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Moms Talk Q&A: Circumcision

This week's Moms Talk Q&A focuses on the controversial practice of circumcision.

Moms Talk Q&A is a forum designed to give hard-working parents a place to ask questions and have an open and honest discussion about the issues they face. You ask the questions and the offers their answers.

This week's Moms Talk Q&A focuses on the controversial practice of circumcision.

You're in labor giving birth to your new bouncing baby boy. Emotions are high, and after a long and productive labor, you spend the better part of a day getting to know your son. The two of you are blissfully happy, then in comes a nurse jolting you back to reality with the question:

Q: Are you going to have your son circumcised?

A: With all four of my sons, within moments of knowing I was bringing a baby boy into our lives, I had the feeling in my belly of dread and anxiety over circumcision. I was pretty certain it had to be performed, but not knowing how it would affect my son was horrible.  

Each time it was done, there were different protocols in place. Over the span of 14 years, the actual procedure was nearly identical, but the preparation of the baby was vastly different. Knowing what I know, I've compiled a few tips to help lessen the discomfort of your son (and his mommy!)

  • If it can be done in the presence of the baby's parents, insist on being next to your baby to soothe him and hold him.
  • Ask your pediatrician if it's possible to administer some pain medication (Tylenol) about an hour before the circumcision.
  • Time it to where your baby will be able to nurse (or take a bottle) immediately following the procedure (most nurses will let you know their schedule ahead of time so you can plan your baby's feeding times).
  • Depending on the current protocol in place, you will need to treat this area with antibiotic gel or something of the like, topped by a small square of gauze. Keeping the area protected from the diaper, and its contents will keep the baby comfortable after the circumcision is complete.

 

A: Well, not having sons, I have never had to wonder, but when I found out about both my pregnancies, the question came up for sure.

My husband, the naturalist, was completely against it. I was for it given my (few and far between) experiences working in a hospital and hearing horror stories of adult men who suffered the indignity of having it done as an emergency procedure. So there are a few considerations to keep in mind including: personal experience, religious affiliation and medical history.

The one point I would like to clarify is that circumcision should be discussed and decided upon prior to the day you give birth!

