Wednesday, July 29, 2009

Major Problems with African Web-Reported Study and "Circumcision Makes Sex Pleasureable For Women" Statement



Several of those in the pro-circ camp - encouraging the non-consenting genital cutting of infant boys - have recently jumped onto a Web-reported article.

This study (and the way it is being reported) is flawed in 2 major ways:

1) It was conducted via interview in Uganda where people are being saturated with messages (from outside, white, male, U.S. researchers) that circumcision is a great thing and is good for all adults involved. People (especially when questioned by those in positions of authority) regularly report what is favorable and being asked of them -- the "white coat" impact on psychology and interview responses.

2) Even with the above stated influence, 60% of women interviewed STILL reported there was either LESS pleasure after their adult male partner was circumcised, or no change.

Stating, then, that this study "proves male circumcision benefits women" or "proves circumcision increases pleasure for women" is a 100% false statement.

The title of this article itself very misleading (which may not be surprising as it was NOT published in any valid, empirical, peer-reviewed, medical journal, but rather posted and passed around online). In addition, the entire pro-circ premise of those quoting the study is also very much unrepresentative of the actual study and the results found.

Furthermore, even if this study had shown different results -- (rather than 60% of women reporting what we already know to be true - there is LESS pleasure or no change depending on the life cycle stage that a woman is in and how 'tightly' her male partner is cut) -- it was conducted via interview in Uganda, Africa where ADULT men are being given the option of circumcision themselves (and being pressured to do so). It is in no way applicable to non-consenting INFANTS in the United States.

Finally, even if all women had better sex lives as a result of male genital cutting (which they certainly do not - 70 years of valid, reliable, medical research in the fields of human sexuality and healthy psychology have shown the exact opposite to be true)...but IF they did - does that then justify us cutting up baby boy's penises at birth?

If men enjoyed sex more - or obtained more pleasure as a result of women having modified genitals/labia/clitoris/vagina, should we then begin genital cutting on newborn baby girls at birth as well?

The argument based upon such logic is absurd.

Just as each woman has the right to make decisions about her own body (and what happens TO it), men's (and boys' - even BABY boys') bodies belong to them - for each and every one to decide for himself what he will do - with his arms, ears, eyes, nose, legs, feet -- and even his penis.



So, put down the knife: Step away from the baby.




Tuesday, July 28, 2009

Circumcision & Human Behavior


By George Hill, Bioethicist and Medical Scientist,
Member of Doctors Opposing Circumcision
Article also posted by
Prashant

The emotional and behavioral effects of circumcision.

Psychologists now recognize that male circumcision affects emotions and behavior. This article discusses the impact of male circumcision on human behavior.

Introduction

Medical doctors adopted male circumcision from religious practice into medical practice in England in the 1860s and in the United States in the 1870s. No thought was given to the possible behavioral effects of painful operations that excise important protective erogenous tissue from the male phallus. For example, Gairdner (1949) and Wright (1967), both critics of male neonatal non-therapeutic circumcision, made no mention of any behavioral effects of neonatal circumcision.[1] [2]

The awakening

Other doctors, however, were beginning to express concern about the behavioral effects of male circumcision.
Levy (1945) studied the behavioral effects of various operations, including circumcision, on young children.[3] He found that children who had undergone operations experienced an increase in anxiety and various fears, including night terrors, fear of physicians, nurses, and strange men. The oldest age group exhibited greater hostility and aggression. Levy compared their behavior to that of soldiers who suffered from what was then called "combat neurosis," and now recognized as post-traumatic stress disorder. Anna Freud (1952) pointed out that operations on the genitals, such as circumcision, would cause "castration anxiety."[4] Cansever (1965) tested Turkish boys before and after circumcision.[5] Cansever reported severe disturbances in functioning, including regression in behavior, and withdrawal of the ego as protection against outside threats. Cansever also observed various anxieties, including castration anxiety. Foley (1966) noticed that circumcised men are more likely to be biased in favor of circumcision.[7] Moreover, he said that circumcised men are more likely to engage in "problem-masturbation" but non-circumcised men were equally unlikely to engage in "problem-masturbation." Grimes (another critic of non-therapeutic neonatal circumcision) (1978), apparently unaware of the research described above, sounded an alarm:
"In contrast to the sometimes dramatic somatic responses of the neonate to operation without anesthesia, the psychological consequences of this trauma are conjectural. Psychoanalyst Erik Erickson has described the first of eight stages of man as the development of basic trust versus basic mistrust. For the baby to be plucked from his bed, strapped in a spread eagle position, and doused with chilling antiseptic is perhaps consistent with other new-found discomforts of extrauterine existence. The application of crushing clamps and excision of penile tissue, however, probably do little to engender a trusting, congenial, relationship with the infant's new surroundings."[8]

Behavior during unanesthetized circumcision

Gunnar et al. (1981) studied the relationship of system cortisol levels to behavioral state. Gunnar et al. report that, as system cortisol rises, infants increase wakefulness and crying.[9] Malone et al. (1985) report that infants show little change in behavior due to limb restraint (of the type used for circumcision).[10]
Porter et al. (1986) report that newborn infants who are undergoing unanesthetized cirumcision emit cries of extreme urgency.[11] The studies, carried out with the aid of computer spetrographic analysis, show that infants who have been circumcised vocalize their anguish with higher pitch, fewer harmonics and shorter cries. The most invasive procedures produced the most urgent cries, as judged by observers. Porter et al. (1988) report that vagal tone decreases as the pitch of the cry increases.[12]
Gunnar et al. (1988) report that infants decrease distressed behavior when given a non-nutritive pacifier, although system cortisol does not decrease.[13]

