Tuesday, October 31, 2017

RESEARCH: Male Infant Circumcision Named a Possible SIDS Factor

Intactivists have always known that death is one of the risks of circumcision, much to the chagrin of circumcision advocates who always try to minimize it, if not completely pretend like it's not even there.

The problem with coming up with an accurate number for the risk factor of death from circumcision is that no one is counting, and people have incentive, financial, religious, cultural or otherwise, to keep from counting.

Financial Incentive
1.3 million babies are circumcised annually, and it brings a pretty penny to doctors who perform it, and hospitals who provide male infant circumcision as a service.

Doctors can charge anywhere from $400.00 to $700.00, maybe even more per head, and, at least in Alaska, hospitals can charge up to $2,000.00 in fees.

A malpractice lawsuit for a botch or death due to circumcision would not only cost doctors and hospitals millions, it could mean that respected medical organizations like the AAP would be compelled to condemn the practice, which is such a relatively simple procedure and an easy money maker.

Doctors and hospitals are not required to release this information, and it's not like medical organizations, some with a majority of members who profit from circumcision, are demanding it either.

To cover their tracks, doctors and hospitals may attribute the death caused by a circumcision to secondary causes, such as "hemorrhage" or "septic shock."

Additionally, parents who suffer guilt and regret for signing the consent forms are easily complicit in keeping their child's death under wraps.

"It's difficult to get a man to understand something, when his salary depends on his not understanding it." ~Upton Sinclair

Religious Conviction
Male infant circumcision is a closely safe-guarded possession in some religious communities, where the practice of male infant circumcision as a holy sacrament has been under attack for millennia.

Particularly in ultra-orthodox Jewish communities, members have been known to react with hostility when the practice and those who perform it come under scrutiny.

Particularly in New York, male infant circumcision as performed in ultra-orthodox Jewish community has been under the microscope after it has been discovered that mohels (ritual circumcisers) are spreading herpes to babies.

In ultra-orthodox Jewish circumcision, the ritual circumciser sucks the freshly circumcised child's penis directly with his mouth in a ritual procedure known as "metzitzah b'peh".

Some babies have died with herpes as the cause, and still many others have been infected.

When investigators have gone to find details, community members have been known to work together to protect the identities of those involved.

Fear of the Anti-Semite Card
As circumcision is the sensitive issue that it is, gathering data on adverse outcomes and effects of male infant circumcision could be ipso-facto be seen as "anti-Semitic" or "an attack on Judaism," so scientists and researchers may choose to ignore it in order to stay clear of controversy.

Instead of noting deaths and adverse outcomes, doctors and researchers may choose to say that circumcision is a "parental choice," shirking their onus of professional responsibility, and placing it on parents instead.

The recent publication of a research paper on Sudden Infant Death Syndrome (SIDS) factors in a medical journal might be a sign that times are changing, however.

Where No Researcher Has Gone Before
Whereas there have been a few attempts to come up with an estimate on deaths due to male infant circumcision, given the above factors, the numbers anyone can come up with are modest estimates at best.

And while most of these attempts merely attempt to count deaths due to circumcision,  in a recently published article, the authors make the bold move of going as far as to name male infant circumcision as a factor for SIDS.

Other factors, such as preterm birth, non-urgent pediatric surgeries and skin-breaking procedures are mentioned, but entire sections are dedicated to male infant circumcision.

I don't have the time to type a long, drawn-out post as I'd like to, so I'm just going to copy/paste relevant excerpts here.

From the abstract:
 We argue that the important characteristics of SIDS, namely male predominance (60:40), the significantly different SIDS rate among USA Hispanics (80% lower) compared to whites, 50% of cases occurring between 7.6 and 17.6 weeks after birth with only 10% after 24.7 weeks, and seasonal variation with most cases occurring during winter, are all associated with common environmental stressors, such as neonatal circumcision and seasonal illnesses.
From "Background"
Neonatal Circumcision
In North America, ~1.2 million male infants are circumcised every year (58) often within the first 2 days of life (59). Although not requiring general anesthesia, circumcision is an intensively painful procedure requiring adequate analgesia (60). Circumcision is associated with intraoperative and postoperative risks, including bleeding, shock, sepsis, circulatory shock, and hemorrhage (6163) that can result in death (63, 64).
This part of the paper doesn't hold back and outright names the known risks and complications, complete with citations.

Infant deaths following religious neonatal circumcision have been known for at least two millennia (65). Talmud (the central text of Rabbinic Judaism) sages ruled in the first centuries A.D. that mothers with two children who have died following the surgery should receive an exemption from circumcising their infants. During the nineteenth century, developments in medical knowledge on one hand and the rise of Jewish “Enlightenment” on the other hand, brought many Jews to reject the authority of the Talmud and with that the practice of circumcision. A new wave of accusations toward Jewish circumcisers (mohels) and rabbis of infant deaths following circumcision soon appeared and prompted community leaders to appeal to the governing authorities to forbid this practice – efforts that were countered by rabbis’ threats to ban the admission of uncircumcised Jewish children from Jewish schools. The fierce arguments about the necessity of the procedure last to this day and led many Jews to opt their infants out of the procedure, including Theodor Herzl, one of the fathers of modern political Zionism (66).

Here, the authors don't shy away from talking about Judaism and death due to circumcision, even ritual circumcision as recorded in Jewish texts.

This is important, because often, Jewish advocates of circumcision like to say how much "safer" male infant circumcision is when a Jewish practitioner performs it.

Here we see that death due to circumcision is documented, and that children die, even when mohels are the ones performing it.

