Thursday, November 26, 2009

Breastfeeding & Circumcision

By Danelle Frisbie, M.S., M.A.
With contributing notes from Yuki
Shirt from Made By Momma

Beginning in the late 1800s, changes in the way Americans viewed childbirth began to surface. By a post-WWII era, birth culture the the U.S. looked dramatically different than it had a century prior. Birth itself had been taken over by male obstetricians, and childbirth became a medical condition - one that women were in need of being saved from. During this time, women were routinely pumped full of drugs to give birth, subjected to shaving, enemas and episiotomies. New mothers were encouraged not to breastfeed, and if a baby was born male, chances are likely that he would be circumcised, whether or not this was ever discussed with the baby's parents.

Today, more women are choosing to return to a birth that is more innate and primal to their bodies and their babies. Modern medicine is, indeed, a wonderful thing in birth when truly needed. Surgical births have saved lives, and obstetrics is a needed science. However, this does not mean that medicalizing and pathologizing every aspect of birth and the postpartum period is also a good thing. The baseline ways in which our bodies are designed, in form and function, is typically best for us as humans - especially when it comes to pregnancy, birth, and babyhood.

Despite being frowned upon for some time, the normalcy of feeding human babies human milk has also made a comeback in the last generations. Today, breastfeeding is largely embraced by the medical community, encouraged and recommended by every pediatric organization the world over, and women commonly feed their babies in public. While nursing in public has yet to become ubiquitously accepted across the United States, breastfeeding is becoming more commonplace again.

In the mid-1900s, the postnatal subjects of breastfeeding and circumcision were treated as opposites by some in the U.S. medical community. Circumcision (the complete amputation of the prepuce organ at birth) was claimed to be beneficial and encouraged, or even forced; while breastfeeding was said to offer no benefits, or be negligible.

We now find that the claimed 'benefits' of circumcision have been found to be without merit across the board, while the list of powerful, positive good that comes from breastfeeding is constantly growing. Today, routine infant circumcision is not recommended by any national health organization in the world, while breastfeeding is universally recommended by all medical and health organizations.

The American Academy of Pediatrics (AAP) states that babies should receive exclusive human milk for a minimum of the first 6 months of life, and continue nursing for at least the first 24 months of life. The World Health Organization (WHO) states that human babies need to receive human milk for the first 24 months of life, minimum, for a baseline level of health, and that most infants on a global scale (especially those not encumbered by a broken U.S. lactiphobic culture) receive their mother's milk well past the age of 2 years.

Unfortunately, in some U.S. hospitals today, circumcision is still more common than breastfeeding when we peer into the lives of newborn babies. According to 2013 CDC statistics, 49% of babies in the U.S. are breastfeeding at 6 months, and the figure drops to 27% at 12 months of age. (1) At the same time, while the national circumcision average is slightly less than half, there remain several states (especially in the Midwest and Northeast) where well over 50% of baby boys continue to be circumcised at birth. (2, 3) Lactation reports from many state hospitals reflect that it is the babies who are circumcised who are most at risk for breastfeeding complications such as poor latch, disinterest in nursing, withdrawal from their environment, have higher rates of 'failure to thrive,' and are least likely to have a successful breastfeeding outcome. Intact boys and girls tend to latch better, nurse more effectively, and breastfeed longer than their peers who endure genital cutting as babies. In fact, breastfeeding complications following circumcision are so common, that La Leche League International used to routinely caution mothers about this connection. (4)

Medical benefits of breastfeeding

According to the AAP, "human milk feeding decreases the incidence and/or severity of diarrhea, lower respiratory infection, otitis media, bacteremia, bacterial meningitis, botulism, urinary tract infection, and necrotizing enterocolitis infant death syndrome, insulin-dependent diabetes mellitus, Crohn's disease, ulcerative colitis, lymphoma, allergic diseases." (5) It should be noted that urinary tract infections (UTIs) are also reduced by breastfeeding (6, 7) even though some claim circumcision may reduce UTIs during the first 12 months of an infants life. Breastfeeding, which does not permanently alter a boy's body via amputation as does circumcision, is shown to be much more effective at reducing UTI risk throughout infancy and childhood (not just in the first 12 months).