Behavior immediately after unanesthetized circumcision

Studies show that circumcision affects the sleep of newborn boys. Emde et al. (1971) studied the sleep of boys who had had a non-therapeutic circumcision with the Plastibell device.[14] Emde et al. report that non-therapeutic circumcision "was usually followed by prolonged nonrapid eye movement (NREM) sleep." The authors considered this type of sleep "to be consistent with a theory of conservation-withdrawal in response to stressful stimulation."
Anders & Chalemian (1974) studied the sleep of boys who had had a non-therapeutic circumcision with a circumcision clamp. They report significant increases in wakefulness after circumcision.[15]
Marshall et al.(1979) studied newborn infant behavior using the Brazelton Neonatal Behavior Assessment Scale.[16] The study shows that infants change their behavior for at least 22 hours after circumcision. In a second study, Marshall et al. (1982) showed that circumcised infants kept their eyes closed during feeding or did not feed at all. Marshall et al. considered that mother-infant interaction and bonding was disrupted by the stress of circumcision.[17]
Numerous observers report that circumcision inteferes with the normal feeding behavior of circumcised boys. La Leche League leaders (1981) suggest that circumcision should be delayed for a time.[18] Marshall et al. (1982) found that circumcision interfered with normal feeding behavior.[17] Howard et al. (1994) report that "babies feed less frequently and are less available for interaction after circumcision."[19] Howard et al. report that some newly circumcised babies are unable to suckle at the breast and require formula supplementation. Lee (2000) also comments on the difficulty with feeding that circumcised boys exhibit.[20] Breastfeeding provides the best nutrition for infants and is of key importance in giving an infant a good start in life with optimum mother-infant bonding, health, and well-being,[21] so non-therapeutic infant circumcision should not be allowed to interfere with breastfeeding.

Behavior at vaccination

Hepper (1996) surveys and reports research that indicates memory commences to function in the fetus at about the 23rd week of gestation.[22] Infant memory continues to function through the birth experience and afterward. Anand & Hickey (1987) firmly established that newborn infants have fully functioning pain pathways.[23] When an infant is subjected to a painful and traumatic experience all the necessary factors are present to create posttraumatic stress disorder (PTSD). Boyle et al. (2002) describe the etiology of PTSD:
"A traumatic experience is defined in DSM-IV as the direct consequence of experiencing or witnessing of serious injury or threat to physical integrity that produces intense fear, helplessness or (in the case of children) agitation. The significant [circumcision] pain and distress described earlier is consistent with this definition. Moreover, the disturbance (e.g., physiological arousal, avoidant behaviour) qualifies for a diagnosis of acute stress disorder if it lasts at least two days or even a diagnosis of post-traumatic stress disorder (PTSD) if it lasts more than a month. Circumcision without anaesthesia constitutes a severely traumatic event in a child's life."[24]
PTSD is a normal response to an abnormal and terrifying experience. One would, therefore, expect to find PTSD in circumcised boys.
Taddio et al. (1995) compared the behavior of circumcised boys with the behavior of girls at the age of 4 to 6 months when vaccination with DPT occurred. Taddio et al. report that circumcised boys demonstrate a much greater response to the pain of the vaccination than do girls.[25] In a second study, Taddio et al. (1997) compared the behavior of circumcisied boys with the behavior of non-circumcised boys at vaccination. [26] Similarly, the circumcised boys demonstrated a greater response to the pain of vaccination than did the non-circumcised boys. Taddio et al. commented:
"It is, therefore, possible that the greater vaccination response in the infants circumcised without anaesthesia may represent an infant analogue of a post-traumatic stress disorder triggered by a traumatic and painful event and re-experienced under similar circumstances of pain during vaccination."[26]
Taddio et al. suggested that the pain of circumcision "may have long-lasting effects on future infant behaviour."[26]
Circumcision of boys is nearly universal in the Philippine Islands for cultural reasons. Ramos & Boyle (2001) studied the psychological effects of circumcision in Phillipine boys. They report a high incidence of PTSD in these boys. Sixty-nine percent of boys who had been circumcised by the traditional "tuli" Philippine ritual circumcision and 51 percent of boys who had been medically circumcised satisfied the DSM-IV criteria for PTSD.[27]

Behavior in later life

There is increasing evidence that male circumcision influences the behavior of adult males. Menage reports PTSD after genital surgery.[28] More specific to male circumcision, Rhinehart reports finding PTSD in adult males in his clinical practice in which the stressor was neonatal circumcision.[29] Rhinehart lists symptoms of:
  • a sense of personal powerlessness
  • fears of being overpowered and victimized by others
  • lack of trust in others and life
  • a sense of vulnerability to violent attack by others
  • guardedness in relationships
  • reluctance to be in relationships with women
  • defensiveness
  • diminished sense of maleness
  • feeling damaged, especially in the presence of surgical complications such as skin tags, penile curvature due to uneven foreskin removal, partial ablation of edges of the glans and so on
  • sense of reduced penile size, a part cut off or amputated
  • low self-esteem
  • shame about not "measuring up"
  • anger and violence toward women
  • irrational rage reactions
  • addictions and dependencies
  • difficulties in establishing intimate relationships
  • emotional numbing
  • need for more intensity in sexual experience.
  • sexual callousness
  • decreased tenderness in intimacy
  • decreased ability to communicate
  • feelings of not being understood[29]
Van der Kolk (1989) reports that persons who have been traumatized have a compulsion to repeat the trauma and to find new victims on which to re-enact the trauma they suffered.[30] This may apply with full force to victims of circumcision. The circumcision of an infant is a way to reenact the trauma of circumcision.[31] The compulsion to circumcise is very strong and has resulted in unlawful batteries and abductions to circumcise an unwilling victim.[32] [33] [34] [35] [36]
There is some evidence that adverse experiences in the perinatal period (from the 28th week of gestation through the first seven days of extra-uterine life) cause self-destructive behavior in adult life.[37] [38] [39] [40] Circumcised males may tend to be more self-destructive, but more research is needed to verify the effect traumatic non-therapeutic circumcision has on self-destructive behavior.
The condition of the male phallus impacts a male's feeling of well-being. A phallus diminished by the loss of the erogenous foreskin to circumcision necessarily adversely affects one's feelings about one's self, resulting in uncomfortable feelings of low self-esteem. There is, therefore, a strong tendency to deny that any loss occurred. Minimization of the loss is a common defense mechanism; ridicule of the subject is another. Persons who have lost body parts must grieve their loss.[41] Failure to grieve and accept the loss puts one in permanent denial of loss.[42] Many men who have been circumcised do not want non-circumcised males, including their own sons, around to remind them of their irreversible loss. For these emotional reasons, as Foley (1966) observed, there tends to be a strong irrational bias in favor of universal circumcision among circumcised males.[7] Many fathers who were victims of neonatal circumcision, for the reasons described above, adamantly insist that any male offspring be circumcised.[24] This phenomenon has come to be called "the adamant father syndrome." Circumcision, therefore is a repeating cycle of trauma in which circumcised infant males grow up to be adult circumcisers.[31]

