Circumcision may stop millions of HIV deaths-study

[chobie]

My ds was quiet during the procedure, that was to point out that he did not have any pain what so ever.

Or maybe he was in shock.

 

[Galahad]

They asked for them NOT to be circumcized? Shouldn't be the other way around and they would have to ask for this procedure to be done? Does this OB group recommend it or assume it will be done? What helped me to make the decision not to cut my son was my OB practice did not take a stance either way but did say it was basically a cosmetic procedure. Had they made it seem that it was the norm and that not having him cut would be some bizarre (or perhaps even wrong) choice to make, I might not have made the choice I did.

Sigh! No it is not automatic or assumed. The doc asked if they want it done. The parent says yes or no. The OB group does not take a stance either way. In our State the OB's do the circ's. Most OB's don't like doing them (not for any philosophical reason, it's just not how they want to spend their time) so they definitely wouldn't be pushing them.

 

[sskem96]

I am a nursery nurse. Our circumcision rate of white males is nearly 100%. I can only remember 1 couple cauc. couple in the last 3 years that has not consented to the procedure, and we have 1,500 births/year. Maybe the difference has to do with what area of the country you live in.

At our hospital, hispanics are rarely circ'd, AA are circ'd probably 50-75% of the time, and Asian Indians are rarely circ'd, although a few more of them are starting to get it done now.

I have NEVER seen a baby in shock during the procedure. They cry when we first put them on the board and we put velcro straps on their arms and legs. I put on a glove, dip my finger in sugar water, and let them suck on it. Our hospital also requires the Dr. to use anesthetic, and most use a small shot of lidocaine. After that, 99% of the time, the child is completely calm. Those that do cry are usually the ones who have been crabby anyway, usually just because mom doesn't have any milk yet. The procedure is generally done on the day the baby is going home.

Here's a tip: Before you have your son circ'd, ask moms of other boys who did their sons' and how it turned out. Just because you love your OB or you Pediatrician, doesn't mean they do pretty circs! Some take off way too much, others not enough. It's no fun to have it repaired later!

 

[chobie]

Sigh! No it is not automatic or assumed. The doc asked if they want it done. The parent says yes or no. The OB group does not take a stance either way. In our State the OB's do the circ's. Most OB's don't like doing them (not for any philosophical reason, it's just not how they want to spend their time) so they definitely wouldn't be pushing them.[/QUOTE

No need for a . They way you worded that made it seem like circumcizing was the routine and parents had to opt out of that. Patients, especially pregnant ones tend to take doctors recommendations very seriously and often fear that any questioning of routines and procedures will make them seem like a bad parent. Many women, including myself, can attest to having felt bullied into a procedure they did not want while pregnant. They way you wrote that parents asked not to have it done made me wonder if the OBs at that practice assumed that everyone would have it done and parents had to go out of their way to not have it done.

 

[becka]

I went ahead and decided to have my son circ'd for a number of reasons. One is because I have a good friend who decided not to circ and then her son developed problems as a toddler and he finally had to have it done when he was 4. I cannot imagine having to take a 4 year old in to have that procedure done. It was very hard on him and his family and while I guess the odds of not needing that done are slight they are there and I guess I would prefer to be preventative on this one.

Also, when I was trying to make a decision and talking to my Mom she mentioned that my Dad was not circ'd (something I had never wanted to know... ) and that when my brother was born he insisted that it was best to have my brother circ'd. I figure my Dad surely had a very good reason and while I did not ask for any specifics the fact that he was not circ'd and inisisted that my brother be lent a lot of weight into my decision.

 

[Tinijocaro]

I am a nursery nurse. Our circumcision rate of white males is nearly 100%. I can only remember 1 couple cauc. couple in the last 3 years that has not consented to the procedure, and we have 1,500 births/year. Maybe the difference has to do with what area of the country you live in.

At our hospital, hispanics are rarely circ'd, AA are circ'd probably 50-75% of the time, and Asian Indians are rarely circ'd, although a few more of them are starting to get it done now.

I have NEVER seen a baby in shock during the procedure. They cry when we first put them on the board and we put velcro straps on their arms and legs. I put on a glove, dip my finger in sugar water, and let them suck on it. Our hospital also requires the Dr. to use anesthetic, and most use a small shot of lidocaine. After that, 99% of the time, the child is completely calm. Those that do cry are usually the ones who have been crabby anyway, usually just because mom doesn't have any milk yet. The procedure is generally done on the day the baby is going home.