In the UK, Gairdner (67) estimated an annual rate of 16 per 100,000 circumcision-associated deaths for boys under 1-year old in a study that influenced the British government to exclude circumcision coverage from the National Health Service. Remarkably, the SIDS rates in the UK (0.38 per 1000) are much lower than in the USA (0.55 per 1000) (10) where most male infants are circumcised (58). Moreover, most of the deaths in the USA occur in non-Hispanic blacks (83% higher death rate compared with non-Hispanic whites). SIDS rates were 44% lower for Hispanics compared with non-Hispanic whites (68). Interestingly the circumcision rates among Hispanics are about half that of the two other groups (69).

Interesting observations!

This section goes into a lot more detail that I really don't have time to get into here (for this I encourage my readers to go read the paper itself right here), but I feel this last section warrants copy/pasting:

To date, circumcision in the USA, despite being the most common pediatric surgery, has not been subjected to the same systematic scientific scrutiny looking at immediate and delayed adverse effects, including pain [e.g., Ref. (112)], nor has circumcision status been included as part of a thorough SIDS investigation/registry or analyses [e.g., Ref. (2)] in spite of the male predominance of both neonatal circumcision and SIDS. However, based on assessment of risk of harms versus benefit, despite the latter including decreased risk of urinary tract infection (113), the Royal Australasian College of Physicians, the British Medical Association, the Canadian Paediatric Society (87), and several west European medical societies have recommended against routine neonatal circumcision (114), arguing that the benefits of circumcision to children are minimal, non-existent, or outweighed by the risks, and that circumcision is thereby unwarranted. The AAP’s recommendation in favor of this routine (115) has been widely criticized [e.g., Ref. (116)].

This reiterates what I have been saying on my blog all along; at least in the US, no one wants to look at the adverse affects of circumcision and document them. Circumcision is often ignored as a factor in many studies.

We intactivists have been saying it all along, but there is not a single respected medical organization in the West that recommends male infant circumcision based on the current body of medical literature.

The author seems to be oblivious of the fact that the AAP didn't actually recommend male infant circumcision in their 2012 statement, instead saying that "the benefits are not great enough" to recommend male infant circumcision, and shirking professional responsibility on parents instead.

Before concluding, the authors make the three following testable predictions:
  1. Neonatal Circumcision is a Risk Factor for SIDS
  2. Neonatal Circumcision Accounts for a Large Fraction of the Gender Bias in SIDS
  3. Circumcised Premature Infants are at High Risk
It's one thing to come up with a hypothesis and make predictions, and it's quite another to test it to see if the predictions are accurate or not.

Something tells me that there is still going to be some time before researchers actually go through testing this hypothesis, as they may yet feel inhibited by the implications of doing so.

No doubt there are going to be circumcision advocates that are already trying to attack this paper any which way possible, but I hope that the publication of this paper is only the beginning, and that more and more scientists get bold about calling out the elephant in the room that is circumcision, and about going through with testing hypotheses such as this one, and going through with publishing their collected data for all to see.

List of Deaths and Complications Documented on This Blog:
FACEBOOK: Another Baby Fighting For His Life Post Circumcision

MADERA, CA: Another Circumcision Complication

CIRCUMCISION BOTCH: Another Post-Circumcision Hemorrhage Case Surfaces on Facebook

LAW SUIT: Child Loses "Significant Portion" of Penis During Circumcision

CIRCUMCISION BOTCHES: Colombia and Malaysia


FACEBOOK: KENTUCKY - Botched Circumcision Gives Newborn Severe UTI

FACEBOOK: Circumcision Sends Another Child to NICU - This Time in LA

GEORGIA: Circumcision Sends a Baby to the NICU


FACEBOOK NEWS FEED: A Complication and a Death

INTACTIVISTS: Why We Concern Ourselves


CIRCUMCISION: Another Baby Dies

CIRCUMCISION DEATH: Yet Another One (I Hate Writing These)

Another Circumcision Death Comes to Light

CIRCUMCISION DEATH: Yes, Another One - This Time in Israel

FACEBOOK: Two Botches and a Death

CIRCUMCISION DEATH: Child Dies After Doctor Convinces Ontario Couple to Circumcise


Joseph4GI: The Circumcision Blame Game

Phony Phimosis: How American Doctors Get Away With Medical Fraud

FACEBOOK: Two More Babies Nearly Succumb to Post Circumcision Hemorrhage

FACEBOOK: Another Circumcision Mishap - Baby Hemorrhaging After Circumcision

What Your Dr. Doesn't Know Could Hurt Your Child

FACEBOOK: Child in NICU After Lung Collapses During Circumcision

EMIRATES: Circumcision Claims Another Life

BabyCenter Keeping US Parents In the Dark About Circumcision

DOMINICAN REPUBLIC: Circumcision Claims Another Life

TEXAS: 'Nother Circumcision Botch

New York Herpes Circumcision Problem:
NYC: More Herpes Circumcision Cases Since de Blasio Lifted Metzitzah B'Peh Regulations

BUSTED: Agudath Israel of America's Antics Revealed

NEW STUDY: Ultra-Orthodox Mohels Don't Give Babies Herpes

NEW YORK: Two More Herpes Babies, One With HIV

NEW YORK: Metzitzah: Two mohelim stopped after babies get herpes

NEW YORK: Yet Another Herpes Baby

Rabbis Delay NYC's Metzitzah B'Peh Regulations - Meanwhile, in Israel...

While PACE Holds a Hearing on Circumcision, Another Baby Contracts Herpes in NYC

Israel Ahead of New York in Recommending Against Metzitzah B'Peh

New York: Oral Mohel Tests Positive for Herpes

Herpes Circumcision Babies: Another One? Geez!

Mohels Spreading Herpes: New York Looks the Other Way

Circumcision Indicted in Yet Another Death: Rabbis and Mohels are "Upset"

Related Posts:
Politically Correct Research: When Science, Morals and Political Agendas Collide

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