The Effect of Circumcision on Exclusive Breastfeeding, Phototherapy, and Hospital Length of Stay in Term Breastfed Newborns

O’Callahan, Cliff; Te, Silena; Husain, Aaftab; Rosener, Stephanie E.; Hussain, Naveed

doi:10.1542/hpeds.2019-0270

Cited by 4 publications

(5 citation statements)

References 30 publications

(31 reference statements)

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“…Bottle‐feeding before and after NMC was also unaffected in a Michigan study 32 . A Connecticut study found no effect of NMC on exclusive breastfeeding or length of hospital stay 28 . A US mid‐west study found no significant difference in mother‐infant interactions for 43 discrete behaviors during 4 hospital feeding sessions comparing neonates randomized to receive NMC without anesthesia on day 2 postbirth and neonates whose NMC was delayed to day 3 33 .…”

Section: Resultsmentioning

confidence: 93%

“…Figure 1 summarizes results of sequential searches in which articles already retrieved were not included again. Keyword combinations and articles meeting the inclusion criteria retrieved by PubMed searches were: “circumcision pain psychology,” 11,13–18 “circumcision trauma,” 19,20 “circumcision autism,” 21–24 “circumcision SIDS,” 25 “circumcision breastfeeding,” 26–29 “circumcision newborn.” 30–34 For EMBASE these were “circumcision pain,” 35,36 and “circumcision psychology.” 37 A SCOPUS search for “circumcision male psychology” found one further article 38 . The Cochrane Library search did not yield further articles.…”

Section: Resultsmentioning

confidence: 99%

“…Figure 1 summarizes results of sequential searches in which articles already retrieved were not included again. Keyword combinations and articles meeting the inclusion criteria retrieved by PubMed searches were: "circumcision pain psychology," 11,[13][14][15][16][17][18] "circumcision trauma," 19,20 "circumcision autism," [21][22][23][24] "circumcision SIDS," 25 "circumcision breastfeeding," [26][27][28][29] "circumcision newborn." [30][31][32][33][34] For EMBASE these were "circumcision pain," 35,36 and "circumcision psychology."…”

Section: Studies Selectedmentioning

confidence: 99%

“…32 A Connecticut study found no effect of NMC on exclusive breastfeeding or length of hospital stay. 28 A US mid-west study found no significant difference in mother-infant interactions for 43 discrete behaviors during 4 hospital feeding sessions comparing neonates randomized to receive NMC without anesthesia on day 2 postbirth and neonates whose NMC was delayed to day 3. 33 A New York study found that, compared with uncircumcised male siblings, infants circumcised within the first 3 days of life breastfed for 4 fewer weeks, and were less likely to breastfeed for 4-6 months (49% vs. 71%, p = 0.016) or for more than 6 months (29% vs.…”

Section: Breast-and Bottle-feeding Outcomesmentioning

confidence: 99%

See 3 more Smart Citations

Critical evaluation of contrasting evidence on whether male circumcision has adverse psychological effects: A systematic review

Morris

Moreton²,

Bailis³

et al. 2022

J Evidence Based Medicine

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Objective: To conduct the first systematic review critically examining evidence on whether early male circumcision has short-and long-term adverse psychological effects. Methods:We searched PubMed, EMBASE, SCOPUS, Cochrane Library, and Google Scholar. Results:Twenty-four studies with original data met the inclusion criteria. These comprised 11,173 total males, 4340 circumcised in infancy and 6908 uncircumcised.Nineteen were rated 1+, 2++ or 2+, and 5 were rated 2-by SIGN criteria. Neonatal circumcision, particularly without anesthetic, increased vaccination pain response, but had little effect on breastfeeding or cognitive ability. Studies reporting associations with sudden infant death syndrome, autism, alexithymia and impaired sexual function and pleasure had design flaws and were rated 2-. Sexual arousal, touch, pain, and warmth thresholds measured by quantitative sensory testing were not diminished in neonatally circumcised men. Neonatal circumcision was not associated with empathy in men, contradicting the hypothesis that procedural pain causes central nervous system changes. After correcting all associations with socioaffective processing parameters for multiple testing only higher sociosexual desire, dyadic sexual libido/drive, and stress remained significant. The relatively greater sexual activity found in circumcised men might reflect reduced sexual activity in uncircumcised men overall owing to pain and psychological aversion in those with foreskin-related medical conditions (reverse causality). Most studies employed case-control designs with limited follow-up. Studies beyond childhood were prone to confounding. Conclusion:The highest quality evidence suggest that neonatal and later circumcision has limited or no short-term or long-term adverse psychological effects.