Here's a tip: Before you have your son circ'd, ask moms of other boys who did their sons' and how it turned out. Just because you love your OB or you Pediatrician, doesn't mean they do pretty circs! Some take off way too much, others not enough. It's no fun to have it repaired later!

I'm probably the reason your hospital's rate is only NEARLY 100%. I lived in Bloomington, IL when I had my first son and the pressure to circumcise by all doctors and nurses was unbelievable. The nurses kept asking me-"Are you sure you don't want to get him done? It prevents lots of diseases and he won't feel so alone in the locker room" I knew that stuff to be absolute drivel so I ignored it. My Dr was Dr Lin at St. Joe's. We lived in an apt. right near the hospital, could've walked there.

I used to teach orchestra at Bloomington Junior High back in '93-'95!

 

[chobie]

I'm probably the reason your hospital's rate is only NEARLY 100%. I lived in Bloomington, IL when I had my first son and the pressure to circumcise by all doctors and nurses was unbelievable. The nurses kept asking me-"Are you sure you don't want to get him done? It prevents lots of diseases and he won't feel so alone in the locker room" I knew that stuff to be absolute drivel so I ignored it. My Dr was Dr Lin at St. Joe's. We lived in an apt. right near the hospital, could've walked there.

I used to teach orchestra at Bloomington Junior High back in '93-'95!

And the truth is that most people get it done because its just always been done and everybody does it. My son was born in the Seattle area where the rate is closer to 50% for uncirced.

 

[paigevz]

My mother had a hard time with our decision not to circ our two sons. She kept saying how odd they'd feel being "different". Well, my husband isn't circed, only one of our friends' kids are, and my brother's son is, but none of the nephews on the other side are. I wonder exactly how "different" she thinks they will be! Seems to me, they'd be more different if they were.............besides, if they really want to, they can change appearances, as it were..............

 

[BuckNaked]

Here's a novel approach - how about everyone doing what is right for their own family and stop judging the other side.

 

[becka]

Here's a novel approach - how about everyone doing what is right for their own family and stop judging the other side.

Brenda, Brenda....you have been here long enough to know we can't allow such a thing here on the DIS!!! Tsk! Tsk!

 

[JennyMominRI]

"Adult only, no infant consentment" arguments do not stand against the Jewish laws, which requires infant circumcism. Their faith includes this procedure. You can go read Leviticus and some other Old Testament books to further understand. I'm not Jewish, I'm just defending them.

My DS cried when his diaper was removed .

But he was quiet during the procedure.

An adult however, would feel it.

I ,personally, am talking bout RIC and not a Bris..
A Bris uses the far less painful clamp than the one RIC uses

 

[JennyMominRI]

And the truth is that most people get it done because its just always been done and everybody does it. My son was born in the Seattle area where the rate is closer to 50% for uncirced.

I had my oldest son crced for that reason..He got an infection and It was horrible..My younger son was not circed and it has never been a problem

 

[BuckNaked]

Brenda, Brenda....you have been here long enough to know we can't allow such a thing here on the DIS!!! Tsk! Tsk!

**hangs head and skulks away***

 

[MickeyMouseGal]

Well, this may or may not be true, I guess we'll never know, but as for penile cancer, it's still a rare disease for all men, so I'm not going to spend much time worrying about it.

Well, that came from the American Cancer Society's website, so we're just going to have to agree to disagree. As for the foreskin protecting against STD's, I'm going to stick with known medical sites rather than unknown sources. I'm in the medical community myself (I'm a veterinarian) and I know that if you look around enough and do enough searches, google will eventually give you what you are looking for... even if the information is wrong or misquoted. I get people all of the time who bring me downloded information on everything from ear infections to cancer. Most of the time, it's from an unknown site and the information is either wrong or just downright dangerous.

From what I've read, studied, been told by doctors, etc. I believe there are health benefits.

 

[MickeyMouseGal]

I am a nursery nurse. Our circumcision rate of white males is nearly 100%. I can only remember 1 couple cauc. couple in the last 3 years that has not consented to the procedure, and we have 1,500 births/year. Maybe the difference has to do with what area of the country you live in.

At our hospital, hispanics are rarely circ'd, AA are circ'd probably 50-75% of the time, and Asian Indians are rarely circ'd, although a few more of them are starting to get it done now.

