Notes on Care

NOTES ON THE CARE OF UNCIRCUMCISED INFANTS

by Jeffrey R. Wood

    (The following is copied from an article on circumcision that was written by Grame Hutchings, FRCS, which originally appeared in the New Zealand Family Doctor and was later reprinted in the November, 1964 Bulletin of the Federation of N. Z. Parents’ Centres.)

A lot of people know that when a baby is born the prepuce (foreskin) is nearly always stuck to the glans so that it is somewhat difficult to pull the prepuce back. They therefore get a bit worried and think the end of the prepuce is likely to cause some obstruction to the flow of urine from the urethra.

It is, however, quite normal for the prepuce to be rather stuck to the glans at birth. In fact, when the glans and prepuce are first formed in the embryo they are completely stuck together. Then slowly and quite gradually little spaces appear between them here and there. The spaces get bigger and join up with one another until the prepuce becomes quite separate from the glans and can be pulled back from it. In other words it is “retractile”. As a rule this process is incomplete at birth but is usually complete at about the age of three.

Gairdner found that about 96 per cent of newborn males had a non-retractile prepuce, but by the age of three years only 10 per cent were non-retractile. So, if your baby’s prepuce is non-retractile, forget about it for the time being. Ten to one it will right itself by the age of three.

Another thing that often worries parents is the rather swollen red area which some babies develop on the end of the prepuce. Their natural reaction is to think that the best method of dealing with it is to have circumcision performed to get rid of the whole prepuce. However, this condition of a red swollen prepuce is, in fact, a very good reason for not having the operation done.

One of the main constituents of urine is a substance known as urea. Certain germs from the bowel can alter urea to form ammonia, and the red area I have mentioned is really a small burn caused by the action of ammonia which is usually the result of a wet and dirty napkin (diaper). If circumcision is performed, the ammonia now can burn the meatus (urethral orifice) instead of the prepuce and thus produce a small ulcer. When this ulcer heals a tiny scar forms, resulting in a slight constriction at the meatus.

Indeed the calibre of the urinary meatus in 100 intact (non-circumcised) men has been compared with that of 100 men who were circumcised in infancy, and was found to be greater in the former group. Any constriction of the urethra, whether at the meatus or elsewhere, is something to be avoided, if possible, as it may lead to obstruction to the entire “waterworks system”.

The logical treatment of such an ammonia burn is not to circumcise the child, but to attack the cause, i. e., the ammonia itself. There are two simple ways of doing this. First, the germ which acts on the urea flourishes in an alkaline medium rather than an acid one. The motions in a baby tend to be acid in the breast-fed, alkaline in the bottle-fed. Breast-feeding should thus be encouraged apart from all the other reasons in favour of it. Secondly, napkins (cloth diapers) should be rinsed several times in water to remove the soap (which is alkaline). (Another idea that has been suggested is the use of disposable diapers. —Ed.)

Excerpt from The Canadian Medical Association Journal, January 28, 1967:

What has been largely missing in North American literature is information on the proper care of the foreskin in babies and young children. This lack of information has in fact produced complications in intact (non-circumcised) children which are unfortunately due to ignorance rather than lack of circumcision. Since the foreskin is normally not retractable in babies, it is not necessary for the mother to do anything at all about it. To quote Dr. Illingworth in the Family Doctor booklet, Common Ailments in Babies, published by the British Medical Association: “Don’t try to draw back the baby’s foreskin. It is not usually ready to come back in the first few months or year or 2 of life. Leave it alone till he is at least 2 years old.” The same author in The Normal Child states “Every casualty department is well used to seeing babies with paraphimosis, which results from the mother’s efforts to retract the foreskin on someone’s wrong advice.”

Since the young child is able to bathe himself (if given the chance) by the age of 4 or 5, retraction of the foreskin can be put off until the child is old enough to take care of it himself, in the same way that girls gradually learn to take care of personal hygiene. Even in older children the matter is not of great urgency from a medical standpoint.

T.D. Swafford, M.D.
Group Health Medical Center
Seattle, WA

“I am in favor of leaving the penis alone. Pediatric opinion is swinging away from routine circumcision as unnecessary and at least mildly dangerous. I also believe that there is potential danger of emotional harm resulting from the operation. Parents should insist on convincing reasons for circumcision, and there are no convincing reasons that I know of.”

Benjamin Spock, M.D.
(Moneysworth, March 29, 1976)

“In the United States only the children of very well educated parents escape neonatal circumcision. Let us hope that further enlightenment of parents and doctors will spare many more boys the ordeal of this amputation.”

C. J. Falliers, M.D.
(Journal of the AMA, December 21, 1970

“If I had to explain in a single word why I would not allow a newborn son of mine to be circumcised, the word would be conscience. In a matter as personal and controversial as this, I would simply want him to be able to make his own decision when mature enough to do so intelligently. What is so hard for many to face is that the vast majority of those given a choice decide against this surgery, instinctively favoring the natural state.”