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Section: Resultsmentioning

confidence: 93%

Section: Resultsmentioning

confidence: 99%

“…Figure 1 summarizes results of sequential searches in which articles already retrieved were not included again. Keyword combinations and articles meeting the inclusion criteria retrieved by PubMed searches were: "circumcision pain psychology," 11,[13][14][15][16][17][18] "circumcision trauma," 19,20 "circumcision autism," [21][22][23][24] "circumcision SIDS," 25 "circumcision breastfeeding," [26][27][28][29] "circumcision newborn." [30][31][32][33][34] For EMBASE these were "circumcision pain," 35,36 and "circumcision psychology."…”

Section: Studies Selectedmentioning

confidence: 99%

Section: Breast-and Bottle-feeding Outcomesmentioning

confidence: 99%

See 2 more Smart Citations

Critical evaluation of contrasting evidence on whether male circumcision has adverse psychological effects: A systematic review

Morris

Moreton²,

Bailis³

et al. 2022

J Evidence Based Medicine

View full text Add to dashboard Cite

show abstract

“…Taddio et al demonstrated a stronger pain response to routine vaccination in infants circumcised without anesthesia in comparison with uncircumcised infants or circumcised babies treated with topical anesthesia; they argued that MC without anesthetic may induce changes in infant pain behavior because of alterations in the neural processing of painful stimuli [10]. By contrast, a recent analysis by O'Callahan et al demonstrated that newborns circumcised with proper analgesia (24%sucrose plus local anesthesia with lidocaine or DPNB and acetaminophen) showed no differences in the rate of exclusive breastfeeding during the initial hospitalization compared with non-circumcised newborns [45]. Therefore, it is imperative for clinicians to attempt all the possible strategies to reduce neonatal pain, and since MC is an invasive painful procedure, performing it without anesthesia appears to be contraindicated [8].…”

Section: Discussionmentioning

confidence: 97%

Management of pain in newborn circumcision: a systematic review

2020

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Male circumcision (MC) is one of the most common surgical procedures performed on neonates. In the last decades, there have been consistent advances in the understanding of pain mechanisms in newborns, and analgesia has become a fundamental part of neonatal care. MC is still often performed with inappropriate analgesic methods, and there is still great variability among the various centers about surgical and anesthethic techniques to do it. The purpose of this review is to summarize the findings in the literature about pain management and analgesia during newborn MC. We performed a systematic review of neonatal MC studies published in the last 20 years. The most effective technique appeared to be the combination of pharmacological and non-pharmacological methods of analgesia.Conclusion: Combining local anesthesia with non-pharmacological analgesic strategies appears to be effective preventing procedural pain during MC. However, a standardized protocol for analgesia during MC is yet to be determined. Sensorial saturation appeared to help when used in conjunction with the local anesthesia techniques. What is Known:• Male circumcision is a painful procedure and it is frequently performed with inappropriate analgesic methods.• A gold standard practice in analgesia during male circumcision is still lacking and there is a great variability in the modus operandi between centers. What is New:• The combination of RB + EMLA + sucrose appears to be an analgesic strategy superior to other approaches.• We advocate for the integration of sensorial saturation during male circumcision in order to improve the efficacy of current analgesic practices.

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Timing of Circumcision and Breastfeeding Frequency: A Multicenter, Randomized Clinical Trial

Mondzelewski

Michalski

et al. 2022

Hospital Pediatrics

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OBJECTIVE: To date, there is little in the literature that describes any relationship between newborn circumcision, its timing, and breastfeeding outcomes. We sought to determine if the timing of circumcision in term, healthy newborns affects exclusive breastfeeding rates during the first 6 months of life. METHODS: One hundred and forty-eight maternal-infant dyads were enrolled in a randomized, multicenter, clinical trial between June 2016 and July 2019. Study participants included parent-infant dyads who desired both circumcision and breastfeeding. Newborns were randomized into 3 groups for circumcision: “early,” circumcised within 24 hours of delivery; “intermediate,” circumcised between 24 to 72 hours of age; and “late,” circumcised between 1 and 3 weeks of age. The primary outcome was exclusive breastfeeding duration, assessed at discharge, 2 weeks, and 2, 4, and 6 months. RESULTS: Baseline characteristics between groups were similar. Exclusive breastfeeding decreased more rapidly over 6 months in the intermediate group (by 74%, 89% to 23%), as compared to the early (by 34%, 81% to 53%) or late (by 50%, 88% to 44%) groups (P = .04). Exclusive breastfeeding was less common in the intermediate group (circumcision between 24 and 72 hours), as compared to the early and late circumcision groups, at each measured time point beyond 2 weeks of age. CONCLUSIONS: Circumcision before 24 hours of age may be advantageous with respect to increased exclusive breastfeeding throughout the first 6 months of life. Deferral of circumcision beyond the immediate newborn period was not superior to performing the procedure within the first 24 hours.

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The Effect of Circumcision on Exclusive Breastfeeding, Phototherapy, and Hospital Length of Stay in Term Breastfed Newborns

Cited by 4 publications

References 30 publications

Critical evaluation of contrasting evidence on whether male circumcision has adverse psychological effects: A systematic review

Critical evaluation of contrasting evidence on whether male circumcision has adverse psychological effects: A systematic review

Management of pain in newborn circumcision: a systematic review

Timing of Circumcision and Breastfeeding Frequency: A Multicenter, Randomized Clinical Trial

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