In the RACPs statement on Breastfeeding they recommend that:
- Where appropriate, they should encourage the development of local practice guidelines, in particular the introduction of the Baby Friendly Hospital Initiative and the Baby Friendly Community Initiative, which increase the chance of successful breastfeeding.
- Peadiatricians should encourage the critical evaluation at each step in health care during pregnancy, the intra-partum and postnatal periods, to determine any factors which may benefit or hinder the establishment of successful breastfeeding and refer women to expert help as needed. 1
When routine infant circumcision (RIC) takes place the baby is taken away from the mother, put through a very painful cosmetic procedure with minimal pain medication then handed back to the parents once he has been all cleaned up. If circumcision is done in the days following his birth this then impedes on the Baby Friendly Hospital Initiative ‘Step 7: Practice rooming-in – allow mothers and infants to remain together – 24 hours a day.’2 How? Circumcision can take from (on average) 20 minutes – 45 minutes. This is precious time that the baby could have spent doing skin-to-skin contact with his mother or father.
In regards to the second recommendation listed above Paediatricians will not always inform parents that circumcision can have a negative impact on breastfeeding. This can then cause parents to overlook the effects it may have on their child and choose to circumcise without being fully informed.
So how does RIC impact breastfeeding?
It is a known fact that trauma can affect anyone and everyone in one way or another. Babies are no exception to this as the La Leche Leauge International (LLLI) was aware of this back in the late 1950’s. They had Circumcision included in one of their earlier books and mothers would learn that RIC is painful and unnecessary, an optional surgery that does not have to be done, even if it is chosen it can be done later so that it does not interfere with breastfeeding, can harm bonding between both the mother and baby and they also offered further academic resources for parents to read.3
Trauma is real, especially when babies are put through levels of pain that could be labeled as inhumane4. For an infant to go through such pain he (or she) would go into shock, a semi-comatose state. After the circumcision, the baby may sleep (or seem lethargic) for several hours, days or in some cases weeks which is much more than normal as the body attempts to heal itself, as well as dealing with the pain of the wound that has been left and the post-traumatic stress.
Due to the baby’s lethargic or sleepy ways he will not nurse as often which can cause the mother to experience supply issues which can then lead to mastitis. He may not want to latch on anymore or appear to be too tired to latch properly and so a bottle is given. This again can impact on the mothers supply as some do not respond well or at all to a breast pump or hand expressing. Another side effect is that the baby may develop severe colic (that he otherwise would not have had) for an extended amount of time and he may need to be put on formula specifically made for infants with colic5. This would then end the breastfeeding relationship.