Jeffrey R. Wood
Founder of INTACT (now defunct)

WHAT THEY SAY

( Compiled by Jeffrey R. Wood  in 1976.)

    Since its inception in the Fall of 1976 INTACT has received a lot of mail — mostly requests for the information we offer, but aside from that, more than a few people have gone out of their way to express deeply personal feelings that question, if not condemn the practice of routine circumcision. It is as if our existence has provided for the first time an opportunity to express thoughts on a heretofore taboo subject in American culture. Thus we have gradually amassed a substantial body of material that stands as a unique commentary on one small, highly symbolic and too often ignored aspect of the confused age in which we live. The inspiration provided to INTACT by these unsolicited remarks is well worth sharing, and to this end we have selected for reproduction below some excerpts of outstanding significance from the letters we’ve received. Sometimes gratifying, too often tragic and occasionally amusing, the remarks that follow through their publication, hopefully will further awaken America to the issue at hand.

“… When my wife was pregnant the OB-GYN people would not listen to her when she insisted that if it were a boy we would not tolerate his being circumcised under any circumstances The doctor stopped badgering her only when I spoke to him and told him that I would take him to court and sue him if there were the slightest ‘slip-up’ and he were “accidentally” circumcised. When she was admitted to the hospital I wrote boldly on the admission slip that I would sue the hospital if my child were a boy and they permitted him to be circumcised. My child was a girl.”
W C., New Jersey

“I am the mother of a nine year old intact (non-circumcised) boy, and we have gotten some flak from relatives, friends and strangers, but my son is totally grateful that we left him “like God made him…”
L. C., Colorado

“…As one who was circumcised as a child I wish someone had put in a kind word for me when my parents were making up their minds. I will certainly do so for others in the hopes of sparing someone the trauma this has been to me…”
G. W. California

“From my own experience with four sons ages 4 to 20, I think one of the most critical matters is to stop solicitation of parents for circumcision. Even as a doctor, we had to be subjected to the humiliation of the circumcision pitch. I regard it as highly insulting and detrimental to the well-being of my wife and children. Why should we have to put up with something so degrading and so deeply contrary to our moral philosophy, to be asked to subject our children to a brutal and unnecessary operation! Regardless of what you do, you are presented with the circumcision form! It makes me sick every time I think of it! Hospitals and doctors have no right to do this …”
D. S. (MD), State of Washington

“My wife and I have initiated legal action for the unauthorized circumcision of our son. Somehow in the hospital procedures, it was routinely done The hospital has admitted a battery has been committed, but they claim the boy has suffered no damages My wife and I have also filed suit for mental suffering. It is good to know that I am not alone in my strong feelings regarding the routine practice of circumcision.”
R. E., Hawaii

“… I firmly believe that people should be able to participate in making important decisions that affect their own lives whenever possible. Of course, some decisions must be made for children without their initial participation, such as vaccination against polio, smallpox, or teaching them the native language of their area. But the circumcision decision can in almost every case be postponed with no bad consequences until a male has grown old enough to weigh the alternative values for himself, and participate in making that decision for himself. I was robbed of that right to decide for myself….”
J. B., Indiana

“… I feel circumcision is a subject given too little attention; they do it for a number of reasons, none of them good. Phase keep up the good work of educating an ignorant public….”
G. K., California

“… A shining light has been one of my former secretaries who refused to let her two boys be circumcised. They are 8 and 4 now and delighted to see they aren’t like the others….”
C. S., Michigan

“… I was successfully “restored” through plastic surgery to being uncircumcised. The return of sensitivity week by week incensed my awareness of the incredible butchery this country performs.”
R. H., New Mexico

“… I am not circumcised but my two sons are — routine at birth. I would like to advise them so that they don’t commit the same error that I did …”
P., Pennsylvania

“… I shall always be grateful to my father for insisting his sons remain intact even though he had been circumcised…”
R. O., Massachusetts

“… I believe that a foreskin is a beautiful, natural and healthy part of the normal male anatomy, and efforts to mutilate and amputate it are repugnant to me…”
T. B., Minnesota

“… I was recently informed that yours is a society to uphold the dignity of the male body and was pleased to know that someone has begun a campaign against this unnecessary and mutilating custom. I commend you on the use of the word intact rather than uncircumcised. The connotation is so much more positive …”
J. S., Ohio

“… Being firmly opposed to routine circumcision, I am continuously horrified by its almost national character, tacit acceptance, and general ignorance of the subject on the part of most Americans Perhaps most upsetting is the role media plays in continuing this hoax….”
R. G., Florida

“…. I want to congratulate you for your efforts in this monumental struggle in which we are engaged. That sounds a little pompous, I know, but every time I think of Dear Abby and Ann Landers and the millions of people they reach with just one of their pro-circumcision columns, I can’t help but compare that with the relatively few people we can reach. But that doesn’t mean that we shouldn’t fight as hard as possible. We will eventually win the war, there’s no doubt about that….”
N. C., California

(Originally compiled by Jeffrey R. Wood in 1976)

Distributed and put on website by Peaceful Beginnings

Revised and updated – 2013