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Position Statement on Circumcision and Breastfeeding. Includes detailed UTI study info.

In recent years, one of the reasons for circumcision being talked about on news shows and the like has been urinary tract infections, or "UTI's". There was a study done in 1985 which said that infants who had not been circumcised had higher rates of UTI's than those that were circumcised. They relayed this information in the form of "Uncircumcised males are 10 times more likely to get a urinary tract infection than circumcised males." What is conveniently left out, however, by those who support this study, is that the "10 times" was .1% and 1% and that girls have a rate higher than both non-circumcised and circumcised boys combined! This is another study which has since been peer-reviewed and deemed "methodologically flawed"-- i.e. they weren't very "scientific" and consistent with their study. A group of premature infants were looked at for incidences of urinary tract infections by Dr. Wiswell, et al. (See "Doctors: Doctors' Advocacy" for more on Dr. Wiswell.) As part of this, they forcefully retracted the preemies' foreskins. Not only is this totally unnecessary, but its harmful. Not only does doing this rip the immature foreskin off the head of the penis, but also introduces "germs" from the hands of the "testers" into the new wound they had inflicted. (See "Issues: Caring for the Penis" in the blue menu bar at the right.)

"Just got home from work and thought I'd share this with you. I was on the resuscitation team last nite and was called to a delivery for a 27wk preemie. It was a boy. This tiny 500 or so gram baby was lying on the warmer while we worked to intubate him, secure some IV access etc.The father walks over to the warmer, and the FIRST thing out of his mouth was, 'When does he get circumcised???' I wanted to say, 'Well, FIRST we get him to BREATHE....' AAAArrrrrggghhhhh! I just had the VENT THAT!!!!!!! There. I feel better. Thank you." --Lori (5/5/99)

Since the early 1970's, the American Academy of Pediatrics- or AAP- mandated that any infant weighing 5 pounds or less and all premature infants not be circumcised because it is deemed 'unnecessarily stressful' on them. Therefore, all infants in a Neonatal Intensive Care Unit (where premature babies are kept) would have not been circumcised. Having been a premature infant myself -- not that I remember in concrete terms, mind you!-- I know that "we" frequently have tubes in us of various natures, including catheters. Catheters in themselves have a high potential for introducing bacteria into the urinary tract, resulting in an infection for anyone. In fact, females --who aren't circumcised in the U.S., by the way, partly because it has recently been made illegal-- are more susceptible to them in general, anyway. Urinary tract infections can be serious if left untreated, and are sometimes not easy to detect in babies. However, what must be remembered is that they are extrememly rare in children and that the rate for girls and women is many times higher than both non-circumcised and circumcised boys put together.

Basically, the participants in this study compared very sick, premature (non-circumcised) infants, to healthy term infants, who, at the time the study was conducted, were most likely circumcised. There was a new study done in 1997 on UTI's which was reported in Physician's Weekly. It found that in fact, abnormal urinary anatomy was responsible for UTI's-- not the foreskin.

"I too did not have 'Bob' circ'ed because while in the NICU I witnessed 2 of them & to hear those babies cry! I was doing kangaroo care both times so they let me stay. I cried right along with them & promesed 'Bob' that I would NEVER let that happen to him! And what was worse - the Dr. telling the mom's & dad's of the circ'ed babies that he 'didn't make a peep'. I asked the nurse about that & she said that that is what they tell the parents so as not to get them upset. I guess it would not do any good to the parents to know how those babies screamed but I think that if they were present during one that they would definatly change there minds."-- Martha, TJ's Mommy

The original 1985 study on UTI's is now considered at least controversial, if not just bad scienfitic methodology. Two new independent studies regarding urinary tract infections were done since the 1985 one. See Two Reports of 12/98 on UTI's and the foreskin. #1 #2 You may also find more information on Urinary Tract Infections at the Circumcision Information Resource Pages.

In January, 2002, Science News, a weekly magazine, reported that a vaccine has been developed to prevent urinary tract infections. It was originally develped in injection form in Switzerland, but currently is being manufactured in the U.S. as a suppository.

"Hi, I posted last week about my son's recurrent UTI's He had his appointment with a urologist today. This is how it went. The urologist said that since all his tests had comeback normal, we need to circumcise him. Plain and simple. He could tell by the look on my face that I wasn't pleased, so he tried to reassure me that it [circumcision] is really no big deal. He informed me that I need to take this [the UTIs] very seriously. He toldm me that it has been proven that there is a link between an intact foreskin and UTIs. He said that circumcision is the only option. I sat there and just looked at him the entire time, getting madder and madder and just not saying anything. I did at one point mention that anytime you put an infant under anestetic it is a big deal. He said we do open heart surgery on infants as young as 6 hours old. I said, well that's not elective surgery. He said neither is this..... Upon leaving his office I went directly to the pediatrician's office. I told her that we had seen the urologist and that I didn't like what he had to say. I told her point blank that I simply do not believe that ds is getting UTIs because he hasn't been circumcised. I told her that most men on earth are not circumcised and do not get infections. I told her that I want another referral so that I can get a second opinion. He has to take antibiotics until he is circumcised. (sulfa this time) He can't get in to see the other urologist (who was the first choice anyway) until September 8th. What if she says the same thing. What if they simply won't look for what is really wrong because everybody is circ. happy? It is so frustrating, I see circumcision as a last resort, but everyone else seems to think we should circumcise ds first “and see if that clears up the problem. The urologist didn’t even do anything, all the tests had already been done, he simply came in and said circumcise him. He even had the nerve to treat me like if I didn't do what he said then I wasn't doing what was best for my son. I'm sorry I have babbled on and on. I will leave it at this. I HAD A BAD DAY AND I AM NOT HAPPY WITH THE WAY THIS TRANSPIRED." -- rhume

"Has anyone had to wait a long time to have their son circ'ed?

"My 6month old son was born prematurely and was in the NICU of a children's hospital for a short time. He was not stable enough to circ at the hospital he was born at. At one day of age was transferred to the childrens hospital, where we asked repeatedly to have him circumcised. You'd have thought we were the first ever to ask them this question! After a million "I don't know"s, we were told they didn't do non-life-threatening procedures there and to check with our pediatrician when we were discharged.

"Well, we visited with our pediatrician after our son was discharged. He was then 3 weeks old. Our Dr. told us that premature boys don't have enough foreskin to get a good cut, that it is still growing, and she would do it, but we'd likely have to redo it after a year. So here we are waiting for a year to do it. I'm worried about how hard it will be on him. Apparently he will have to see a urologist and have anesthesia. It is very important for him to be circ'ed, and, before anything negative is said, it is not just for cosmetic reasons.

"Does anyone have any experience with this kind of situation? Thanks for being patient and reading through this." --"gardenbabyok"