[Breastfeeding after male neonatal circumcision]

Leaven: Page 78, Sep-Oct 1994.

A recent study of the use of acetaminophen to control pain after circumcision drew attention to yet another factor that may adversely affect getting breastfeeding off to a good start. The feeding behavior of both breastfed and formula-fed infants deteriorated in the hours after surgery, regardless of whether acetaminophen was administered.

The observed deterioration in ability to breastfeed may potentially contribute to breastfeeding failure. Furthermore, some neonates in this study required formula supplementation because of maternal frustration with attempts at breastfeeding or because the neonate was judged unable to feed postoperatively. This finding is disconcerting because early formula supplementation is associated with decreased breastfeeding duration, the study's authors commented.

Unquestionably, many babies are circumcised and go on to breastfeed without difficulty. But for some, the pain after circumcision may cause just enough disruption to interfere with the breastfeeding relationship. When a Leader is contacted by a mother whose male infant is having difficulties with breastfeeding, it may be appropriate to ask about circumcision. If the mother understands that there could be a legitimate cause for her baby's fussiness, and the fussiness is temporary, she may be able to persist with breastfeeding a little longer.

This study can be mentioned if the subject of circumcision is brought up by a mother at a meeting. It can be appropriate in a discussion of how the choices parents make about the birth experience can affect breastfeeding in the early days. Care should be taken to avoid a protracted discussion of circumcision, which is beyond the appropriate scope of an LLL meeting and may be a religious choice for some parents.

The Leader's goal is to show that events in the baby's life in the early days can have positive and negative effects on breastfeeding and to encourage mothers to learn about their options.

References

  1. Howard CR, Howard FM, and Weitzman ML. Acetaminophen analgesia in neonatal circumcision: the effect on pain. Pediatrics 1994; 93(4): 641-46.

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