Human babies who are not exclusively fed human milk in their 6+ months of life have higher rates of infections, allergies, and a greater intensity of issues from these immunological concerns throughout life. Over the course of childhood and adult life, these same babies grow to have higher rates of cancer (including increased childhood lymphomas, and increased breast cancer in women who were not breastfed as infants), and adult intestinal disorders. Infants not provided with human milk score lower on tests of neurological development. (8, 9) Artificial substitutes for human milk clearly do not offer the same nutritional or immunological value to babies, and formula fed infants suffer as a result. They routinely experience higher rates of morbidity and mortality across the board, regardless of parents'  socioeconomic status, but we continue to ignore the severity of this issue while presenting formula as an alternative to breastfeeding. (9)

Effects of circumcision on breastfeeding

In their policy on breastfeeding, the AAP states, "Except under special circumstances, the newborn infant should remain with the mother throughout the recovery period. Procedures that may interfere with breastfeeding or traumatize the infant should be avoided or minimized." (5)

Circumcision is the most commonly performed traumatic and painful surgical procedure done on infants today, is 100% unnecessary and avoidable, and is typically conducted in the first 48 hours of life without anesthesia. When anesthesia is used, its effectiveness is negligible at best. (14) We routinely watch as newly circumcised babies slip into a state of shock; or scream and fight to free themselves from the circumstraint and away from the blade with such force that vomiting, seizures, stroke, and even heart failure have occurred. Today, over 100 babies die each year in the United States alone as the result of circumcision. (15) Watching circumcision take place leaves the viewer without question as to why breastfeeding (or simple eating/drinking) complications arise post-genital cutting. A quick YouTube search today will lead readers to the two most common circumcision methods in use in the United States -- Gomco and Plastibell. (16, 17)

Even if we ignore commonsense and human observation on this issue, studies demonstrate without a doubt that circumcision interferes with breastfeeding. Dixon et. al., conducted a study on circumcision pain and behavioral consequences with and without anesthesia. The Brazelton Neonatal Assessment Scale (BNAS), a series of stimuli designed to elicit measured response from infants was used, and researchers found that all neurological and behavioral aspects of an infant circumcised at birth were impacted - including breastfeeding. They state, "Behavioral differences were still evident on the day following the procedure. This report adds to the growing body of data that indicate that circumcision is a painful procedure that disrupts the course of behavioral recovery following birth." (11)

Marshall et. al., performed a study on how circumcision effects mother-infant interaction. This study also used the BNAS and was double blind (neither the researchers nor the nursing mothers knew when boys were circumcised). One group of babies were circumcised at two days and the other at three weeks. Results showed significant behavior changes in infants after circumcision in 90% of cases, and that circumcision also has a "brief and transitory effect on mother-infant interactions observed during hospital feeding sessions." (12) Approximately half of babies circumcised became more aggressive in movements, agitated, and fussy ('colicky') after being cut. The other half of babies subjected to genital cutting became subdued, drowsy, withdrawn and 'sleepy.' When mothers were given their infants post circumcision, results showed that women attempted to nurse their baby 62% of the time. While breastfeeding, baby's eyes were closed 71% of the time while nursing (rather than looking at mom while breastfeeding as was common while intact), 91% of babies had negative or neutral facial expressions while breastfeeding, 8% did little vocalizing, 13% were clinging to mom, and 40% refused to nurse. (12)

Howard et. al., did a randomized, double blind, placebo controlled study on acetaminophen analgesia for pain management with circumcision. Among their results they found, "Neonates in both groups showed significant increases in heart rate, respiratory rate, and crying during circumcision with no clinically significant differences between the groups. Postoperative comfort scores showed no significant differences between the groups until the 360-minute postoperative assessment, at which time the acetaminophen group had significantly improved scores. Feeding behavior deteriorated in breast- and bottle-fed infants in both groups, and acetaminophen did not seem to influence this deterioration." (13) The majority of hospitals circumcising babies today do so with either topical numbing agents, which are ineffective in numbing the dorsal nerve of the penis during genital cutting, and/or sugar-dipped pacifiers, which change infant facial expressions during genital cutting, but do nothing to reduce the lived experience of pain, or the neurological impact on a baby's brain. (14, 18)


Circumcision and breastfeeding both represent areas that too many parents receive very little research based information on before their baby is born, and even less support in making a fully informed decision. Many parents are not well educated on the advantages and purposes of the prepuce organ (foreskin), and are unaware that no medical organization recommends circumcision for their baby, or that the majority of medical organizations worldwide take a strong position against genital cutting. (19, 20) Few parents can name the 16+ functions of the foreskin, or recognize that all mammals on earth (girls included) are born with this same organ. We nickname the prepuce the 'foreskin' on boys and the 'clitoral hood' on girls, but we only pathologize this organ on the bodies of one sex in the United States. In similar fashion, far too many parents do not realize that exclusive breastfeeding is recommended across the board for a minimum of 6+ months of their baby's life by all medical organizations, with partial breastfeeding for several years to follow. Just as parents are not equipped with the knowledge of all the side effects that result from circumcision, they are also not routinely aware of the enormous health problems that result from a human baby not receiving the milk that s/he needs for a baseline level of health and development.

