Email: Breastfeeding and the AAP's Policy Statement on Circumcision

This is my email to the 2012 AAP Task Force on Circumcision, their liaisons, consultants and staff as well as the AAP Board of Directors Executive Committee:


Hello, I am writing to you today as a mother and a Certified Lactation Counselor, in disappointment and horror. The recent release of the AAP’s revised policy statement on circumcision has led me to believe that you and your colleagues truly do not support children’s health; why else would you have been supportive of a procedure that not only robs babies of a healthy part of their body but can also kill them? Why would you support something that lactation professionals know disrupts the breastfeeding process, often causing babies to stop breastfeeding altogether? In the risks of the procedure there is no mention of breastfeeding cessation, nor is that included in the cost analysis. Breastfeeding is supposedly endorsed by the AAP, from their policy statement:

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.

What about the fact that baby boys are more likely to be diagnosed as FTT? That they are less likely to breastfeed than their female peers? Do the supposed benefits of circumcision trump the lifelong proven health benefits of breastfeeding? Is the supposed cost of health care related to an intact penis greater than the cost of formula induced illnesses over the course of a lifetime and the cost of formula for programs such as WIC?

Furthermore, breastfeeding has been shown to decrease the incidence of urinary tract infections in all babies, something that the newly revised AAP statement claims circumcision does for boys. Breastfeeding is certainly less risky and traumatic for a baby with other benefits that are well documented.

Lactation professionals are becoming more aware of the link between circumcision and breastfeeding difficulties and the literature is beginning to reflect this. I urge you to consider this as it pertains to the AAP’s policy statement. Please consider breastfeeding in your assessment of circumcision and rescind the current policy statement.

Sincerely,

Anna Lahr, Certified Lactation Counselor

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