In the midst of all of the commentary and outrage at the AAP’s impending release of their updated policy on infant circumcision, I’m going to hop back onto the topic I tend to cover the most in this blog: Breastfeeding & Circumcision.
You see, I think it’s important to note the widespread effects of circumcision, beyond the surgery itself and healing time. The short-term (but still very real and painful) suffering of the baby during the procedure is often forgotten; at least after the healing has occurred parents may not even give it a second thought. But, there are long term consequences to the procedure and there are also long-term consequences to not breastfeeding.
Let me spell it out clearly:
For babies that have been circumcised, breastfeeding may become difficult or cease altogether. For those infants the complications are not just those of the surgery, the complications include all of the increased health problems they are now at risk of from not being breastfed.
Oh but wait, the AAP hasn’t said anything about infant circumcision causing problems with breastfeeding in their policy statements on circumcision. What pray tell do they have to say about breastfeeding though?
Breastfeeding and human milk are the normative standards for infant feeding and nutrition. Given the documented short- and long-term medical and neurodevelopmental advantages of breastfeeding, infant nutrition should be considered a public health issue and not only a lifestyle choice. The American Academy of Pediatrics reaffirms its recommendation of exclusive breastfeeding for about 6 months, followed by continued breastfeeding as complementary foods are introduced, with continuation of breastfeeding for 1 year or longer as mutually desired by mother and infant. Medical contraindications to breastfeeding are rare. Infant growth should be monitored with the World Health Organization (WHO) Growth Curve Standards to avoid mislabeling infants as underweight or failing to thrive. Hospital routines to encourage and support the initiation and sustaining of exclusive breastfeeding should be based on the American Academy of Pediatrics-endorsed WHO/UNICEF “Ten Steps to Successful Breastfeeding.” National strategies supported by the US Surgeon General’s Call to Action, the Centers for Disease Control and Prevention, and The Joint Commission are involved to facilitate breastfeeding practices in US hospitals and communities. Pediatricians play a critical role in their practices and communities as advocates of breastfeeding and thus should be knowledgeable about the health risks of not breastfeeding, the economic benefits to society of breastfeeding, and the techniques for managing and supporting the breastfeeding dyad. The “Business Case for Breastfeeding” details how mothers can maintain lactation in the workplace and the benefits to employers who facilitate this practice.
You see, the AAP wants us all to believe they are really out there to support healthy children. Look how NICE their breastfeeding policy sounds; surely they support breastfeeding with such pretty words, right? Well, I’m going to say NO, they don’t really support breastfeeding because if they did they wouldn’t be on the verge of endorsing a procedure that could very well stop a great deal of babies from breastfeeding. I’ll even go so far as to say their actions don’t match their words and they are more concerned with their profit and looking good to their shareholders and the general public. You see, I’ve read through some of the leaked policy statement and I don’t see a list of the REAL risks associated with circumcision. I don’t see them informing parents that circumcision could cause death, loss of penis, serious injury, infection (the list is rather long...) or that it could stop their child from breastfeeding. In fact, the listed “benefits” they claim DON’T EVEN APPLY TO THE AGE GROUP THEY WOULD BE OPERATING ON. You read that right. They would have people believe that it’s beneficial to their baby and it’s not even a BABY that is at risk for the things they list other than UTI’s which luck would have it breastfeeding decreases the risk of (and girls are at higher risk of anyway). So let’s weigh at least one potential risk against the one potential benefit for that age group:
Slightly lower risk of UTI’s (supposed benefit of circumcision according to the AAP) versus breastfeeding
That’s what the picture would really look like for a baby. A possible lowered chance of UTI’s in exchange for NOT being breastfed. And as previously mentioned breastfeeding lowers the risk of UTI so it’s really just circumcision vs. breastfeeding.
Yeah, AAP, I can clearly see how concerned you are about infant health and how supportive you are of breastfeeding.
Suggested reading (Other than what I have written on the topic):
"The Womanly Art of Breastfeeding: Circumcision"
"Breastfeeding and Circumcision"
"How the Foreskin Protects Against UTI"
"Cut vs Intact Outcome Statistics"
"The Effects of Circumcision on Breastfeeding"
"The Womanly Art of Breastfeeding: Circumcision"
"The Bias of the AAP"
"Doctors Opposing Circumcision Statement"
"Around the Bush and Closer to Nowhere"
"ARC Law Statement"
"I don't need the AAP to know..."
"AAP Images"
The AAP said that looking forward, RIC should always be performed under local anesthesia. However there is no way of enforcing that requirement, and no penalties for violating it. This is why circumcision without anesthesia should be a crime. Until it is, you and your allies will continue to notice adverse effects of nursing boys.
ReplyDeleteThe AAP's report is downright incompetent, for a host of reasons. Here are three riposts that have reached that conclusion:
http://www.circumcision.org/aap.htm
http://www.doctorsopposingcircumcision.org/pdf/2012-08-26A_Commentary.pdf
http://www.drmomma.org/2012/08/aap-circumcision-policy-statement.html#comment-form