Behavior of circumcised medical doctors

Medical doctors in Australia, Canada, and the United States practiced circumcision in the twentieth century, so these nations have a heavy proportion of circumcised men, some of whom become medical doctors. These circumcised male doctors share the same bias in favor of male circumcision as do other circumcised males.[7] [31] [43] Male doctors who were circumcised as infants are more likely to recommend circumcision of infants to parents.[44]
The Australian Paediatric Association recommended non-circumcision—genital integrity—in 1971;[45] thereafter, the incidence of circumcision among Australia's newborn plummeted.[46] At the present time, in regard to genital integrity status, Australia is, in effect, two nations, one of which has mostly circumcised men and the other that has mostly intact men. The dividing point is the year 1978, because the incidence of genital integrity among newborn boys rose above 50 percent in that year.[46] The ever-increasing percentage of genitally intact younger men in the population is causing increasing anxiety and distress among some older circumcised males. There now is a peculiar phenomenon happening in Australia, where one sees middle-aged men trying to restore Australia's medical practice back to that which prevailed before 1971. This is, of course, an attempt to defend the culture-of-origin and is carried out for the emotional reasons described here, although, as Goldman reports, pseudo-scientific reasons are advanced .[31]

Behavior of circumcised medical authors

The high proportion of circumcised males in the medical community create a distorted, biased medical literature.[47] Goldman (1999) writes:
"One reason that flawed studies are published is that science is affected by cultural values. A principal method of preserving cultural values is to disguise them as truths that are based on scientific research. This 'research' can then be used to support questionable and harmful cultural values such as circumcision. This explains the claimed medical 'benefits' of circumcision."[31]
Hill (2007) writes:
"The medical literature on circumcision is voluminous and contentious. Circumcised doctors create papers that overstate benefits and minimize harms and risks. When these doctors publish such claims, other doctors come forward to refute them....The result is an unending debate driven by the emotional compulsion of circumcised men."[43]
Female doctors from a circumcising culture of origin have been known to contribute pro-circumcision pieces.
Most American medical editors are circumcised men. They share the pro-circumcision bias of other circumcised men. They tend to select papers for publication that conform to their bias. The literature, therefore, is filled with pro-circumcision papers written by circumcised doctors. The behavior of these circumcised doctors has served for a century to prolong the practice of a nineteenth century surgical operation that has no medical indication and is injurious to infants and children.

Behavior of medical societies

Medical societies in the English-speaking nations have a high proportion of male members (fellows) who are circumcised. The societies that represent medical specialities that practice circumcision have found themselves unable to adequately address the problem of circumcision and to repudiate this harmful, outmoded practice.
Goldman writes:
"Although medical committee members highly value rationality, a rational and objective evaluation of an emotional and controversial topic like circumcision can be difficult. It is suggested that the potential psychological and social factors surrounding the practice of circumcision could affect the values and attitudes of circumcision policy committee members, the attitude toward evaluating the circumcision literature, and the publishing of circumcision literature itself. If the members are polarized, the process of negotiating to arrive at a consensus statement could introduce additional psychosocial factors that could affect the final policy."[48]
Dr. Goldman published the two articles cited here in the United Kingdom and Canada, not the United States. This may be a testimony to the bias and censorship present in the medical literature of the United States.

Conclusion

All of the behavioral changes described in this paper are negative, unfavorable, or maleficial in nature. No positive, favorable, or beneficial behavioral changes have been found.
The English-speaking nations have a high proportion of circumcised males and, therefore, a high proportion of psychically-wounded males. A society containing so many psychically-wounded males cannot be as healthy as it should be. The United States has clung to circumcision even after Australia and Canada have rejected circumcision of infants. Consequently, the United States has the highest proportion of circumcised males to intact males and the greatest injury to society.
The best way to stop the cycle of trauma is to stop circumcising infants.[31] [42] Non-traumatized intact infants usually do not grow up to become circumcisers, so the cycle of trauma would end.

Additional Reading

Miller A. Appendix: The Untouched Key: Tracing Childhood Trauma in Creativity and Destructiveness. Anchor Books (Doubleday) New York, 1991.
Goldman R. Circumcision: The Hidden Trauma. Boston: Vanguard Publications, 1997.
Fleiss P, Hodges FM. What your Doctor May Not Tell You About Circumcision. New York: Warner Books, 2002.
Ritter TJ, Denniston GC. Doctors Re-examine Circumcision. Seattle: Third Millennium Publishing Company, 2002.