Craig Ginsberg March 20, 2011 at 02:56 AM
policy statements of official medical organizations: http://www.cirp.org/library/statements/ I am not bigoting gays. I don't make up the statistics. Some of my best friends are gay.
Craig Ginsberg March 20, 2011 at 03:02 AM
is every medial organization in the world stupid? Dr. Robert Van Howe actually conducted the largest review of the scientific literature on STD’s and circumcision ever published. His conclusions are startling: "The medical literature does not support the theory that circumcision prevents STD’s" (6) Van Howe R. Does Circumcision Influence Sexually Transmitted diseases?: a literature review. BJU Int 1999 Jan;83 Suppl 1:52-62. [7] To confirm this, the National Health and Social Life Survey conducted at the University of Chicago, found: "First, Circumcision status does not appear to lower the likelihood of contracting an STD. Rather, the opposite pattern holds. Circumcised men were slightly more likely to have had both a bacterial and a viral STD in their lifetime." [8] 7 Van Howe R. Does Circumcision Influence Sexually Transmitted diseases?: a literature review. BJU Int 1999 Jan;83 Suppl 1:52-62. http://www.cirp.org/library/disease/STD/vanhowe6/ 8 Laumann EO, Masi CM, Zuckerman EW. Circumcision in the United States: prevalence, prophylactic effects, and sexual Practice. JAMA 1997 Apr2;277(13):1052-7 http://www.cirp.org/library/general/laumann/
Craig Ginsberg March 20, 2011 at 03:03 AM
Most studies on HPV performed before 2006 had poor controls and relatively small study groups. In order to clear up this confusion, a recent 2008 study on HPV had an enormous study group of almost nine thousand men in the United States. This is currently the largest study on circumcision and HPV ever performed in the U.S. And since the study was performed in the U.S., the results are directly applicable to people who live in the U.S. They concluded: "The percentage of circumcised men reporting a diagnosis of genital warts was significantly higher than uncircumcised men, 4.5% (95% CI, 3.6%–5.6%) versus 2.4% (95% CI, 1.5%–4.0%)". [3] Circumcised men where about twice as likely to have HPV! The claim that circumcision prevents cervical cancer in women is a detestable myth with sexist implications. This is based on the presumption that circumcision prevents HPV and that HPV increases the risk for both cervical cancer and penile cancer. Since this HPV claim has been thoroughly discredited, the cervical cancer myth is also now debunked. It has now been shown that circumcision increases the risk for HPV. Hence circumcision may increase the risk of both penile and cervical cancer by increasing the spread and acquisition of HPV. The practice of circumcision could very well be a contributing factor to the prevalence of HPV in the U.S.
Craig Ginsberg March 20, 2011 at 03:03 AM
Nevertheless pro circumcision advocates have continued to mine for data in inapplicable communities like rural Uganda with the intent to prove that circumcision does reduce the risk for HPV. Yet, when these studies are performed they get an incredible amount of press. Why did the previous study I present not gain any publicity? In the studies I have provided thus far, they have have used racially and socioeconomic homogeneous study groups in developed urban western settings. This is something that most if not all of these pro-circumcision studies do not account for. (3) Dinh, T.H.; M. Sternberg, E.F. Dunne and L.E. Markowitz (April 2008). "Genital Warts Among 18- to 59-Year-Olds in the United States, National Health and Nutrition Examination Survey, 1999–2004". Sexually Transmitted Diseases 35 (4): 357–360.http://journals.lww.com/stdjournal/Fulltext/2008/04000/Seroepidemiology_of_Human_Papillomavirus_Type_11.8.aspx Retrieved 2011-03-5
Craig Ginsberg March 20, 2011 at 03:06 AM
if the benefits where so "FACTUAL" we would not have SOOOOO many Conflicting conclusions.
Julieanne March 20, 2011 at 03:13 AM
Craig has never heard of the CDC apparently. http://www.cdc.gov/hiv/resources/factsheets/circumcision.htm http://www.msnbc.msn.com/id/29777922/ns/health-mens_health/ UNAIDS and WHO (world health organization) http://www.unaids.org/en/media/unaids/contentassets/dataimport/pub/pressrelease/2007/20070328_pr_mc_recommendations_en.pdf Really it goes on and on.. Also to comment on your claim of nerve endings in the foreskin. UNTRUE. There are no nerve endings. The nerve endings are in the GLANS and the FRENULUM. WHICH is not removed during circumcision. Please learn your biology. For those who went to nursing school in the 70's um--they don't do it that way anymore. IT is painless. Like I said in my first comment surgeries can go wrong. BUT Craigs claim that 1 out of 3 babies dies..IS INACCURATE MISINFORMATION. 1 out of 3000 have complications...not leading to death. BUT nice try. As I stated in the beginning do your research. Do not spread misinformation because you have a strong opinion. THAT is irresponsible. Good night.
Michelle March 20, 2011 at 04:15 AM
Since the beginning of America's male genital cutting era, "Doctors" and religious zealots have been inventing new claims by fabricating "studies" "prooooving" it: *cures epilepsy*1870 Lewis A. Sayre; *prevents spinal paralysis"1870 Lewis A. Sayre; *creates an immunity against masturbation* 1871 M.J. Moses; *prevents clubfoot*1875; Lewis A. Sayre *cures nocturnal emissions and abdominal neuralgia*1879 H.H. Kane; *prevents crossed eyes* 1886 William G. Eggleston; * 1888 John Harvey Kellogg promotes circumcision as punishment for boys to discourage them from masturbating.*; *1890 William D. Gentry declares that circumcision cures blindness, deafness and dumbness. *; *1893 Mark J. Lehman demands immediate implementation of mass circumcision of all American boys.*; *1894 P.C. Remondino says circumcising blacks will help prevent them from raping whites.*; *1898 T. Scott McFarland says he has "circumcised as many girls as boys, and always with happy results."* and of course, lets not forget the modern day scare tactics used to $ell/ $olicit an arbitrary male genital reduction surgery, such as the current claim "circumcision prevents HIV/AIDS ". When one claim has been refuted, another takes its place. "Circumcision" is a "cure" always in search of a disease. Why do the circumcised in America try so hard to demonize a normal, natural body part? Doctors lack the understanding of a complete anatomically correct male genitalia. They're only taught to remove the "unknown".
