Circumcision

[BeeXxX]

Hi, I posted a few days ago about my little one having club feet.
Well the same little one (9 weeks old) has been circumcised today...I understand some people don't agree with it, but it is personal choice...I'm just wondering if anyone who's little boys have had this done have any advice on handling the discomfort??
My older son had the procedure last year (he was 7 weeks old) and he was alright but my little one seems to be unsettled which is understandable. I used savlon and Vaseline with my older son but just wondering if there is anything else I can do or use. TIA x

No I was not told that. I am aware what FGM entails. I am aware it is horrific and much more brutal than circumcision.

I was also told by the speaker that they also couldn't understand why circumcision was not classed as abuse.

Just because it isn't as horrific as another abuse doesn't make it ok.

Well, clearly it is not abuse and is not legally seen as abuse.

If you (and your speaker) want to understand why, I can briefly explain.

but it is personal choice

Yes, it is personal choice. HIS. When he's old enough to consent. FFS.

Too late for that, though. I hope he recovers quickly from this unnecessary pain.

our son was circumcised for religious reasons but as a nurse (and having seen my fairs share of nasty infections etc) i can see the medical benefits of it too. Obviously I know these problems only effect a small proportion of boys/men with foreskins and it's not enough for circumcision to be done as a routine procedure as it used to be in America, but I can't see how taking off about 1cm off the end of an anethetised foreskin is so bad in comparison to a child having to endure years of infections and then having to have it done anyway but when they are older and acutely aware of the pain?
My son was fine during the procedure I was with him and watched it throughout, he was 5 weeks old he didn't show any signs of discomfort after and all healed up fine within a week with no problems.
The only problem with circumcision is when it is done in someone's living room by the local barber!

I'm sure there are other websites, OP, where you can get advice on pain relief for this procedure. Ones specifically for people who have chosen to do this.

For any surgical procedure, advice on aftercare should be sought from the surgeon that performed it.

It was a surgeon wasn't it?

Oh.

Ours was done by a surgeon and advice provided, what makes you think that op's wasn't? I think the reason she posted on here was maybe for advice from real life people who had experienced it the same reason people often post on here about various different subjects.

My friend had her son nap with no diaper on. She used a towel with a puppy pee pad on top of the towel to quicken up the dry out time. After its fallen off then you use the Vaseline.

If he seems in discomfort still I would speak to a pharmacist or your gp. I presume he procedure was carried out at least 24 hours ago? My son who is now 5 had a circumcision carried out when he was about 1. He was playing with his siblings the next day, rolling around with them etc. I got cream to put on his penis (for a few days I think) from the hospital when we took him home.

I think I am going to post this link to the very informative Daughters of Eve website ( www.dofeve.org/types-of-fgm.html ) which outlines the different types of FGM every time I see someone trying to shut someone else up by claiming that male circumcision is not the same as FGM or that someone needs to educate themselves about what FMG entails. Whereas most of the girls I have worked with who have undergone FGM have been subjected to type 3 FGM (or infibulation as it is also known), FGM practices around the world include traditions where only the clitoral hood is removed (classified as type 1). This is pretty much exactly what the removal of the foreskin from around the glans is. And it is just as illegal as "more severe" types 2 and 3, which involve removal of more tissue with devastating consequences. Go figure. I am so cross I'm shaking, typing this. It is the same bananas wilfully self-deluding, pseudo-religious indoctrination at work whether you are inflicting this utterly barbaric practice on a girl or a boy. It frightening to see the complete disconnect apparent in OP's post.

As a midwife overseas, my mum had to attend non-medical circumcisions. She would hand the sleeping babies back to their mothers, who would ask things like, 'Aww, did it go well? Was he/she fine?'

She always told them how it had actually been. She's haunted by them and says that if parents choose to do this to their babies, they should be made to watch. Were you there?

I was railroaded into having DS1 circumcised (we're American) and he was okay with Vaseline and a little Tylenol. Think this is similar to calpol?

I told my Dr that no one was to even mention the word to me at DS2's birth. No one did. And my Dr thanked me because she doesn't like to do them.

It constantly amazes me that HCP such as Etak are so out of touch with actual medical research on neonatal pain.

Neonates feel pain as acutely or more acutely than older children - they are just less able to express it. Circumcision at an early age may make you feel better but the impacts on your child are potentially worse than an older child

"It is now acknowledged that neonates experience pain to a similar extent or possibly more intensely than older children and adults and are at risk of
adverse long term behavioural and developmental effects due to inadequate
management of pain relief in the newborn period"
Longterm impacts of neonatal pain are discussed here
www.southampton.ac.uk/assets/centresresearch/documents/wphs/LRNeonatal%20PainTheory%20and%20Concepts.pdf

BeeX you can tell yourself that your baby is in 'discomfort' not pain or that babies feel pain less than older children, but you're deluding yourself - all the scientific evidence points to the opposite
www.cochrane.org/CD004217/NEONATAL_pain-relief-for-neonatal-circumcision

Sunshineandshadows the article you link to is about neonate in intensive care who are enduring long term pain either through illness or medical interventions whilst they're there, it's not at all relevant to circumcision also the article is not current some of the references in it are from the 60s! And the most recent are 4 years old!
What the baby feels in circumcision is comparable to when they have immunisations ( In fact the anesthetic needle is smaller) and the plastibell device and healing process is comparable to the clamp on a babys umbilical cord, shall we stop these practices too?
The other article you linked to says that circumcision is painful with pain relief - well yes of course this is true!

Sorry typing error that was supposed to say painful without pain relief!