I have NEVER seen a baby in shock during the procedure. They cry when we first put them on the board and we put velcro straps on their arms and legs. I put on a glove, dip my finger in sugar water, and let them suck on it. Our hospital also requires the Dr. to use anesthetic, and most use a small shot of lidocaine. After that, 99% of the time, the child is completely calm. Those that do cry are usually the ones who have been crabby anyway, usually just because mom doesn't have any milk yet. The procedure is generally done on the day the baby is going home.

Here's a tip: Before you have your son circ'd, ask moms of other boys who did their sons' and how it turned out. Just because you love your OB or you Pediatrician, doesn't mean they do pretty circs! Some take off way too much, others not enough. It's no fun to have it repaired later!

I agree. True traumatic 'shock' in an infant is a life threatening condition that requires immediate medical attention. If these babies were truly in 'shock', they wouldn't be going home the same day.

For what it's worth, in the veterinary community, we dock puppy tails at roughly the same age as infant circumcision (approx. 3 days old). Like you have observed, they hardly complain. The medical reason for this is that the nervous system is very immature at this age and pain preception isn't the same at three days old as it is at three months, three years, etc.
*disclaimer* I am in no way comparing a baby to a puppy, just offering a medical/physiological comparison.

 

[Tinijocaro]

I agree. True traumatic 'shock' in an infant is a life threatening condition that requires immediate medical attention. If these babies were truly in 'shock', they wouldn't be going home the same day.

It isn't true medical shock that babies go through when being circumcised, but more of a withdrawal coping mechanism. The pain is so great that they must withdraw into what appears to be a calm state. Many babies go into a deep sleep after their circumcisions. From Dr. Sears site:

"Does it hurt?

Yes, it hurts. The skin of the ***** of a newborn baby has pain receptors completely sensitive to clamping and cutting. The myth that newborns do not feel pain came from the observation that newborns sometimes withdraw into a deep sleep toward the end of the operation. This does not mean that they do not feel pain. Falling into a deep sleep is a retreat mechanism, a withdrawal reaction as a consequence of overwhelming pain. Not only does circumcision cause pain in the *****, the newborns over all physiology is upset. New research shows that during unanaesthetized circumcision, stress hormones rise, the heart rate speeds, and valuable blood oxygen diminishes. Babies should never be subjected to the shock of unanaesthetized circumcision. "


The items that are bolded are not just arbitrary guesses but things that can be actually measured.

 

[JennyMominRI]

Circumcision study halted due to trauma

A newborn winces in pain after a circumcision
In this story:
Study measured heart rate, crying pattern
Topical woefully inadequate

December 23, 1997
Web posted at: 11:46 p.m. EST (0446 GMT)
ATLANTA (CNN) -- A new study found circumcision so traumatic that doctors ended the study early rather than subject any more babies to the operation without anesthesia.

The researchers discovered that for those circumcised without anesthesia there was not only severe pain, but also an increased risk of choking and difficulty breathing.

The necessity of circumcision is the subject of increasing debate , but the traditional reasons for the operations have always been prevention.

Dr. Arthur Gumer of Northside Hospital in Atlanta says circumcision has been thought to provide "protection against infectious diseases later in life which would include either sexually transmitted diseases or urinary tract infections."

Up to 96 percent of the babies in the United States and Canada receive no anesthesia when they are circumcised, according to a report from the University of Alberta in Edmonton.

One of the reasons anesthesia is not used, the study found, is the belief that infants feel little or no pain from the procedure. It has also been argued that injecting anesthesia can be as painful as circumcision itself, and that infants don't remember the procedure, anyway.

Study measured heart rate, crying pattern

Preparation for a circumcision
But there are those who find that reasoning difficult to believe, and Gumer is one of them.

"To say that the baby doesn't remember it is not an adequate excuse to me," he said. "Babies experience other painful procedures and we worry about that, and we do give them anesthetics for those procedures."

But the Edmonton researchers, whose study was published in this week's Journal of the American Medical Association, studied the heart rates and crying patterns of babies during different stages of circumcision. Some babies were given an anesthetic and others were not.

Topicals woefully inadequate
Rabbi Ariel Asa has performed hundreds of circumcisions. When families request it, he says he puts an anesthetic on the skin, in an effort to reduce some of the pain. But he admits it's not very effective.

"Due to the fact that moyels (the people who do the procedure) do it very quickly and the pain that the baby experiences is minimal, I don't think that the overall benefits are gained," he says.

