Circumcision

babym6705 · December 2013

DH and I are researching the pros, cons, and procedure of circumcision. However, I'm wondering is the procedure done in the hospital, at a pediatric office or a urologist? Is it better for a urologist to do it instead of a ped dr.?

sweetmelissa0707 · December 2013

One of the OBs did it in the hospital, it healed up quickly and we've had no problems at all, and DS is nearly five.

mrscrcalli · December 2013

I'm not sure what's "better" our OB is doing it for us.. She's amazing and has been doing this since before I was born so I blindly trust her on this one.

Rrrrrachel · December 2013

All three of those are options. IMO you want someone who does a lot of them, which is true for some obs and peds but not all, so ask

abbeylanecb · December 2013

A surgeon has to do it at our hospital so an OB did it before we left.

Smores730 · December 2013

Our OB did it in the hospital before we left

momofmanyinthemitten · December 2013

Where DH did his residency, the pedi did the circs, the OB did the circs at the hospital where DD was born, and family docs did them where DS was born. Every institution is different. Also, each doc/hospital has their preferences with the equipment they use, as well as anesthesia. DS didn't get anesthesia, which is why we're not using the family docs if this baby is a boy. We're hoping to use the urologist in the next town over. Plus, the fam doc didn't take enough skin off and we're going to have to have DS's circ repeated once he's a year. Not looking forward to it

As to pros and cons, I usually go with what DH has to say, since he's a pedi. He highly recommends it. My grandpa wasn't circed as a baby and had to have it done as an adult and said he wished it had been done when he was a baby.

richiel · December 2013

I had it done on my older 3 boys, but I wont with this one. It was put there for a reason so it will stay as is.

Bluebird2318 · December 2013

I am on the fence about whether I would like it done or not, but I am pretty sure DH is strongly for it. If we do, I just insist on knowing that we are not handing DS over to anyone unless they perform the procedure often. Whether that means urologist, OB, or pedi I do not know.

ksulli · December 2013

My OB is very popular with a large Jewish community, so I trust her to handle it if this is a boy.

sorarose · December 2013

Usually, they do it in the hospital. I know at my hospital, they have a board up with all things that the baby needs to receive before discharged. I need to make sure it is NOT done, since we will be having a bris the next week.

Cassi215 · December 2013

I let my husband decide. I figured I made so many decisions already that this one can be up to him. Also the OB does it right in the hospital the next day.

sayysayy13 · December 2013

My OB doctor does it in the hospital

pete0121 · December 2013

My OB does it at the hospital also.

Rrrrrachel · December 2013

Essentially pacifiers made of sugar.

JoelleOK · December 2013

My midwife recommended waiting on the circ until the 10 day appointment if we planned on breastfeeding. DS was able to comfort nurse after the procedure.
This LO is also a boy. I'm not sure I want to do the circ again. Last time it was DH decision and since then I've read up a little.

ashcole28 · December 2013

DS's pedi did his the day after he was born while we were still in the hospital.

KatieGummow · December 2013

We interviewed a pediatrician (who prefers parents don't circumcise) who said he prefers to do it in the hospital ASAP-unless the babies are pre-mature, however, he also does it in his office at the parent's convenience.

HNRomance · January 2014

anyone else who waited a few days? I'm a FTM, my DH is adamantly for circumcision so we are doing it but the horror stories are making me nervous and if the whole comfort feeding thing works I wonder if it's worth waiting?

thomas930 · January 2014

@HNRomance My DS had his done at 1.5 weeks old.

Rrrrrachel · January 2014

I think when it's done for religious reasons you wait around ten days. I've also heard doctors recommend waiting as long as a week or two. I'm sure opinions vary, but I think if we were doing it we would wait.

Sisimama10 · January 2014

We are doing it while we are still in the hospital. Our OB will do it.

fireflygirl12 · January 2014

They don't offer the procedure at our hospital, so we went a guy referred to as the Penis Guru. It's all he does. $100 cash only and he does it out of his basement. Just kidding, it's a real office but they really do call him the Penis Guru at several of the pediatric offices in our area.