References

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  2. Wright JE. Non-therapeutic circumcision. Med J Aust 1967;1:1083-6.
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  3. Levy D. Psychic trauma of operations in children: and a note on combat neurosis. Am J Dis Child 1945;69:7-25.
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  4. Freud A. The role of bodily illness in the mental life of children. Psychoanalytic Study of the Child 1952; 7:69-81.
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  5. Cansever G. Psychological effects of circumcision. Brit J Med Psychol 1965;38:321-31.
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  6. Richards MPM, Bernal, JF, Brackbill Y. Early behavioral differences: gender or circumcision? Dev Psychobiol 1976;9(1):89-95.
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  7. Foley JM. The unkindest cut of all. Fact 1966;3(4):2-9.
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  8. Grimes DA. Routine circumcision of the newborn: a reappraisal. Am J Obstet Gynecol 1978;130(2):125-29.
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  9. Gunnar MR, Fisch RO, Korsvik S, Donhowe JM. The effects of circumcision on serum cortisol and behavior. Psychoneuroendocrinology 1981; 6(3):269-75.
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  10. Malone SM, Gunnar MR, Fisch RO. Adrenocortical and behavioral responses to limb restraint in human neonates. Dev Psychobiol 1985;18:435-46
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  11. Porter FL, Miller RH, and Marshal RE. Neonatal pain cries: effect of circumcision on acoustic features and perceived urgency. Child Dev 1986;57:790-802.
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  12. Porter, FL, Porges SW, Marshall RE. Newborn pain cries and vagal tone: parallel changes in response to circumcision. Child Dev 1988;59:495-505.
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  13. Gunnar MR, Connors J, Isensee, Wall L. Adrenocortical activity and behavioral distress in human newborns. Dev Psychobiol 1988;21(4):297-310.
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  14. Emde RN, Harmon RJ, Metcalf D, et al. Stress and neonatal sleep. Psychosom Med 1971;33(6):491-7.
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  15. Anders TF, Chalemian RJ. The effects of circumcision on sleep-wake states in human neonates. Psychosom Med 1974;36(2):174-9.
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  16. Marshall RE, Stratton WC, Moore JA, et al. Circumcision I: effects upon newborn behavior. Infant Behavior and Development 1980;3:1-14.
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  17. Marshall RE, Porter FL, Rogers AG, et al. Circumcision: II effects upon mother-infant interaction. Early Hum Dev 1982; 7(4):367-74.
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  18. The Womanly Art of Breastfeeding, 3rd ed. Franklin Park, IL: La Leche League International, 1981: 92-93. (ISBN 0-912500-10-7)
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  20. Lee N. Circumcision and breastfeeding. J Hum Lact 2000;16(4):295.
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  21. Section on Breastfeeding. Breastfeeding and the use of human milk. Pediatrics 2005;115(2):496-506.
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  22. Hepper PG, Fetal memory: Does it exist? What does it do? Acta Pædiatr (Stockholm) 1996; Suppl 416:16-20.
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  23. Anand KJS, Hickey PR. Pain and its effects in the human neonate and fetus. New Engl J Med 1987;317(21):1321-9.
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  24. Boyle GJ, Goldman R, Svoboda JS, Fernandez E. Male circumcision: pain, trauma and psychosexual sequelae. J Health Psychol 2002;7(3):329-43.
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  25. Taddio A, Goldbach M, Ipp E, et al. Effect of neonatal circumcision on pain responses during vaccination in boys. Lancet 1995;345:291-2.
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  26. Taddio A, Katz J, Ilersich AL, Koren G. Effect of neonatal circumcision on pain response during subsequent routine vaccination. Lancet 1997;349(9052):599-603.
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  27. Ramos S, Boyle GJ. Ritual and medical circumcision among Filipino boys: evidence of post-traumatic stress disorder. In: Denniston GC, Hodges FM, Milos MF (eds) Understanding circumcision: A Multi-Disciplinary Approach to a Multi-Dimensional Problem. New York: Kluwer Academic/Plenum Publishers, 2001: pp. 253-70.
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  28. Menage J. Post-traumatic stress disorder in women who have undergone obstetric and/or gynaecological procedures. J Reprod Infant Psychol 1993;11:221-28.
    Abstract
  29. Rhinehart J. Neonatal circumcision reconsidered. Transactional Analysis J 1999;29(3):215-21.
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  30. van der Kolk BA. The compulsion to repeat the trauma: re-enactment, revictimization, and masochism. Psychiatr Clin North Am 1989;12(2):389-411.
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  31. Goldman R. The psychological impact of circumcision. BJU Int 1999;83 Suppl. 1:93-103.
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  32. Anonymous. Man killed for not going to circumcision school. SAPA, South Africa, Monday, 27 June 2005
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  33. Anonymous. Man forcibly circumcised as crowd watches. The Nation, Nairobi, Kenya, 23 August 2002.
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  34. Vusi Mona. A bit mundane and a little more light. [opinion] City Press, South Africa, 13 July 2002.
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  35. Anonymous. 'Spy' cut up about initiations. African Eye News Service, 27 August 2002.
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  36. Anonymous. Take boys home, parents urged. South African Press Association (SAPA), 3 July 2002.
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  37. Salk L, Lipsitt LP, Sturner WQ, et al. Relationship of maternal and perinatal conditions to eventual adolescent suicide. Lancet 1985;i:624-7
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  38. Jacobson B, Eklund G, Hamberger L, et al. Perinatal origin of adult self-destructive behavior. Acta Psychiatr Scand 1987;76(4):364-71.
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  39. van der Kolk BA, Perry JC, Herman JL. Childhood origins of self-destructive behavior. Am J Psychiatry 1991; 148;1665-71.
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  40. Jacobson B, Bygdeman M. Obstetric care and proneness of offspring to suicide. BMJ 1998; 317:1346-49.
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  41. Maguire P, Parks CM. Coping with loss: surgery and loss of body parts. BMJ 1998;316(7137):1086-8.
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  42. Denniston GC. An Epidemic of Circumcision. Third International Symposium on Circumision, University of Maryland, College Park, Maryland, May 22-25, 1994.
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  43. Hill G. The case against circumcision. J Mens Health Gend 2007;4(3):318-23.
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  44. LeBourdais E. Circumcision no longer a "routine" surgical procedure. Can Med Assoc J 1995;152(11):1873-6.
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  45. Belmaine SP. Circumcision. Med J Aust 1971;1:1148.
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  46. Young H. Circumcision in Australia.
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  47. Fleiss PM. An analysis of bias regarding circumcision in American medical literature.In: Denniston GC, Hodges FM, Milos MF. (eds) Male and Female Circumcision: Medical, Legal, and Ethical Consideratons in Pediatric Practice. New York: Kluwer Academic/Plenum Publishers, 1999: pp. 379-402.
    [Abstract]
  48. Goldman R. Circumcision policy: a psychosocial perpective. Paediatr Child Health 2004;9(9):630-3.
    [Full Text]

Adolescent Sexual Health in Europe & the U.S.—Why the Difference?


Advocates for Youth compares sexually transmitted infection (STI) rates of the United States to rates found in France, Germany and the Netherlands.

One significance of the major difference?

None of the countries with much lower STI rates circumcise infant boys.

Unfortunately, almost 50% of baby boys born in the United States continue to have their prepuce organ surgically removed at birth. This is the amputation of an organ that has protection from infections as one of its primary functions. In conjunction with a lack of comprehensive sexuality education (that other nations have), genital cutting is a factor contributing to the CDC estimated 1 in 3 Americans with an STI.


