Effects of circumcision on breastfeeding, maternal bonding, and child development
Circumcision vs. Child Health, Breastfeeding and Maternal Bonding
This index page contains links to documents about circumcision versus breastfeeding, the effect of circumcision on mother-infant bonding and interaction, and information about breastfeeding's beneficial effect on reducing the risk of urinary tract infection (UTI) in infancy.
See also The Birth Scene, a site having an excellent discussion of circumcision in seven articles by leading writers.
Circumcision's Adverse Impact on Breastfeeding Initiation
Medical authorities agree that there are no medical indications for circumcision in the newborn period. Male neonatal circumcision is a non-therapeutic operation, an unnecessary procedure that does not promote child health.
Authorities agree that male circumcision is a painful and distressing event for a baby. Infants have fully functioning pain sensors at birth,2 and the pain of the surgery is severe and longlasting.3
It has been established in numerous studies that circumcision causes changes in infant brain function and behavior. Marshall el al. (1982)1 and Howard et al (1994)5 have studied the effect of the pain, stress, and trauma, of male neonatal circumcision upon subsequent feeding behavior. They each found that male circumcision disrupts feeding behavior. Sometimes the infant is returned to the mother in an exhausted and debilitated state in which he is unable to manage the task of latching-on and feeding.5
Breastfeeding provides many health and developmental benefits to the infant, so clearly breastfeeding failure should be avoided. Traumatic and stressful events in infancy interfere with breastfeeding success. The AAP Policy statement on breastfeeding states that traumatic procedures should be avoided lest they interfere with breastfeeding initiation. Taddio and colleagues report that male neonatal nontherapeutic circumcision causes an "infant analogue of posttraumatic stress disorder."6Rhinehart has clearly and indisputably documented neonatal male circumcision as a traumatic procedure.7 Parents who intend to provide the benefits of breastfeeding should think carefully before subjecting their new baby to circumcision.
If parents decide to have their son circumcised despite prevailing medical opinion, La Leche League advised that circumcision should be deferred until after breastfeeding is well established.11 See the articles indexed below for more information:
The American Academy of Pediatrics now has recognized officially that circumcision interferes with feeding behavior.10 The AAP advises that painful or stressful procedures (such as circumcision) intefere with breastfeeding initation and should be avoided.9,11
Journal of Human Lactation, (Official Journal of the International Lactation Consultant Association)
Two mothers and lactation consultants report their observations about the effect of circumcision on breastfeeding initiation in letters to the Journal of Human Lactation.16,17 Hill advises that lactation consultants should tell mothers about the adverse effects of circumcision and that breastfeeding should be given priority over circumcision.18
Generally, the post circumcision infant, who is in pain, traumatized, and exhausted post-circumcision infant, may be less available for mother-child interaction for a period of several days to a week. The following indexed articles discuss the effect of the stress and trauma of circumcision on the infant and on mother-infant bonding:
Emde RN, Harmon RJ et al. Stress and neonatal sleep. Psychosomatic Medicine, Vol 33, No. 6 (November-December 1971), Pages 491-497.
LeBoyer, Frederic. Birth Without Violence: The Book That Revolutionized the Way We Bring Our Children Into the World. Inner Traditions International, Ltd. (ISBN 089281540). 1995 Reprint of 1975 Classic.
Mary Kroeger with Linda J. Smith. Circumcision. In: Impact of Birthing Practices on Breastfeeding: Protecting the Mother and Baby Continuum. Sudbury, Massachusetts: Jones and Bartlett Publishers, 2003: pp. 197-8. (ISBN 0-7637-2481-5)
Breastfeeding and UTI reduction
Some methodologically-flawed studies that were published in the mid-1980s suggested that male neonatal circumcision may provide some protection against urinary tract infection.
Later information that was published in 1990-1992 show that breastfeeding provides a three-fold reduction in the incidence of urinary tract infection (UTI) in the first year of life as compared with bottlefeeding. The earlier studies had no control for the variable of bottlefeeding or breastfeeding (amongst other methodological problems) so they have become invalidated by the later information. There is now no reliable evidence that male circumcision offers any protection against UTI.
The following articles indicate that breastfeeding can protect infant boys from urinary tract infections:
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