Ruth March 20, 2011 at 04:20 AM
Apart from the fact that all the HIV study's quoted were not conducted done in the US and really have no reflection on our society.. it also did not address the fact that said studies did not prevent HIV in WOMEN or Homosexuals, at the end of the day, the argued studies were done in countries where Raping a new born baby is considered a way to cure AIDS !!!! Condom's are the only real barrier against STD.... And as for your "no nerve endings" in the Penis, first off Lady! your not a male so don't try to claim like you know cause you DON'T..... Secondly... You do need to "Rip"the foreskin from the GLANS to REMOVE IT hence forcible removal 20.000 nerve endings!!....... if you've ever seen an INTACT infants penis you'd know this!!! your comments are idiotic, ignorant and just plane stupid...get your facts straight!!!!! his body his choice! If that ain't good enough for you Julieanne!!! Since your a CHICK how about we through back to them "Olden days" and remove the hood of your Clit and sew up your vagina so it can look good and feel tight!!!! ... hell while we're at it let's give you a boob job and take away your right to vote too!!!!!!!!!!!
Kyle March 20, 2011 at 03:08 PM
Julieanne: You seem to be well-informed on the subject, so I'm hoping that you can answer something for me. I'm very interested to know how my foreskin can be so sensitive to fine-touch and stretching if it contains no nerve endings. Since you have done your research, and know your biology, please point me to a source that can explain that.
a March 20, 2011 at 03:27 PM
there isn;t one part of my body that does not have nerve endings, that statement is ludicrous, no nerve endings in the foreskin, just crazy! just look at the stats, not of these studies which are VERY flawed, but of the stats of the civilized places like England, Ireland, Italy, India, where intact men are very much the majority, and look at their rates of all the diseases that some say circumcision "cures" get the WHOLE story! it is not necessary to perform this painful surgery on newborn baby boys, no one gains anything... I dare you to leave the boys intact and see what happens.... they grow up just as healthy as circ'd boys, and they get to skip the painful surgery, and keep their whole penis, AS GOD MADE THEM
vanessa h March 20, 2011 at 03:43 PM
There is some great information and some solid resources. All I can add is this: Routine infant circumcision is unnecessary. The risks and damage caused to the genitals far outweigh any arguable pros when using logic. It is a basic human rights violation.
Lindsay March 20, 2011 at 05:50 PM
In most European countries men are not circumcised. These countries do not have a higher STD/HIV rate, in fact they have lower rates than the US(where most adult men our circumcised). The men there also do not NEED to be circumcised later as they know how to take care of the foreskin there and know phimosis or infection does not mean a man needs circumcision. All those countries think we are nuts for performing infant circumcision.
Craig Ginsberg March 20, 2011 at 08:16 PM
1 i don't just imagine the medical literature. 2 the frenelum is usually removed. The innervation of the foreskin IS A FACT. there is no refuting the work of countless respected nero anatomical researchers. The foreskin is the most sensitive part of the penis PERIOD! 3. The CDC nor the WHO recommend infant circumcision they promote volitionality adult male circumcision in AFRICA. They use African studies to delegate AFRICAN POLICY. African studies CAN NOT nor EVER be extrapolated to populations in developed Western urban settings . PERIOD. Fore the reasons described in my HIV post. Besides an HIV vax will be available by the time CHILDREN today grow up. CHILDREN IN AMERICA don't have sex with prostitutes infected with genital ulcer disease at trucker stops in Kenya.
Craig Ginsberg March 20, 2011 at 08:16 PM
never said 1/3 i said 117 to 230 a year that about 9.7/10,000
Craig Ginsberg March 20, 2011 at 08:24 PM
yep Europeans think it s joke. They think we are a joke. They are usually shocked to hear that America is such a primitive bronze age tribe of savages.
Henry March 21, 2011 at 12:04 AM
Julieanne, the CDC is not a medical professional association, but a governmental agency, and we all know what governmental agencies are like…. Likewise, UNAIDS and WHO are not medical associations, but international agencies supported by governments, and we all know that they are even worse than our US governmental agencies. No nerve endings in the foreskin? Circumcision is painless? I should let my medical students know about that tomorrow. It should make the news. You are absolutely correct that surgeries can go wrong. It is particularly sad, when unnecessary surgical interventions go wrong. It is unethical and it should be criminal when unnecessary and contraindicated surgeries are forced on non-consenting individuals, such as in routine infant circumcision, and it should at least be involuntary manslaughter when any of these infants die as a result of such an assault. And it happens every year in this country ….