Also available in [PDF] format. Order publication.


by Ammie N. Feijoo

Each summer since in 1998, Advocates for Youth and the University of North Carolina at Charlotte sponsor annual study tours to France, Germany, and the Netherlands to explore why adolescent sexual health outcomes are so much more positive in the three European countries than in the U.S.

Rights. Respect. Responsibility.® The study tour participants—policy makers, researchers, youth-serving professionals, foundation officers, and youth—have found that this trilogy of values underpins a social philosophy regarding adolescent sexual health in these countries. Each of these nations has an unwritten social contract with young people: "We'll respect your right to act responsibly, giving you the tools you need to avoid unintended pregnancy and sexually transmitted infections, including HIV."

In these nations, societal openness and comfort in dealing with sexuality, including teen sexuality, and pragmatic governmental policies create greater, easier access to sexual health information and services for all people, including teens. Easy access to sexual health information and services leads to better sexual health outcomes for French, German, and Dutch teens when compared to U.S. teens.

Adolescent Pregnancy, Birth, and Abortion Rates in Europe Far Outshine Those in the U.S.*

Pregnancy

In the United States, the teen pregnancy rate is more than nine times higher than that in the Netherlands, nearly four times higher than the rate in France, and nearly five times higher than that in Germany.1,2,3

Teen Pregnancy Rate

Birth

In the United States, the teen birth rate is nearly 11 times higher than that of the Netherlands, nearly five times higher than the rate in France, and nearly four times higher than that in Germany.2,3,4

Teen BirthRate

Abortion

In the United States, the teen abortion rate is nearly eight times higher than the rate in Germany, nearly seven times higher than that in the Netherlands, and nearly three times higher than the rate in France.1,2,3

teen abortion rate

U.S. HIV/STI Rates Also Compare Poorly.

HIV in Young Women and Men

In the United States, the estimated HIV prevalence rate in young men ages 15 to 24 is over five times higher than the rate in Germany, nearly three times higher than the rate in the Netherlands, and about 1 ½ times higher than that in France.5

HIV prevalence rate in young men

In the United States, the estimated HIV prevalence rate in young women ages 15 to 24 is six times higher than the rate in Germany, nearly three times higher than the rate in the Netherlands, and is the same as that in France.5

HIV prevalence rate in young women

Syphilis

In the United States, the teen syphilis rate is over six times higher than that of the Netherlands, over five times higher than the rate in former West Germany, and nearly three times higher than that in former East Germany. Data are not available for France.6

teen syphilis rate

Gonorrhea

In the United States, the teen gonorrhea rate is over 74 times higher than that in the Netherlands and France, over 66 times higher than the rate in former West Germany, and over 38 times higher than that in former East Germany.6

teen gonorrhea rate

Chlamydia

In the United States, the teen chlamydia rate is over 20 times higher than that in France. Data are not available for Germany or the Netherlands.6

teen chlamydia rate

American Youth Have Sex at the Same Age or Even Earlier than Youth in Europe. Young People in the U.S. Have More Sexual Partners.

In the United States, young people typically initiate sexual intercourse at the same age or even earlier compared to young people in the Netherlands and France.3,7 Data are not available for Germany.

Finally, the proportion of sexually active teenage men and women ages 18 to 19 that had two or more sexual partners within the past year is substantially higher in the United States than in France. Data on number of sexual partners are not available for Germany or the Netherlands. Having two or more sexual partners increases youth's potential risk of becoming infected with HIV and other STIs.7



% With Two or More
Sexual Partners in Past Year7


Typical Age at First Sexual Intercourse3,7



Women Ages 18 to 19


Men Ages 18 to 19

United States

48.6%

48.8%

17.4 years

Netherlands

17.7 years

France

12.8%

28.8%

18.0 years

Germany

Implementing the Model: Potential Impact on Adolescent Sexual Health in the U.S.

If society in the United States became more comfortable with sexuality and if governmental policies created greater, easier access to sexual health information and services, adolescents' sexual health outcomes could improve markedly. Imagine that the United States' adolescent pregnancy, birth, and abortion rates improved to match those in the European nations studied. The reduced rates would mean large reductions in the numbers of pregnancies, births, and abortions to teens in the United States each year—and in the public funds needed to support families begun with a birth to a teen.


If the U.S. Rates Equaled Rates in:


Fewer Pregnancies


Fewer Births


Fewer Abortions


Lower Public Costs8

Netherlands

657,000

441,000

215,000

$921 million

France

550,000

391,000

160,000

$815 million

Germany

588,000

367,000

221,000

$767 million

The Lessons Learned: A Model to Improve Adolescent Sexual Health in the U.S.9

So, if Dutch, German, and French teens have better sexual health outcomes, have fewer sexual partners, and initiate sexual activity at the same age or even later than U.S. youth, what's the secret? Is there a 'silver bullet' solution for the United States that will reduce the nearly four million new sexually transmitted infections occurring among U.S. teens each year, or the 20,000 new HIV infections among 13- to 24-year-old youth, or the 900,000 teen pregnancies?1,10,11

Unfortunately, there is not a single, 'silver bullet' solution. Yet, the United States can use the experience of the Dutch, Germans, and French to guide its efforts to improve adolescents' sexual health. Indeed, the United States can overcome obstacles and achieve social and cultural consensus respecting sexuality as a normal and healthy part of being human and of being a teen by using lessons learned from the European study tours.

