What you Need to Know about
Many parents believe their child can be
protected against the pain of circumcision through the use of anesthesia, but
there is no pain control method that is 100 percent effective. All infants
suffer during and after the procedure. There are risks from anesthesia
and there are risks if anesthesia is not used. If a baby is left intact, he
is not subjected to any of these risks.
|DPNB - Dorsal Penile Nerve Block is more effective than EMLA
but DPNB does not block the ventral nerve pain pathways so it is only
partially effective. The infant still feels pain when DPNB is used.
Lander et al
reported that ring block is more effective than either EMLA or DPNB for
control of circumcision pain. Excerpt from Pain of Circumcision and Pain
Control by George Hill
The shot itself can be very painful and the injection of local anesthesia into the penis can cause permanent vascular and nerve damage.
|EMLA is a topical anesthetic cream. Many parents are told
it eliminates the pain of circumcision. Studies show it's only slightly
effective. "Not only have Benini et al
found that EMLA only relieves pain during approximately 1/3 of the
procedure, but EMLA simply does not penetrate deeply enough to be very
effective: During circumcision, the membranes are torn from the glans, the
inner and outer layers are clamped, and the foreskin is cut away with a
scalpel." Excerpt from Pain of Circumcision and Pain
Control by George Hill
EMLA is not recommended for infants under six months of
WARNING In August 1994 a Canadian hospital issued a strong warning against the use of Prilocaine and EMLA cream upon newborns. Their hospital experienced a case where a few hours after his circumcision, a baby developed significant Methaemo-globinaemia [which can cause brain damage and death in small infants]. Two other cases of Methaemo-globinaemia due to Prilocaine have occurred in British Columbia. [Canadian] Lidocaine has been know to cause the same results.
Additionally, a recent survey by Garry and published inOBG Management found that only 14 percent of US obstetricians who perform circumcision use any form of anesthesia for the surgery. A similar study by Stang (et al.) in 1998 found that only 25 percent of OBs, 56 percent of family practitioners, and 71 percent of pediatricians surveyed use anesthesia. Howard (et al.) reported in 1998 that 26 percent of circumcision training programs do not train doctors to use anesthesia/analgesia.
Quoting from the CNN article, Circumcision Study Halted Due to Trauma, "Up to 96% of babies in the U.S. and Canada receive no anesthesia when they are circumcised. ...It has also been argued that injecting anesthesia can be as painful as the circumcision itself."
Dangerous Complications. Lander's study was terminated after several infants circumcised without anesthesia experienced apparent life threatening breathing difficulties, including choking and apnea. The shock of circumcision without anesthesia and extremely vigorous crying can produce additional dangerous complications including heart injury, pneumothorax and gastric rupture. Excerpt from Pain of Circumcision and Pain Control by George Hill
Just as the fingernail is fused to the finger, “at birth the foreskin is fused to the glans.” [Fleiss] In order to remove it, the foreskin is pulled, torn, crushed and cut. We now know that babies actually feel pain more intensely than adults. [Anand] Most babies scream wildly. Blood pressure and heart rate increases markedly. Some go into severe shock, and lapse into a semi-comatose state. This is often misunderstood by medical professionals who later insist that the baby experienced no pain because they laid there without moving or crying. Babies continue to feel pain after the surgery.
Events that cause stress and pain appear to
affect a baby’s feeding patterns. [*Marshall] Breastfeeding failure occurs at a
higher rate among circumcised babies. [Marshall] Newborns are acutely aware of
their mothers. When an infant suffers overwhelming pain, he cannot formulate the
idea that this invasion was well intended. He can only assume that his mother was
somehow responsible. A common opinion is that the trauma of circumcision impairs
maternal bonding and can cause psychological damage. [Laibow]
CHICAGO (AP) and AP-NY-12-24-97
“Circumcision causes newborns a lot of pain, and they should always receive anesthesia for it, researchers say. Suffering caused by the procedure was so clear in a new study of anesthetics that researchers stopped enrollment early because they decided it was unethical to circumcise any more newborns without an anesthetic.”
Rabbi Gerald Chirnomas of Boonton, N.J., who estimates that he has done more than 11,000 circumcisions without anesthesia or complications, disagreed. He says he discussed the issue with many urologists and never met one who favored injecting anesthetic into the penis. He thinks it’s very dangerous.
With her express permission, Mothers Against Circumcision is featuring a sensitive and thought provoking article by Jeannine Parvati Baker, a mother,midwife, writer and nominee for the Woman of the Year Award `93 for contributions to Medicine.
Ending Circumcision: Where Sex and Violence First Meet
Strong warning against the use of Prilocaine and EMLA cream
The Birth of Pain by Maria Fitzgerald
You're Having a Baby
Return to Mothers Against Circumcision
Anand, K.J.S., Hickey, PR, “Pain and its Effects in the Human Neonate and Fetus,” The New England Journal of Medicine, Vol. 317:21, November 19, 1987, pp. 1321-9.
Canadian Nurse, August 1994, pp. 5-6.
Fleiss, M.D. Paul M. and Frederick Hodges, The Foreskin is Necessary, in the Townsend Letter for Doctors and Patients, April 1996.
Laibow, R. Circumcision: Relationship Attachment Impairment. NOCIRC International Symposium on Circumcision, San Francisco, April, 1991:14.
*Marshall, RE, Stratton WC, Moore JA, Boxerman SB, Circumcision I: effects upon newborn behavior. Infant Behavior Dev. 1980;3:1-14
Marshall RE, Porter FL, Rogers AG, Moore J, Anderson B, Boxerman SB, Circumcision II: effects upon mother-infant interaction. Early Human Development 1982;7:367-374