Johan van Grussvoldt March 21, 2011 at 01:10 AM
Hi to whomever wrote the article and others here present. I would like to say that I was more than shocked to learn that in USA males born have to be circumcised like Jews and Muslims and create a problem maiming their penises with a surgery that it is only done in Europe only WHEN there is a problem in the penis that can not be corrected by other means which it is very rare.Less than 1 boy in 3,000 may have a problem related in their penis or testicles to require such a radical surgery like the one here discussed and so gratuitously offered.And I will like to inform the article writer that I can assure you that foreskin has many more nerves and veins because I do own one and has always felt very good everywhere and not only in the frenulum and glans.From where have you got such erroneous information,it is just not possible.Others here are trying to help you,listen.
Michelle Helms March 21, 2011 at 01:38 AM
Johan, I wrote the article, but you must have me confused with one of the comments from another reader. This is a Question and Answer Forum for readers in our community to discuss these questions with one another, and I presented the question: Should you circumcise your son? I answered with my personal experience and never once did I imply that the foreskin or any other part of the male anatomy has no nerve endings! Wow. In fact, I welcomed the opinions of others and mentioned that when my son was circumcised 14 years ago, there was very little information on circumcision available easily. But thanks for your comments, it's interesting to hear what others in our community (or from another community, in this case) feel about these particularly heated topics.
Craig Ginsberg March 21, 2011 at 03:41 PM
I never said any thing like this this pisses me off. "BUT Craigs claim that 1 out of 3 babies dies..IS INACCURATE MISINFORMATION" This is what i said. A wide range of surgical complications occur in 2-10% of the cases.(1) Since there are approximately 120 million circumcised men in the United States today, it stands to reason that there are millions of men who suffer daily from the effects of these botched circumcisions. Perhaps worst of all, more then 117(2) to 230(3) infants in the U.S. die from circumcision every year. The 117 estimate is from, 2010 and it makes for 9.01/10,000 deaths. The complications estimate is all FARR newer then you 1970s' education. back then complication rate studies dident exist, studies on trauma and every thing else did not exist either. (1)Williams, N; L. Kapila (October 1993). "Complications of circumcision". British Journal of Surgery 80 (10): 1231-1236. (2) Bollinger, Dan; Boy's Health Advisory (2010-04-26). "Lost Boys: An Estimate of U.S. Circumcision-Related Infant Deaths". Thymos: Journal of Boyhood Studies 4 (1): 78–90 (3) Gellis, SS. Circumcision. Am J Dis Child 1978;132:1168.
Craig Ginsberg March 21, 2011 at 03:45 PM
every circ research expert i have ever consulted agrees that this complication estimate is the most accurate publication that exists in the medical literature(1). This estimate uses a superior and realistic methodology. (1)Williams, N; L. Kapila (October 1993). "Complications of circumcision". British Journal of Surgery 80 (10): 1231-1236.
Craig Ginsberg March 21, 2011 at 03:56 PM
i mean if i really wanted to give you skewed info i could throw you a couple publications that claim a 35(1)-55(2)% complication rate. these count more "minor skin tags". Where as other studies ignore them because the bodies of children are typically not something to be respected. However a complication rate of 2-10% (3) is most accurate as it is based on the largest review of the medical literature on complications and circumcision ever published! I guess cultural, ideological, and religious indoctrination is just to powerful for some. Such childish behaviour generates reason to dismiss the academic literature. I mean these people already live in a world where their "facts" do not requite scientific validation, the arbitrary and scientifically unfounded sataus-quo of their primitive and uneducated culture is typically good enough for them. "No nerves in the foreskin" is a perfect example of such unfounded claims. (1) Kaplan, G.W. (August 1983). "Complications of Circumcision". Urologic Clinics of North America 10 (3): 543–549. PMID 6623741. http://www.cirp.org/library/complications/kaplan/. Retrieved 2006-09-29. (2)Patel H. The problem of routine infant circumcision. Can Med Assoc J 1966; 95:576. (3)Williams, N; L. Kapila (October 1993). "Complications of circumcision". British Journal of Surgery 80 (10): 1231-1236. http://www.cirp.org/library/complications/williams-kapila/#n14
Craig Ginsberg March 21, 2011 at 04:02 PM
To me, this sounds like Julieanne IS the IRRESPONSIBLE one spreading MISINFORMATION. ""1 out of 3000 have complications...not leading to death. BUT nice try. As I stated in the beginning do your research. Do not spread misinformation because you have a strong opinion. THAT is irresponsible. Good night."" I mean here 1/3000 claim has absolutely no reference. Did she make this number up? Is she a reciting a number she read in a text book in the 70"S? As i explained today we have abetter idea of the complication rates because there has been more data collected, in then 70s no body had any clue what it was, no accurate study's have ever been done yet.
Craig Ginsberg March 21, 2011 at 04:25 PM