  • Adults in the Netherlands, France, and Germany view young people as assets, not as problems. Adults value and respect adolescents and expect teens to act responsibly. Governments strongly support education and economic self-sufficiency for youth.
  • Research is the basis for public policies to reduce unintended pregnancy, abortion, and sexually transmitted infections, including HIV. Political and religious interest groups have little influence on public health policy.
  • A national desire to reduce the number of abortions and to prevent sexually transmitted infections, including HIV, provides the major impetus in each country for unimpeded access to contraception, including condoms, consistent sexuality education, and widespread public education campaigns.
  • Governments support massive, consistent, long-term public education campaigns utilizing the Internet, television, films, radio, billboards, discos, pharmacies, and health care providers. Media is a partner, not a problem, in these campaigns. Campaigns are far more direct and humorous than in the U.S. and focus on safety and pleasure.
  • Youth have convenient access to free or low-cost contraception through national health insurance.
  • Sexuality education is not necessarily a separate curriculum and may be integrated across school subjects and at all grade levels. Educators provide accurate and complete information in response to students' questions.
  • Families have open, honest, consistent discussions with teens about sexuality and support the role of educators and health care providers in making sexual health information and services available for teens.
  • Adults see intimate sexual relationships as normal and natural for older adolescents, a positive component of emotionally healthy maturation. At the same time, young people believe it is "stupid and irresponsible " to have sex without protection and use the maxim, "safer sex or no sex."
  • The morality of sexual behavior is weighed through an individual ethic that includes the values of responsibility, respect, tolerance, and equity.
  • France, Germany, and the Netherlands work to address issues around cultural diversity in regard to immigrant populations and their values that differ from those of the majority culture.

Rights. Respect. Responsibility.®: A National Campaign to Improve Adolescent Sexual Health

In October 2001, Advocates for Youth launched a long-term campaign — Rights. Respect. Responsibility.® — based on the lessons learned from the European study tours. The Campaign will work to shift the current societal paradigm of adolescent sexuality away from a negative emphasis on fear and ignorance and towards an acceptance of sexuality as healthy and normal and a view of adolescents as a valuable resource.

  • Adolescents have the right to balanced, accurate, and realistic sexuality education, confidential and affordable sexual health services, and a secure stake in the future.
  • Youth deserve respect. Today, they are perceived only as part of the problem. Valuing young people means they are part of the solution and are included in the development of programs and policies that affect their well-being.
  • Society has the responsibility to provide young people with the tools they need to safeguard their sexual health and young people have the responsibility to protect themselves from too early childbearing and sexually transmitted infections, including HIV.

Advocates is developing and disseminating campaign materials for specific audiences, such as entertainment industry and news media professionals, policy makers, youth-serving professionals, parents, and youth activists.

Each summer, Advocates will continue its thought-provoking European study tours. Advocates will also collaborate with key national organizations and state-based stakeholders to promote Rights. Respect. Responsibility.® through campaign materials, workshops, presentations, and technical assistance. For additional information on the Campaign or to become an organizational partner in this important initiative, contact Advocates for Youth at 202.419.3420 or visit www.advocatesforyouth.org.

References

  1. Ventura SJ et al. Trends in pregnancy rates for the United States, 1976-97: an update. National Vital Statistics Reports 2001;49(4):1-10.
  2. Singh S, Darroch JE. Adolescent pregnancy and childbearing: levels and trends in developed countries. Family Planning Perspectives 2000;32(1):14-23.
  3. Rademakers J. Sex Education in the Netherlands. Paper presented to the European Study Tour. Utrecht, Netherlands: NISSO, 2001.
  4. Martin JA et al. Births: preliminary data for 2000. National Vital Statistics Reports 2001;49(5):1-20.
  5. UNAIDS. Report on the Global HIV/AIDS Epidemic. Geneva, Switzerland: UNAIDS, 2000.
  6. Panchaud C et al. Sexually transmitted diseases among adolescents in developed countries. Family Planning Perspectives 2000;32(1):24-32 & 45.
  7. Darroch JE et al. Adolescent Sexual and Reproductive Health: A Developed Country Comparison. New York, NY: The Alan Guttmacher Institute, forthcoming in Family Planning Perspectives.
  8. Calculations, using 1997 data, are based on Feijoo AN. Teenage Pregnancy, the Case for Prevention. Washington, DC: Advocates for Youth, 1999.
  9. Berne L and Huberman B. European Approaches to Adolescent Sexual Behavior & Responsibility. Washington, DC: Advocates for Youth, 1999.
  10. American Social Health Association. Sexually Transmitted Diseases in America: How Many Cases and at What Cost? Research Triangle Park, NC: ASHA, 1998.
  11. Office of National AIDS Policy. Youth and HIV/AIDS 2000: A New American Agenda. Washington, DC: ONAP, 2000.
*Throughout this fact sheet, data are the most recent available for each country, ranging from years 1995 to 2000. Pregnancy data do not include fetal losses. U.S. birth data are for 1999 while U.S. pregnancy and abortion data are for 1997.

BREASTMILK DONATION


Bottle full of donated human milk for baby in need

One of the most amazing gifts we have been blessed to be able to share with other moms/babies in need is human milk. A couple of our favorite places for connecting and sharing between families are the milksharing communities listed below.

Other means of contacting mothers who need your help (if you are a donor) or finding donors if you are a mom in need, are to:

~ contact your local La Leche League (they are all over, internationally)
~ contact local lactation consultants (who can provide you with resources while getting the word out or connecting you with other moms)
~ contact local lactation clinics (often at the hospital, in labor and delivery, where certified lactation consultants will work)
~ contact your local homebirth midwives (who often know lactating moms ready and willing to donate or know moms who need help)
~ contact local doulas (who often know many of the same nursing moms with extra milk to give or those who just birthed and need help)
~ contact local Mom's Milk Cafe groups (often on Meet-Up or other local social network sites)
~ drop us a note (DrMomma.org@gmail.com) and we will post a message to our Facebook page to see if we can connect you with moms in your area

The first (below) is a list of the nonprofit whole human milks in North America (there are not a lot of them). They do not 'mess with' the milk as some other donation locations do. The milk is accepted in frozen form and given directly to families in need.

The second link is a source for mothers wishing to donate directly to families looking for human milk for their little bundle. If you are in need, you can also be connected with those in your area willing to give.

The third and fourth - Human Milk 4 Human Babies (HM4HB), created by informed mothering advocate, Emma Kwasnica, and Eats on Feets, run by Shell Walker, are mother-to-mother milksharing communities formed as a way for moms to network directly with each other and share locally as they wish. HM4HB and EOF truly reflect one of the ways moms have empowered each other for most of human history, and in most of the world (providing milk to each other's babies as it is needed). This shared community of mothering is one that too often has been lost in the recent, modern West, and one which our babies, and humanity, would benefit from us remembering.

