3rd Trimester

Yes, another circumcision post ... just deal ...

DH and I completely disagree about circumcision ... but the pros and cons of doing it and it being a personal choice has been discussed here many time before ... that is not so much the purpose of this post.

My question is a little different. Why is there this immediate need to circumcise within the first couple of days of life? (I have this same question about the routine Hep B vaccination for infants, since Hep B is typically spread through sexual intercourse, sharing needles, and other ways bodily fluids mix). I guess I am trying to understand why circumicision (and Hep B) must be taken care of right away in many people's minds? Why not wait until the boy is at the age of consent to decide about his own penis? Why not wait until he is sexually active for Hep B?

These are serious questions. I am not necessarily trying to start a debate but am looking for answers/rationale.

Thanks.

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Re: Yes, another circumcision post ... just deal ...

  • I COMPLETELY agree with you that circumcision should be something that the individual person consents to. The reason it is not this way (as I have heard it explained) is that when the child is older, it is a completely different procedure - not as quick & easy, and (here comes my nasty bias against it) not as easy to deny the pain the person is experiencing. Many babies will go to sleep during the procedure, which is actually a coping mechanism, not them being comfortable or not feeling pain. I do believe that babies probably heal faster though.

    As far as Hep B is concerned, I think that there are other ways that Hep B is transferred that we still do not know. With something like 30% of cases, they don't know how the person got it. Our MW doesn't offer to do it right away, so we will be delaying it a bit. I have read some compelling reasons on here for doing it in the first few years of life though -- but I don't remember them... sorry! But anyway, I think that is the reason for the rush with that.

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  • As far as Hep B goes, there really IS NO REASON for it to be done the day of birth. My parents are both medical professionals who work with young children and they are very against the Hep B, particularly because there have been NO studies on its effects on newborns- only on babies 6 months or older. Even then, during infancy, it's not necessary.

    So we'll definitely be skipping Hep B.

    I'm not sure why circ'ing happens almost immediately- might be something to ask your pediatrician- we just "got" ours last week, and since it's not something we're on the fence about, I haven't really asked. I do know that it doesn't generally have long-lasting negative effects, which is why I'm comfortable with DH's preference to go ahead with the *snip snip*.

  • I have heard that it is an easier recovery and less painful to get it done just after they are born.  Not sure if that is true or not, but that is what I have been told by quite a few people. 

    Our pediatrician suggested (for those having boys - our triage apt was with multiple couples) that people get it done while in the hospital just after giving birth.  They said if you aren't decided and end up waiting then you have to wait either 6 weeks or 6 mths to have it done then (bad pregnancy memory - sorry).  And I don't remember the reason why that is either.  I wrote it down and have the paper somewhere, but since it didn't pertain to us right now I didn't pay super close attention to what they said.  

    As far as Hep B .... I have no idea!

  • I know that for our insurance if we have it done in the hospital, there is no additional co-pay ($150)... not a deciding factor but an additional one. Also, when I was 16 and having my tonsils out, there was this poor kid, about 12 in recovery with me who had just been circumsized... it was pretty horrible to listen to him and see him. Not sure if the pain was worse, or if it was because he was older and more aware, but I can still see his face after all these years.
  • Circumcision - here it is typically done around the 6 week mark - likely more due to the fact that because circ rates are much lower, there aren't actually alot of doctors who will do it, it might partly be a wait time due to volume.

    Hep-B - is not part of routine infant vaccinations here

  • I've always read/believed that the rational behind newborn newborn circ is that babies were thought not to feel pain.  In fact, until the early 80s, newborns had HEART surgery without anesthesia!  Paralytics only!  Obviously, we know that is not true now.
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  • It's an easier recovery and easier to conceal. If your son was 12 and wanted it done, it would be a lot harder to have clothes rubbing against it and having to cringe through gym class and stuff.

    I don't know if that's the real reason, but that's my opinion.

    Also, you don't have those parts, so I'd say to voice your opinion but ultimately let DH decide. He knows what it's like to have one--locker room teasing (if for some reason someone happened to see--not sure why they would), peeing outside with your friends when you're 18 at a party (or whatever).

    For Hep B, I think there are other ways you can get it. I would rather protect my child against something he might or might not get than to take a risk that he'll get it just because I chose not to vaccinate. I think it's irresponsible not to vaccinate as soon as the dr says it's ok. I don't want my baby getting some horrible disease.

  • imagesazzie:

    Many babies will go to sleep during the procedure, which is actually a coping mechanism, not them being comfortable or not feeling pain. I do believe that babies probably heal faster though.

    Actually, they don't feel it because the dr gives them novicane. They might feel the novicane, but they don't feel the procedure.

  • We had initially planned on having ds circ'd, and our OB had actually prepped DS for the procedure.  Then he noticed that the skin on DS's penis was twisted.  The OB was concerned about hypospidasis (sp?), so he wasn't comfortable doing the circ.  We were referred to a pediatric urologist, who we saw when DS was 5 days old.  Fortunately, DS do not have any issues, just that the skin is twisted.  Because of the skin being twisted, the urologist recommended that if we still wanted DS to be circ'd that we wait until he was 6 months.  At that point, DS would have to be put under a general to have the circ done.  I asked if being put out had anything to do with the twisted skin and he said no.  DH and I decided that we could not put an infant under a general for what is essentially an elective procedure.   

    Just like anything else, it's a personal decision.  We have a  friend whose DS was born 8 weeks early and was also told that they would have to wait until he was 6 months for circ and that he would have to be under a general.  That friend has choosen to go ahead and circ.  It's not a decision that I would make (obviously), but I don't judge them for it.

  • I think the reason that hospitals want to give the hep B right away is b/c the baby can get it from the mother--most likely via breastfeeding.

    I didn't think this was a good reason to give it to my DD, so I managed to avoid in the hospital.  Oh--I've been vaccinated for hep B and my OB had tested me for it (negative)--so that was behind my reasoning.  I think it is a standard thing for OBs to test for, so you might ask you doctor.

  • There are actually good reasons to wait on circumcision.  There is less risk of adhesion if you wait.  You might want to talk to your pedi about that one.

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  • imageBrainySmurfette:

    I think the reason that hospitals want to give the hep B right away is b/c the baby can get it from the mother--most likely via breastfeeding.

    I didn't think this was a good reason to give it to my DD, so I managed to avoid in the hospital.  Oh--I've been vaccinated for hep B and my OB had tested me for it (negative)--so that was behind my reasoning.  I think it is a standard thing for OBs to test for, so you might ask you doctor.

    Actually, they like to give this in the hospital so they can be sure people are vaccinated against Hep B.  The people most at risk for HepB aren't likely to go in voluntarily to be vaccinated.  There is NO reason it needs to be done immediately at the hospital.  At the very least, I will be delaying this vaccine until the baby's immune system is a bit more mature.

  • imageKarin&Ben:
    I know that for our insurance if we have it done in the hospital, there is no additional co-pay ($150)... not a deciding factor but an additional one. .
    This is an honest answer. Re: Hep B, they do it in case your baby needs a blood transfusion (per my OB) but we will personally be opting out of that vaccine. The Hep B vaccine is the first of a two-part series that the baby gets in the first 6 mos of life if you choose to do it. Hep B is not a one-time shot for immunization.
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  • A nurse told me that early on in life, all the blood vessels have not fully be developed and so the pain is less. That's why most do it then.
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