Xxooxtina · January 2014

I've heard it can affect their feeding- put them off it for a few days which is why they say to wait a week at least till they establish feeding. The first week is so crucial with their weight cuz they usually lose a pound or 2 anyways. We've decided to not get it done for our little guy anyways.

KHendy27 · January 2014

We're not circ'ing but if we were to, we'd wait till 6 months so he could have better pain relief and have a urologist do it.

katiedidthat · January 2014

eme520 said:

mummyofsix said:

Rrrrrachel said:

Essentially pacifiers made of sugar.

Ahh. Exactly what I want for my 1 day old baby.

@mummyofsix Sweeties is a sugar water that has been shown in studies to have pain relief equivalent to narcotic pain relief. We give less than one milliliter and it's a great way to control pain without the more serious effects of systemic anesthesia/analgesia.

Do you happen to have any of this research handy? I'm curious to read it since most of what I have read says sucrose that while sucrose is effective in combination with other methods, it is nowhere near the same as lidocaine or a nerve block and that infants who receive only sucrose (2ml or dipped pacifier) have similar heart rate and oxygen saturation changes as those who received a water placebo. I just did an end of semester project on circumcision last month so I'm interested in seeing some other sides of the research.

pdilly2b · January 2014

DS's circumcision was done at the hospital by one of the OBs that affiliates with my midwife office the day after birth. I know they used local anesthetic but I'm not sure about the pacifier/sugar water (I would have objected to that probably because I was really hard core about BFing working - will be less so about no paci's this time, at least not after 1-2 wks, after the experience of a baby that doesn't want to sleep much and won't take a pacifier). He was gone from our room for less than an hour (we weren't allowed by hospital policy to go with).

It didn't cause any problems for us on the BFing front at all (went 23 months) and he didn't seem bothered by it during diaper changes. We did have to wait 4 days to start cloth diapering because they told us to put vaseline for that long and I didn't want to risk that getting on my diapers.

My biggest consideration was method used. 2 of my cousins' sons had that clamp thing that waits for the foreskin to fall off and it left on a little foreskin so they had to go back and have it fixed later. So I talked for a long while with the OB about the method. I can't recall the name of the one he uses, but it's the one that doesn't use the stay-on clamp and also doesn't produce enough blood to be considered Kosher.

This baby is a girl, but had she been a boy, we would have gone the same route, hopefully with that same OB doing it.

Rrrrrachel · January 2014

Statistical significance is not subjective. It's based on pvalues. You can't tell what's significant by looking at raw scores.

Rrrrrachel · January 2014

Those upenn links require log in credentials but here's the cochrane review.

https://summaries.cochrane.org/CD004217/pain-relief-for-neonatal-circumcision

Rrrrrachel · January 2014

If they use the term statistically significant than no they didn't just pick.

Rrrrrachel · January 2014

And, btw, the cochrane review also said evidence didn't support the effectiveness of sugar solutions.

Rrrrrachel · January 2014

Directly from the cochrane review I linked to above: "Trials of oral acetaminophen, sugar solutions, pacifiers, music, and other environmental modifications to reduce circumcision pain did not prove them effective." - See more at: https://summaries.cochrane.org/CD004217/pain-relief-for-neonatal-circumcision#sthash.qur3dbG2.dpuf

Rrrrrachel · January 2014

I thought this (well cited) article from dr Greene was good, too. He says the most effective form is a subcutaneous ring block, even more than a dorsal penile nerve block, which I believe only numbs part of the penis (either the top or the bottom, I can't remember which. I guess the top by the word "dorsal")

https://www.drgreene.com/qa-articles/excuse-circumcision-pain/

Rrrrrachel · January 2014

Yeah, I was talking about the one specific to circumcision, which seems like a whole other level of pain to me than a heel stick, but what do I know.

Personally I don't see a problem with sugar solution, but when something like half of babies don't get any pain management for circumcision and a good proportion of the rest get inadequate pain management I think tips important for medical personnel to get real about what's adequate and what's not.

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