These are all great resources and those that can assist in making sure human babies are fed the one and only thing designed specifically for their health, development, and wellbeing - human milk!


TEETHING PAINS

By Danelle Frisbie © 2009

Ah, the great days of teething. We did all we could to help our little one through his teething pains. The stories and research I'd read on teething (even with 2 dentists in the family) did not prepare me for the realities of molars cutting. It can be tough on a little guy! While I broke down and decided we could not forgo the Infant's Motrin (he was just too uncomfortable for me to deny him drugs any longer), I do also like (and use) the suggestions listed in Gaulin's article below.

Our son's top 7 favorites (that actually worked!) included:

1) Sophie Giraffe - a favorite for his entire first year of life, we had to get one for the car, and one for the house because he chomped on Sophie so much. Plus, I've never met a baby who didn't adore Sophie! (She is made of all natural, non-toxic rubber from trees in the Alps).


2) Born Free's Teether Gum Brush and Teether - we kept these in the freezer and rotated between uses so there was always a cold one on hand. (You can also put teething gel in the ridges on this gum brush, but our son did not like the gel).

3) The Teethifier - especially great for back teeth and molars!


4) The Baby Safe Feeder - we packed it full of peach or banana slices and froze for teething treats - even works in the car (as long as you don't mind a possible messy face/hands)!


5) Baltic Amber Teething Necklace - many people have asked if this really makes a difference. It is a natural pain remedy, but babies do NOT teeth on the necklace. Rather, Baltic amber secretes natural, soothing oils into the skin which aids as a natural pain-reliever. We found that days and nights with the necklace were much more tolerable (not having to use Tylenol or Motrin much) than days/nights without the teething necklace. So it does seem to make a difference for our son. (Baltic Amber necklaces are also used for arthritis pain among adults). Find Baltic amber teething necklaces at the link above, at Inspired by Finn, or here. (We've purchased one from all three companies and each is well made.)

6) Hyland's Colic Tablets & Teething Tablets - although we used both and both do help, for some reason the Colic Tablets (although our son never had 'colic' and rarely cried) seemed to work better for his teething discomfort than the actual teething tablets when he was young. Both are homeopathic remedies that melt quickly and easily in baby's mouth. (Simply slide the tablets into the cheek of your baby/toddler). You can find Hyland's Teething Tablets at most drug stores, some retail stores (Target, WalMart) - and you can find both the Colic and Teething Tablets at many natural food stores like Whole Foods, etc. They are also both available on Amazon.com

[UPDATE: Since Hyland's Teething tablets have been pulled from shelves, you may wish to pick up some Humphreys Teething Tablets - which many parents assert work even better without the lactose as an ingredient.]


7) Good ol' fashioned nursing with Momma. Nothing seems to comfort and sooth a teething baby like being held and breastfed. In fact, I've heard so many reports from parents telling me that during the especially tough days of teething, their baby often chose to forgo all solid foods and simply stuck to nursing. This was surely the case on occasion with our son as well, and I am thankful he still had nature's made-for-baby comfort source to turn to when teething times were a bit challenging. I never had to worry about him getting all the nourishment he needed -- even on days he refused to eat anything other than watermelon, popsicles, and momma milk!


We'd love to hear others 'best teething remedies' as well, so please feel free to share.

Top 7 Natural Remedies for Soothing a Teething Baby

Soothe Baby Naturally
By Pam Gaulin

Nothing tugs at a parent's heartstrings more than hearing baby's painful cries when he or she is teething. There are some natural remedies that can be used to soothe a teething baby during the daytime hours.For some babies who experience most of their teething pain at night, parents may need to use stronger, medicinal remedies to help baby get some sleep while teething.During the daytime hours, babies who are drooling excessively, grabbing at their mouths, and trying to chew on everything in sight might need some relief for those emerging teeth.Some professionals claim that baby's very first teeth to come in are the most painful for baby. Parents may see a different situation. When the molars erupt, the baby can also experience pain that will keep him or her from a good night's sleep.These top 5 natural remedies are for soothing a teethign baby that does not have an accompanying fever of more an 101 degrees.

Top 5 Natural Remedies for Soothing a Teething Baby


Natural Teething Remedy 1: Teethers

Teethers come in all shapes and sizes. A useful and natural remedy for a teething baby is any liquid-filled teether that can be refrigerated for frozen. The cold temperature soothes and numbs baby's gums, without making a mess because the liquid is contained. This is best used for daytime relief.

Natural Teething Remedy 2: Frozen Bananas

For babies who are eating solid foods, and have already been introduced to fruit, a frozen banana does wonders. Take a banana and peel it. If you leave the peel on and then freeze it, you will not be able to peel it very easily. Cut the banana in half. Cut off the tips and remove the "stringy" pieces. Place the banana half in a freezer bag or other plastic bag.When the baby is experiencing teething pain during the day, take one of the half bananas out of the freezer and out of the plastic bag. Either hold the banana for the baby, or let him or her hold it and chew on it.The good thing about using a frozen banana is that the baby will be able to gum it and very small pieces of the banana will come off, not large chunks.

Natural Teething Remedy 3: Frozen Facecloth

Some parents swear by the frozen facecloth method. They freeze a facecloth or two and let the teething baby chew on it.

Natural Teething Remedy 4: Rub Ice on Gums

Rugging ice on the gums can be tricky depending on the size and shape of the ice cubes in your freezer. If you can find icicle-shaped ice cube trays, they will come in handy. Rub an ice cube on baby's gums. This provides very temporary relief, but it might be enough.

Natural Teething Remedy 5: All-Fruit Popsicles
For older babies and toddlers experiencing teething pain, all-fruit Popsicles can provide the same relief as rubbing ice on the gums. This method works for older children. The child may only take a few licks or sucks off the Popsicle. Brush baby's teeth when done.

Natural Teething Remedy 6: Gum Cleaner

Purchase a small rubber gum cleaner. The gum cleaner fits on your index finger. Parents can gently use the gum cleaner to massage baby's gums. It's also useful for applying medicine when needed.