if Julieanne actually read the CDC link she would find that not only do they use the 2-10% complication rate they also say this policy is for AFRICA and can NOT be extrapolated for the U.S. However they misquote this sensitivity study(1) and dodge the innervation of the foreskin all together. However paediatric organizations like the royal Australian college of pediatricians, the royal dutch medical association, the British medical association, and the Canadian paediatric society clearly discuss not only the innervation of the foreskin but the functions of the foreskin. This is typical avoidance behaviour of the authors for those with missing body parts(2) like those at the CDC. So the question is, it is a better decision to follow the recommendations directed to CHILDREN in western cultures as set forth by PAEDIATRIC associations or is it better to follow a policy for VOLUNTARY ADULTS IN AFRICA proposed by an organization like the CDC that does NOT specialize in CHILD care? Looks just like some one grasping at straws to validate the indoctrination of her barbaric culture to me. This is irresponsible, she is in denial for her own children and is spreading MISINFORMATION to put her fragile little world at ease. (1)Morris L. Sorrells, James L. Snyder. Fine-touch pressure thresholds in the adult penis . BJU 2006 Oct:22, pp. 864-869 (2) Maguire P, Parks CM. Coping with loss: surgery and loss of body parts. BMJ 1998;316(7137):1086-8.
Craig Ginsberg March 21, 2011 at 07:48 PM
this is the conclusion from the most recent HIV meta analysis of all available literature "The demographic evidence indicates that the relationship between male circumcision and HIV seroprevalence is complex, and that both positive and negative relations can be found for a variety of reasons. No evidence of an overall protective effect of male circumcision was found for the countries studied, and if there is an effect at the individual level it is buried in a mix of many other intervening factors. " Michel Garenne. African Journal of AIDS Research 2008, 7(1): 1–8.
Craig Ginsberg March 21, 2011 at 07:50 PM
this researcher wrote this article: http://wehonews.com/z/wehonews/archive/page.php?articleID=5792 he says: "Somehow, it seems some in American medicine haven’t progressed that much. Critical evaluation confirms that current reasons for circumcision are no more credible than they ever were."
Craig Ginsberg March 21, 2011 at 07:59 PM
when the RCT's came out the first Cochrane Collaboration Report on circumcision cautioned about researcher bias, stating: “Circumcision practices are largely culturally determined, so there are strong beliefs and opinions surrounding them. It is important to acknowledge that researchers’ personal biases and dominant circumcision practices of their respective countries may influence interpretation of findings.”13 13. Siegfried N, Muller M, Volmink J, Deeks J, Egger M, Low N, Weiss H, Walker S, Williamson P. Male circumcision for prevention of heterosexual acquisition of HIV in men (Cochrane Review). In: The Cochrane Library, Issue 3, 2003. Oxford.
Craig Ginsberg March 21, 2011 at 08:00 PM
why have i never seen a Japanese or Indian, or south American researcher publish a circ study that claims benefit?
Craig Ginsberg March 21, 2011 at 08:25 PM
also if you are to push the claim that there are no nerves in the foreskin you should try reading my research above, look up my references and read them, If i am wrong, which i am not, it should be easy for you to discredit this.
Michelle March 21, 2011 at 09:03 PM
The question: Should you circumcise your son? Its tragic its even a question. Being born healthy does not warrant surgery. The human blueprint included the prepuce organ for both females and males as a default setting. You're already born intact. Someone, a culture, the media, articles (much like this one) will try to influence parents to elect their son for the removal of a normal body part. Someone had to convinced the parents to sign a "piece of paper" risking the amputation of all or parts of his genitals. Some questions are subjective. Pro-cutting health care providers wishing to make an egotistical, as well as, a monetary profit will often phrase this question, "Do you desire to circumcise your son?" This is solicitation. FACT: The AAP does NOT recommend routine infant circumcision. They do encourage doctors to speak with their client's parents. At the same time, the hospital has a strict protocol that states: DO NOT TELL PARENTS ANYTHING UNLESS THEY ASK. You are forbidden to read a "consent form" until AFTER you meet your son. You've just given birth for goodness sakes! You and your partner is exhausted from an amazing feat! Are you really in your best mind frame to even consider an irreversible arbitrary genital surgery? Are doctors soliciting for the removal of any other healthy body part? There should be a SLEEPING DOG'S POLICY: Don't ask parents, "Would you like your son circumcise?" Are you keeping your son INTACT?
Hugh7 March 23, 2011 at 09:21 AM
Julieanne: "There are no nerve endings. " The research showing there are many thousands of nerve endings is Taylor, J.P., A.P. Lockwood and A.J.Taylor The prepuce: Specialized mucosa of the penis and its loss to circumcision Journal of Urology (1996), 77, 291-295 If there are no nerve endings in the foreskin, why does arch-circumcisionist Brian Morris recommend circumcision "to prevent zipper injury"? Zipper injury in a part with no nerve endings would be painless. It is not. Please stop repeating nonsense. "The nerve endings are in the GLANS and the FRENULUM. WHICH is not removed during circumcision." The frenulum is a poor remnant of the ridged band, which Taylor discovered, and which encircles the inside of the tip of the foreskin. The frenulum is frequently removed by circumcision, at the whim of the circumciser, as you can see here. http://www.circumstitions.com/Restric/Images/Comparison/fren1-2.jpg (NSFW)

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