Actually after the initial DISCOMFORT, yes discomfort, my son is alright. He is not in pain and wasn't when the procedure was done.
It's clearly apparent people have strong views against circumcision but I know more people that are for it than against it. Comparing it to FGM is going a tad far, circumcision has benefits where clearly there are no benefits of FGM whatsoever.
Etak you speak total sense, thank you xx

Slippa - I was there for my own children's brit, and also lots of friends and family. I would have thought most people are.

Cue loads of complaints now about how outrageous it is that it is not done in a completely sterile environment.....

Ha! I think it's ok to have someone in the room we might be safe from that one, my sil sat in with my mil while she had cataracts done last week! I think most clinics do encourage parents to be there for the procedure the main thing to distress a child of that age would be separation from its parents.

Etak The point is that your comment have it done anyway but when they are older and acutely acutely aware of the pain? implies that neonates feel less pain than older children - research does not support your assertion. Or can you point me in the direction of an article published that does? The fact that yes this is old data is exactly my point - its been around for ages and yet we still have HCP making unfounded assertions that neonates don't feel acute pain in the same way as older children - you are proving my point for me!

Yes the majority of neonatal pain studies have been performed in relation to NICU procedures - these are the easiest to gather data on. This locational bias in evidence-gathering does not mean that neonates do not feel pain or feel less pain when painful procedures are done to them in other environments. The pain referred in the article is not chronic pain (which is what I assume you mean by 'longterm' pain, sorry but your terminology is unclear) but acute pain. A surgical procedure such as circumcision is also acutely painful. Do you have evidence that that acute pain of circumcision is processed differently than any other acute surgical pain in neonates? If so I'd be interested to see that.

I'd also be interested to see the data that supports your assertion that circumcisional pain is comparable to immunisations - interesting then that there's no Cochrane review to recommend nerve blocks (complete local anaesthesia) to deal with immunisation pain. Of course there isn't because surgical removal of tissue is significantly more painful than immunisation.

Additionally - you clearly missed the conclusion of the report as you say The other article you linked to says that circumcision is painful without pain relief - well yes of course this is true!
No it doesn't - it says:
None of the studied interventions completely eliminated the pain response to circumcision.
Thus circumcision will always be painful even when good analgesic techniques are used

In case you're unclear here's an educational video from Stanford University showing an experienced paediatrician demonstrating the plastibell technique - please elaborate in what way this is similar to an immunisation
newborns.stanford.edu/Plastibell.html

Additionally there is the ethical justification that the disease-protection benefits of immunisation outweigh the short term and relatively minor pain associated immunisation. What would be the ethical justification for an unnecessary and painful surgical procedure? the only one I could think of might be HIV-protective effects if living in a region with poor access to healthcare and barrier contraception and high rates of HIV. Outside of this context it becomes tricky.

You may champion the plastibell method but the data that demonstrates it causes as much pain as other methods of circumcision - again old data and been around for years so surely you're aware of this!
www.nature.com/jp/journal/v22/n3/full/7210653a.html

And journals.lww.com/jaids/Fulltext/2013/04150/A_Randomized_Trial_of_Mogen_Clamp_Versus.14.aspx
Staff involved in the study universally thought the Mogen clamp was better tolerated by the baby than the Plastibell (and indeed the procedure duration was significantly shorter with the Mogen clamp). The only previously published randomized study of Mogen clamp and Plastibell, which was conducted in the United States, reported that the Mogen clamp was “associated with less pain and discomfort

Additionally because of the crushing effect of the string in the plastibell you have not just the acute surgical insult but also chronic pain associated with the tissue crushing by the string which will not stop until nerve/tissue death occurs.

BeeX the reality is that the evidence demonstrates that circumcision is painful., and that measuring pain in non-verbal infants is hugely challenging. You can call it discomfort if that makes you feel better, and I'm sure you love your son and want the best for him - which is I guess why I find these choices bewildering. But how you define the difference between discomfort and pain is purely subjective.

Etak 'speaks sense' because she's saying what you want to hear. It's easy to use the 'I'm a nurse' card to justify your personal opinion/religious agenda, but I think its important that you differentiate your personal opinion from actual evidence, especially when the weight of scientific evidence doesn't support it

I can't point you in the direction of any evidence I'm afraid I'm basing my opinion - just my opinion not research based facts on my own sons experience.
I wasn't comparing immunisation to the actual procedure the point I was making was that the injection is the only thing that they feel, sorry if I didn't make that clear and my use of language is confusing I'm still on Mat leave spending all day with the kids is a bit like I've had a lobotomy! I can't find the words I want!
Thanks for the plastibell video link but as I have said previously I have seen the procedure preformed in front of my very eyes - on my son. So there is no need for me to watch it.
My 'I'm I nurse card' wasn't to add any weight to my personal opinion it was to explain why I've seen lots of penises! (Is that the plural of penis? Sorry don't want to confuse anyone with my language).
So based on the above and on our religious beliefs and the fact that we have had no problems and neither has any of our family friends etc I believe our decision to be the right one. I know that that is not representative of the world but that is my world and is my main priority.
I didn't post on here to have a debate or to persuade other people to do as I have done,just to offer advice to op.

"It's clearly apparent people have strong views against circumcision but I know more people that are for it than against it."

Surely you knew that when you posted on here? As a veteran of many circumcision threads, I can assure you that most mumsnetters are against this kind of mutilation than for it. In 21st century Britain it is not the cultural norm except for religious or medical reasons as there are no health benefits.

I only watched part of the video and it makes me even more bewildered that people would do that to their tiny baby's penis.

"there are no health benefits."

As a "veteran of many circumcision threads", you really should know better.

Please don't make me post all those studies again. Just look up the last thread.

CoteDAzur there are less invasive ways to reduce any health risks - good hygiene and using a condom. I did state 21st century Britain in an earlier post - where access to washing facilities is easy.