But the researchers found that while topical anesthetics may help initially, they are woefully inadequate during foreskin separation and incision.

They concluded that if circumcision must be performed, it should be preceded by an injected anesthetic.

In fact, they found the results so compelling that they took the unusual step of stopping the study before it was scheduled to end rather than subjecting any more babies to circumcision without anesthesia.

Medical Correspondent Dr. Steve Salvatore

 

[MickeyMouseGal]

I read Dr. Sears site. He is obviously quite opinionated on the issue. Like I said before, I'd rather read websites that are based on medical facts and provide both sides rather than one that may be biased.

I stand by my original opinion. Even a minor health benefit... there is way more evidence supporting medical benefits than not... is more than enough reason for me. As for pain, vaccines are painful for children, yet I would rather my child be vaccinated than contract potentially dangerous diseases. True, vaccines have their own risks, but the odds of contracting a dangerous disease outweighs any vaccine reaction IMO. I myself was vaccinated for Rabies. I'd rather pluck my eyeballs out than go through that again, but as a result of that vaccine, I will never contract Rabies in my high risk job.

Basically, my point is, my decision to circumcise my child is an informed decision made by me, my husband and our doctor. It is the right decision for me, regardless of anyone else's opinion.

 

[Tinijocaro]

Even the AAP realizes that circumcision is stressful to infants and that pain relief must be administered. They recommend a PDNB (penile dorsal nerve block) and say that it greatly reduces stress levels in the baby. I don't think that it's up for debate that circumcision causes undue stress in babies.

I think you'll agree that this is a non-biased site.

http://pediatrics.aappublications.org/cgi/content/abstract/71/1/36

"Physiologic stress reduction by a local anesthetic during newborn circumcision

PS Williamson and ML Williamson

To evaluate the effectiveness of the dorsal penile nerve block in reducing the stress of circumcision upon newborns, physiologic measurements in 30 healthy full-term infants (including transcutaneous oxygen levels, crying time, heart rate, and respiratory rate) were monitored continuously before, during, and after the operation. Infants receiving the dorsal penile nerve block with lidocaine (1% Xylocaine) (N = 20) experienced significantly less stress, as evidenced by smaller decreases in transcutaneous oxygen pressure levels, less time spent crying, and smaller increases in heart rate, than infants circumcised in an identical manner without anesthetic (N = 10). No complications resulted from injection of the local anesthetic or from the circumcision procedure itself. Inasmuch as dorsal penile nerve block has a low complication rate, is simple to learn, and adds little time or expense to the overall procedure, and if it proves to be as effective clinically as the physiologic data indicate, the dorsal penile nerve block should be considered for every infant undergoing circumcision."


Legally, it is your right to choose circumcision for your child, as you believe that there are health benefits. But my question to you is, mustn't those benefits outweigh the risks?

The AAP takes a rather wishy-washy stand and dumps it into the parents lap (I assume to avoid liability issues) This is from the AAP policy statement.

"Existing scientific evidence demonstrates potential medical benefits of newborn male circumcision; however, these data are not sufficient to recommend routine neonatal circumcision. In circumstances in which there are potential benefits and risks, yet the procedure is not essential to the child's current well-being, parents should determine what is in the best interest of the child. To make an informed choice, parents of all male infants should be given accurate and unbiased information and be provided the opportunity to discuss this decision. If a decision for circumcision is made, procedural analgesia should be provided."

What other elective surgeries are parents allowed to choose for their child on normal healthy body parts?

Are parents truly made aware of the risks? Or are they told, as I was, that it's perfectly safe, my kid will reap all sorts of benefits and won't get made fun of in the locker room (and they call that informed consent??) Are they made aware of how often meatal stenosis occurs? (10%) Are they told about adhesions and how to care for them? Death and penile amputation are also risks.

Now that doctors are leaving much more foreskin on when they circumcise (loose circumcision) what happens to all those health benefits? Does all the foreskin have to be removed to receive those benefits or is it ok to leave some on. Most boys done today are left with a cuff of foreskin, rather than total removal (tight circ) of the foreskin which led to other problems. I'd say that cuff of foreskin must reduce the benefits in some way.

 

[BuckNaked]

Basically, my point is, my decision to circumcise my child is an informed decision made by me, my husband and our doctor. It is the right decision for me, regardless of anyone else's opinion.

EXACTLY!!!