and use a topic antibiotic cream after the procedure and every diaper change for a week and review the evolution one week after the procedure. If the patient is older than one month of life I always perform the circumcision in the surgical theater with sedative anesthesia and regional block.

Major complications are very few and includes rephimosis of the residual prepucium that requieres separation with a hemostatic clamp. Only one case requiered reexploration with a  hemostatic suture to repair arterial bleeding.

In conclusion it is a safe procedure that you can do in the office in the first month of life only if the parents want to, with a very low complication rate. Most of the parents will understand that this is an unnecessary procedure and  will change their mind about do a newborn circumcision.

There is no definite indication of circumcission in neonates.

 However, circumcised infants appear to have less risk of urinary tract infections than uncircumcised infants, and   It may help prevent cancer of the penis. 

But,  current policy statements from specialty societies and medical organizations do not recommend routine infant circumcision.

Dear Dr.Dutta, I agree with you about the relationship between urinary tract infections and pathological phimosis, which requires circumcision. As for the neonatal circumcision I personally was witness 20 years ago, how this procedure was routinely performed in many leading children hospitals in the USA. It is possible that things have now changed.

Well, thank you all ! From my point of view as pediatric surgeon, dealing also with the male reproductive pathology, circumcision in babies and small Caucasian children is not obligatory except for fibrotic secondary phimosis. And, particularly in cases, where there is no possibility for performing partial plastic methods. Here lies the contradiction with our urologists and especially the pediatric urologists, who put much wider indications for performing circumcision procedures.

There are virtually no medical indications for circumcision at any time.I suggest you read an article by Douglas Gairdner titled 'The fate of the foreskin"I think it was 1948, but could have been later

No indication for circumcision in the newborn except for the very rare case of extreme phimosis with megaprepuce. In the US circumcision are performed for non-medical reasons ( parent´s erroneous perceptions) and partly for profit. I believe ethical physicians should not participate in this practice and should leave it to the religious practitioners who believe in it. As to the prevention of UTI, no evidence that it is superior to antibiotic prophylaxis in patients at risk (reflux, posterior urethral valves). Late in childhood only symptomatic phimosis which does not respond to medical treatment.

There is no real indication for early circumcision except in a situation with severe phimosis. Circumcised glans is sensitive and children feel uncomfortable when they are 8-10 years old and are embarrassed with erections particularly wearing tighter clothes.

In our country, circuncision is only performed in symptomatic patients. I'm totally agree with Dr. R. González. Newborn circuncision is not medical procedure

The debate about whether to circumcise infants in the neonatal period likely will continue. As the medical and ethical issues are discussed and studied, however, economic factors are beginning to limit the practice in the United States. As the shift in reimbursement occurs, parents who believe that circumcision is a medically necessary practice will need to be reassured that their child may lead a healthy life with an intact foreskin.

Circumcision indicated for children with BXO and useful for boys with unitary tract anomalies with UTIs, especial posterior urethral valves. But we have to be advocates for the child, and therefore will perform request circumcisions under GA at 12/12, as these parents would otherwise go and have the procedure performed by non-surgeons.

Indications and contraindications of circumcision:

Circumcision generally is not performed in premature infants. It should not be performed in children with congenital anomalies of the penis, including hypospadias, epispadias, chordee, penile webbing, and concealed penis. Any child with blood dyscrasias should not undergo circumcision.

Indications:

The medical indications for circumcision remain controversial. The religious beliefs of the parents must be respected when considering circumcision

Phimosis :Phimosis is the most common diagnostic code used in conjunction with circumcision.

Urinary tract infection: Although UTIs are more likely to occur in uncircumcised males younger than 6 months of age, the overall incidence of UTI in this age group is low . After 6 months of age, the association is not seen, likely because of the resolution of physiologic adhesions/phimosis. Circumcision should be discussed with parents of infants in whom UTI would pose an increased risk for renal injury, including infants with vesicoureteral reflux, obstructing hydronephrosis, and posterior urethral valves and other congenital anomalies.

Circumcision and malignancy: Circumcision during infancy seems to decrease risk for penile cancer, whereas later circumcision does not . Squamous-cell carcinoma of the penis is rare in circumcised men.

Circumcision and sexually transmitted diseases: Prevention of STDs has been a commonly cited indication for circumcision since the procedure became ‘‘medicalized’’. A report that Jewish men had lower rates of syphilis fueled this theory in the 19th century.

it is worth reading this paper.

 It is worth remembering that neonatal  circumcisions in the US are done with minimal informed consent from the parents and for a financial gain to the person or institution doing it. 

Cliff Roberton,a famous neonatologist at Cambridge, referred to0 it as male genital mutilation.I would agree.There are virtually no indications for circumcision.

I would agree that there is no indications for circumcision. Many of the problems/complications that are proclaimed in the literature in an intact male infant are in fact caused by the improper care of the intact penis. Many erroneously believe that the foreskin should be forcibly retracted for cleaning. This interrupts the body's normal protection mechanisms and introduces bacteria causing an infection, thus creating a self-fulfilling prophecy that intact males are more prone to infection. When left alone this is not the case however. The foreskin, early on in development is fused to the head of the penis and should not be retracted for any reason. Over the course of several years separation occurs. A first retraction can occur any time from infancy to around 18 years old. The average is around 10 years old but often can be well into puberty. Until retraction has occurred naturally for the first time there should be no cleaning under the foreskin. Only the boy himself should do this. Anyone else attempting to retract could force it and injure the boy and cause damage to a sensitive area. Phimosis is one of the most common reasons given for the circumcision of children past infancy but if one looks at the anatomy and physiology of the situation it becomes clear that this is a normal part of the physiological development rather than a pathological problem.

. The religious beliefs of the parents must be respected !The medical indications for circumcision remain controversial. Did you mean especially regional? or religious? The question is Caucasian children

I entirely agree with Dr. Carnes statement. In the frame of respecting the families religious beliefs the surgeon mus also reconcile his own ethical (and religious?) principles in performing medically unnecessary surgery, particularly when monetary remuneration  is involved. 

In the United States, the root term Caucasian has also often been used in a different, societal context as a synonym for "white" or "of European ancestry".

https://kids.kiddle.co/Caucasian_race

Manual for Male Circumcision under Local Anaesthesia - World Health Organization https://www.who.int/hiv/pub/malecircumcision/who_mc_local_anaesthesia.pdf

Kindly check https://www.cdc.gov/nchs/data/nhds/9circumcision/2007circ9_regionracetrend.pdf

This discussion has gone on too long. There are virtually n0 medical indications for male circuncision