Too many Americans today buy into the myths of circumcision, and naivety of the foreskin, while also being uninformed about the benefits of breastfeeding. Only in modern U.S. history have we found a subculture that discourages (or is unsupportive, or sabotaging of) breastfeeding, while at the same time discouraging (or sabotaging) of the normal, purposeful intact male body. We unfortunately see the consequences of these two areas of ignorance impacting the lives of many babies still in 2015.

But times are changing! People are wising up to the myths and misconceptions that surround birth and babies. Parents are choosing to become educated on the realities of breastfeeding and the benefits of keeping babies intact. Advocates for breastfeeding (and milksharing) and genital autonomy share common ground in their work: the health, happiness and wellbeing of babies, and the children and adults they become! Here's to all future men and women having the life-long payoff of a normal start in life: human milk, and intact genitals.


1. CDC Breastfeeding Report Card 2013:

2. CDC Presentation of 2009 National Circumcision Rates in the United States at the International AIDS Conference, Sydney:

3. United States Hospital Circumcision Rates by State:

4. The Womanly Art of Breastfeeding: Circumcision

5. American Academy of Pediatrics: Breastfeeding and the Use of Human Milk (RE9729)

6. Pisacane A. et al. Breastfeeding and urinary tract infection. The Lancet, July 7, 1990, p50.

7. Marild S. Breastfeeding and Urinary Tract Infections. The Lancet 1990; 336:942.

8. A full list of medical benefits of breastfeeding with citations from medical journals to back them up can be found at

9. James W. Prescott, Breastfeeding: Brain Nutrients in Brain Development for Human Love and Peace. Touch The Future Newsletter, Spring 1997.

10. Katie Allison Granju. Infant Formula: What Every Parent Should Know. Minnesota Parent. 1997.

11. Dixon S, Snyder J, Holve R, Bromberger P. Behavioral effects of circumcision with and without anesthesia. Journal of Developmental Behavioral Pediatrics. 1984; 5(5): 246-50.

12. Marshall RE, Porter FL, Rogers AG, et al. Circumcision: II effects upon mother-infant interaction. Early Human Development. 1982; 7:367-374.

13. Howard CR, Howard FM, and Weitzman ML. Acetominophen analgesia in neonatal circumcision: the effect on pain. Pediatrics. 1994;93(4): 641-646. 

14. The Effectiveness of Anesthesia for Circumcision Pain

15. Death From Circumcision:

16. Neonatal Circumcision in Gomco Form for Medical Students in Training:

17. Neonatal Plastibell Circumcision:

18. Tinari, Paul. Pacific Institute for Advanced Study. MRI results of circumcision's impact on the newborn brain

19. Functions of the Foreskin:

20. Medical Organization Position Statements on Circumcision

For more information on circumcision and breastfeeding see:

Intact Care Resource Page:

For more on circumcision, pain and related side effects see:

ALL pain studies conducted on circumcision in the US and Canada have come to an early end as a result of infant trauma.

The Brain Altered by Circumcision

Infant Pain Impacts Adult Sensitivity

Boys cut at birth move their bodies differently

Circumcision: How Much Does it Hurt?

A plastibell circumcision (the type used in Patti Ramos' photo essay on circumcision) - the company likes to claim genital cutting does not hurt as much when plastic clamps are used rather than metal clamps

Reports from mothers who observed son's circumcision

Reports from a father who observed his son's circumcision: Stop MGM and Will You Make the Cut?

Men on this site tell their stories of how circumcision impacted them.

Babies "voice their opinion" [video clip of common newborn reactions]

For statistics on side effects (including death) due to circumcision see: 

Intact vs. Circumcision Outcome Statistics

Death From Circumcision



  1. The first weeks of any baby's life are very tiring and overwhelming for new parents. Why anyone would add a painful penis on to that situation is beyond comprehension.

    Thanks for bringing all these ideas together in one place. I'll be sending it out to other birth workers. Gloria

  2. Wait, you mean to say that our culture has it completely backwards? Like rockets pointed the wrong way?

    Gee, imagine that! *sarcasm*

    In these issues is the ringing of Irony.

  3. A very thorough post - your efforts are appreciated.
    As one of five brothers - all intact - I can attest to the inherit wisdom and functionality in natures design of the male genitalia.
    If men were given the opportunity at eighteen to decide if they wanted to be circumcised...the vast majority would stay stay as they were born.
    Thanks again for your post.

  4. ozzychikk@yahoo.comMay 28, 2010 2:04 AM

    where can i get those diapers?!

  5. They are Dilley Dally diapers - find info and links to the Dilley Dally site in this post:

    The maker is currently on her 'babymoon' so she likely won't be doing orders for a couple more months.

  6. I'm getting really tired of fixing latch issues brought on, at least in part, by RIC. To make it worse, I warn every damn client that this happens frequently and point them toward information. They all seem interested, then I see them PP and realize what they did to those poor little boys. Of all the booby traps I have to help moms through, this is the one that I have the hardest time handling professionally.



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