Circumventing Circumcision

Because we didn't find out the sex of either of our children before their births, my husband and I had the circumcision discussion when I was pregnant with my daughter.  That was four years ago, and the only resource that I had tapped into was my instinct.  I knew that America was the only developed (?) country in which routine circumcision on boys was still practiced, so I wondered what other countries, and entire continents, knew that we didn't.  Why were Americans so quick to cut off part of a healthy penis?  I spoke to my husband about it, who agreed to do whatever I thought was best.  So, my gut told me that circumcision wasn't necessary, and that was that.

Then we gave birth to a boy.  We opted not to circumcise and met no resistance with our decision.  Then the boy got a urinary tract infection at the age of two days.  He was taken to the emergency room, where they did a spinal tap to make sure he did not have spinal meningitis.  They collected a urine sample which involved me holding him down, his arms put into a pillowcase behind him so he could not move them, and a catheter being placed (yes, a tube inserted into his penis) and waiting for him to pee.  You may not have ever noticed, but when a person is screaming, their abdominal muscles engage, which creates a slight "bearing down" effect on the pelvic floor, making it virtually impossible, and certainly extremely painful, to insert anything up into and beyond the pelvic floor.  We were cleared to go home, shouldn't have been, had to return, and spent a couple of days in the hospital with our son getting intravenous antibiotics.  By day seven of his life, he had had more tests and more medicine than my then-2-year-old daughter - five catheters alone!  He came home, was happy and healthy, until another UTI appeared.  Then a third - all before his 1st birthday. 

My pediatrician was concerned and sent him to a specialist.  We had to repeat the same tests done on day three of his life to ensure that there was no physical reason for the recurring UTI's.  With those complete, and no positive test results, we were faced with the circumcision question.  My pediatrician (completely supportive of my parenting decisions) said that the only medical indication to circumcise was recurring UTI's.  

Popular opinion tells us that circumcision is not a big deal.  That the child cannot feel much pain.  That the boy will be able to stay cleaner without the foreskin in tact.  That the chance of contracting HIV and other sexually transmitted diseases is reduced.  That an uncircumcised boy will look weird in the locker room and feel out of place.  I checked in with my gut, which said that if all these things were true, how is it that so many European and Asian men are walking around in perfect penile health?  I had to formalize my research efforts.  

The subject is very emotionally charged, so getting clear information is a challenge.  In short, I found the following:

1. Circumcision is a big deal.  It is surgery.  It is surgery performed without anaesthesia.  It may not be a big deal to a physician who performs several circumcisions each day, but it is a very big deal to your own son, who only has one penis.

2.  If you think your newborn can't feel pain, try cutting their fingernails too close.

3.  Hygiene is important.  When the boy reaches puberty, the foreskin must be retracted during showers in order to clean thoroughly.  I have two comments: First, a girl's genitals have more folds of skin than an uncircumcised boy.  Second, I'm sure telling my post-pubescent son to touch his penis in the shower will be met with complete embarrassment followed by inner delight.  

4.  I have serious questions about the validity of studies which indicate that uncircumcised men have a higher incidence of HIV.  (See the World Health Organization website for more information)

5.  My husband assured me that boys in locker rooms do everything they can to avoid looking at each other's penises.  That is the last place you want to be caught looking.  

Having armed myself as best as possible, wading through emotionally charged "scientific" articles, I returned with my son to the specialist to discuss what can be done about his recurring UTI's, other than have him on antibiotics constantly (which did relieve UTI symptoms, but left poor son with a blistering diaper rash from stem to stern).  I was armed with the best information I could find and a fierce mama-bear attitude of protection.  I was prepared to put up a fight, and would try my best to not sound hysterical.  How happy I was to learn from this doctor that a new study had been released indicating that if an infant has recurring UTI's and the cause is suspected to be the foreskin, that chance greatly diminishes after the age of 1.  My son was 15 months old.  The specialist recommended following up in one year.  Nothing more.

I returned to my pediatrician for an 18-month checkup and told her the good news.  She was very happy that I would not have to pursue this option, primarily because she knew that I was opposed to it.  She was pleased to learn of that study, and would be looking into the matter more herself.

If you are expecting to give birth to a boy and wonder what you should do about circumcision, please keep the following in mind:

The following reprint from Mothering magazine has two articles in which people speak rationally about the circumcision procedure and the rationale in avoiding circumcision:

Mothering Magazine Reprint on Circumcision

There is not a single medical association in the WORLD that recommends routine circumcision.  NONE!  In fact, this information can be found on the website of the American Academy of Pediatrics.  The headline reads, "Scientific Evidence Insufficient to Warrant Routine Circumcision."  This is dated from 1999.  In fact, this statement goes on to say that parents should be given accurate and unbiased information and left to make the decision they feel is best for the child.  As I have said, that information is hard to come by.