Natural Teething Remedy 7: Chamomile Tea Bag

A cooled chamomile tea bag can be gently rubbed onto a baby's gums. Do not use this remedy if allergies run in the family, as some people with allergies cannot tolerate herbal teas. Also, do not leave the tea bag with the baby, as the tea bag can open or tear.

 ~~~~~

Monday, July 27, 2009

PENN SAYS: PUT DOWN THE KNIFE, STEP AWAY FROM THE BABY!

Penn Says:




In case you missed Penn & Teller's episode of Bullshit on Circumcision [contains 'adult' language]:

2 dozen nursing moms come to aid of baby boy in Marquette

July 26, 2009
A caring community gives a little guy a good start


By KRISTA JAHNKE


MARQUETTE -- Robbie Goodrich held his 6-month-old son, Moses, high above him Tuesday in a dining room filled with streaming morning sunlight. Moses smiled and kicked.

"You're hungry, aren't you?" he whispered. "You're excited to see Mama Carrie."

Mama Carrie is not Goodrich's wife, nor is she Moses' mother. She is one of about 25 women who either nurse or pump breast milk for Moses, trying to fill a small part of the hole created when his mother, 46-year-old Susan Goodrich, died 11 hours after giving birth in January.

The memory of that tragedy -- the result of an amniotic fluid embolism -- still brings tears to Goodrich's eyes.

"I've known grief," said Goodrich, 44, a professor of history at Northern Michigan University and also father to one of Susan's other three children, 2-year-old Julia. "I've lost a brother. My mom has died of Alzheimer's. Grief wasn't anything new. But this was different. This was despair. It was black. I really didn't know what to do."

Luckily, his community did.

'Don't leave that baby'

Goodrich wasn't with his wife, also a professor at NMU, when things started to go wrong at Marquette General Hospital. He was in the Neonatal Intensive Care Unit, where Moses was under observation after being born with the umbilical cord wrapped around his neck.

"She was very adamant. She said, 'Don't you leave that baby,' " he said.

Two hours later, with Moses doing well, a nurse told Goodrich his wife wasn't. In fact, she was about to be transferred to the intensive care unit. Soon, a doctor told Goodrich to prepare for the worst.

"I said, 'Could she die?' And they said, 'Yes, you have to prepare for the worst.' "

Susan fell into a coma as doctors tried to figure out what was wrong. They did exploratory surgery, worked on getting her blood clotted and even did an emergency hysterectomy. She stabilized and crashed three times. The fourth time was fatal.

Amniotic fluid embolisms are the fifth leading cause of maternal death in the United States, affecting about one in every 30,000 births. They end in death about 80% of the time.

And so Susan Goodrich, described as fiery and witty, a great conversationalist, died.

A life-changing call

The Goodriches were strongly pro-breastfeeding and, once Susan was gone, Robbie Goodrich had to figure out what to feed Moses.

The nurses ordered about $500 worth of milk (at $5 an ounce) from the Bronson Mother's Milk Bank in Kalamazoo. It wouldn't arrive for two days. In the meantime, Moses would have formula.

Then came a life-changing phone call.

Laura Janowski, a family friend, wanted to do something, anything, to help. She was a nursing mother herself, so she threw it out: Would Robbie like her to nurse Moses?

"She was very cautious and almost even apologetic in her call, and I know why," Goodrich said. "Because nursing someone else's baby in our country is not a normal sight. Heck, breastfeeding itself in public still gets people offended."

The offer was hardly offensive to Goodrich. In fact, he wondered whether other women would do the same. Susan's best friend, Nicoletta Fraire, 34, took on the challenge of making a team.

Through a breastfeeding support group, the Yooper Nursers, word spread quickly. Three days after Moses was born, the women began feeding him on a schedule.

Emotional investment

Most of the women were strangers before Susan died. That included 29-year-old Carrie Fiocchi, the first mother to nurse Moses. She had no reservations about nursing someone else's baby.

"I was like, 'I've got milk. Let's do it.' "

Each volunteer was also nursing her own child. But there was little worry about milk supplies.

"You make enough" milk, Sally Keskey said. "I just started drinking Mother's Milk a lot more. And I take fenugreek. I didn't even have to continue taking it. I just kept pumping."

Fiocchi, who nurses Moses at 9 a.m. every day, said she tried to stay detached, but it was impossible.

"I don't think of myself as his mom, but he's this little baby I see every day. I love him," she said, a sentiment each volunteer echoed. "He definitely feels like family."

That sense of community has been the unpredictable byproduct of a tragic situation. In the first six weeks, Goodrich said there was almost always a nursing mom in his home. Eventually, they came seven times a day. Now, it's five.

They often bring their own children, who romp around the house with Julia. And the women, who plan to nurse Moses until he's a year old, chat with Goodrich over tea and pastries.

"It's life-changing," said 20-year-old Keskey, who nursed Moses for two months. "I think the biggest thing is ... that people can do amazing things when they're open."

'Doing this for Susan'

Moses has grown to a solid 16 pounds, right in the middle of the growth charts. And the memory of Susan is ever-present.

"I kept thinking," Keskey said, "this is supposed to be Susan's job."

Another, 31-year-old Kyra Fillmore said, "I felt like I was doing this for Susan. ... It's really emotional. Because while it's nice to hold a newborn, I think to myself, 'It shouldn't be me.' "

Goodrich said he is not depressed, but he's always sad. He also knows how good he has it, in a sense.

His house is full of life. And his baby is a happy, babbling baldy with blue eyes and chubby thighs who is held and kissed and fed throughout the day by women who love him the best they can.

"The thing that I've come to appreciate the most is the nurturing aspect," Goodrich said. "It's the love. That's the most important thing. Maybe he would have been a happy child anyway. But he's held multiple hours throughout the day in a mother's arms. ... No one can tell me that's not just as important as the milk."

Contact KRISTA JAHNKE at 313-222-8854 or kjahnke@freepress.com

RELATED STORY: http://www.freep.com/article/20090726/FEATURES08/907260465">Robbie Goodrich: Why can't more babies be as lucky?

DISCUSS: http://detroit.momslikeme.com/members/JournalActions.aspx?g=190164&m=6550885&grpcat=Motherhood">Would you nurse another woman's baby? Go to detroit.momslikeme.com.

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