AAP Policy Statement on Neonatal Circumcision

For more anecdotal reference, I have the following story.  A hairdresser (friend of my sister's) is pregnant with a boy.  She has a client who is a mohel (the person in the Jewish faith who performs the religious ceremony of circumcision, known as briss).  The hairdresser was on the fence about the issue, and asked her client about it.  Before she could even complete her question, the mohel answered bluntly, "If it's not your religion, don't do it."

 

Finally, If you have a very strong stomach and can watch a male circumcision being performed, see the following excerpt from "Birth As We Know It," a documentary by a German midwife.  It is not easy to watch, I will warn you.  I was crying and nauseated.  It is restricted on YouTube for content.  I only reference this so you may have all the information I had.  

Birth As We Know It clip

As with all aspects of parenting, one decision does not make you a good or bad parent.  I strongly believe that anyone reading this blog is making the best choices they can make with the information available to them.   So, congratulations.  You are doing a great job.  Keep learning, so you can keep up the good work.

Breastfeeding Dads

Ever heard of a man suffering from breast envy?  Of course you have.  New dads watch their babies nurse and see the amazing, mystical bond that develops between babe at breast and woman providing breast.  Some new dads, therefore, jump at the chance to bottle-feed their little ones, to try to capture some of that intimacy.  My husband mostly just got to beat our children on the back waiting for them to burp.

Although male lactation is possible (just search for it!), I am here to tell you that even without milk coming out of your nipples, you play a key role in your baby's nursing relationship to mom.  I'm not just patting dads on the head with a "There, there, sweetie.  You can burp the baby!"  I'm telling you that without my husband's support, I could not have nursed my daughter for 15 months and my son for 21 months (and counting).  

I knew I wanted to breastfeed my children and I had support before they were born.  My mother nursed all four of her children and was active with La Leche League during the height of formula-pushing.  I read, from cover to cover, The Womanly Art of Breastfeeding.  That was the best book I read during pregnancy - not any of those silly books that talk about how great sex is during your second trimester or how vivid your dreams are.  A book about breastfeeding (see also Martha and William Sears' The Breastfeeding Book) provides so much information that you will need on day one of motherhood.  There will not be time to read this once the baby is in your arms, so use that afternoon couch time to learn what you can expect.  

Yes, breastfeeding is natural and, Yes, it has been done for thousands of years.  But how many times have YOU done it??  The book offered me the knowledge that there may be problems, or special circumstances that can interrupt nursing.  With this knowledge tucked away in my new mommy brain, I felt mostly sure that my daughter and I would succeed.  When problems arose (like copious, projectile vomit), I knew that there would be something in the book that would help me.  When my breasts got so big that even my husband thought they must hurt, and the baby was sleeping for more than 30 minutes for the first time in 2 months so there was no hope of nursing her, I knew I could turn to the book for suggestions (a long, hot shower did the trick).  Knowing that other people had tried, failed, tried again (and sometimes again) and succeeded, and that they had shared their advice in this one book, was a big help.

More important than any book in the world, however, I had my husband.  He knew the benefits of breastfeeding (either he read the book himself or I read aloud to him).  He knew that there was no better option that a healthy mom had to feed her healthy baby.  He knew that my breasts wouldn't always be the domain of our children (and he could eventually reclaim them).  And with this knowledge, he graciously brought me a pillow for nursing, a blanket to cover us both, a glass of water for the always-dehydrated nursing mom, and always a kiss.  He enjoyed watching baby bond with mother.  And every time he helped me nurse our children, our bond as husband and wife strengthened, and our bond as a family strengthened.  

Dads, please educate yourselves about breastfeeding.  Your wife will be too overwhelmed and too exhausted.  Everywhere she turns, someone will be telling her that the formula made today is "just as good" or worse (from the mouth of a friend's ex-pediatrician) "superior to breastmilk."  Mom will see ads everywhere that show a happy, well-rested mom bottle-feeding her baby.  She won't see statistics on breastfed babies with lower incidences of food allergies, asthma, intestinal problems, even higher test scores.  Those statistics are buried under a big, fat bottle filled with formula.

We need you dads.  The human race did not get this far on Nestle's formula.  We got here "on the boob."  And we need your help to protect our right to use our boobs.  Because behind every successful breastfeeding mom is a patient, supportive breastfeeding dad.

When books aren't enough:

Finding a local chapter of La Leche League International can bring you face-to-face with moms who have been through difficulties and nursed their way out of them.  They can also give recommendations for lactation consultants (most leaders of LLL chapters are certified lactation consultants).

If you had a doula or midwife present at your birth, they can usually help after birth with breastfeeding questions.

If you have serious concerns about you and your baby's ability to breastfeed, look for a lactation consultant who will come to your home with a hospital scale.  

To read more about, and use, the breastfeeding symbol (used at top of page), and breastfeeding in general, see Mothering Magazine at www.mothering.com