Advertisement

How does circumcision performed under regional anesthesia affect sleep, feeding, and maternal attachment in babies aged 0–4 months?

      Highlights

      • What is known.
      • Circumcision may affect feeding and sleeping habits in newborns and infants.
      • What is new.
      • This prospective study is the first to simultaneously evaluate the effects of circumcision on feeding, sleeping habits, and maternal attachment in newborns and infants.
      • The negative effects of circumcision on feeding, sleeping habits, and maternal attachment in newborns and infants could not be determined.

      Abstract

      Background

      There is no consensus whether circumcision performed in the first months of life has negative effects on feeding, sleep, and maternal attachment in babies. This prospective study aimed to investigate this relation in the first months of life. This study is the first to investigate the effects of circumcision on feeding, sleep, and maternal attachment simultaneously.

      Methods

      The study group consisted of 75 families with their babies aged 0–4 months. Surgical circumcision procedure under regional anesthesia was applied to all patients. The questionnaires were used to evaluate the babies’ feeding and sleeping habits, and the Maternal Attachment Inventory (MAI) was used to assess mother-baby attachment level. All assessments were performed before and one month after the circumcision.

      Results

      The mean age of the patients when circumcision was performed was 75 (74.52 ± 37.03) (3–120) days. The mean ages of mothers were 32 (32.51 ± 4.05) years. There was no statistically significant change in the sleep habits and feeding status of babies before and after circumcision. The mean maternal attachment value before circumcision was 101 (98.89 ± 6.77) points, while it was 103 (101.36 ± 4.21) points after circumcision. This result indicates that the maternal attachment score increased significantly after circumcision (p < 0.001).

      Conclusions

      The circumcision performed under regional anesthesia between 0 and 4 months did not have any negative effect on sleep, feeding, and maternal attachment in babies.

      Keywords

      Abbreviations:

      MA (Maternal attachment), MAI (Maternal Attachment Inventory)
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Journal of Pediatric Surgery
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Morris B.J.
        • Wamai R.G.
        • Henebeng E.B.
        • et al.
        Erratum to: estimation of country-specific and global prevalence of male circumcision.
        Popul Health Metr. 2016; 14 (Erratum in: Popul Health Metr. 2016;14:11)https://doi.org/10.1186/s12963-016-0080-6
        • BT Many
        • Rizeq Y.K.
        • Vacek J.
        • et al.
        A contemporary snapshot of circumcision in US children's hospitals.
        J Pediatr Surg. 2020; 55: 1134-1138https://doi.org/10.1016/j.jpedsurg.2020.02.031
      1. American Academy of Pediatrics task force on circumcision. Male circumcision.
        Pediatrics. 2012; 130: e756-e785https://doi.org/10.1542/peds.2012-1990
        • Lander J.
        • Brady-Fryer B.
        • Metcalfe J.B.
        • et al.
        Comparison of ring block, dorsal penile nerve block, and topical anesthesia for neonatal circumcision: a randomized controlled trial.
        JAMA. 1997; 278: 2157-2162https://doi.org/10.1001/jama.1997.03550240047032
        • Boyle G.J.
        • Goldman R.
        • Svoboda J.S.
        • et al.
        Male circumcision: pain, trauma and psychosexual sequelae.
        J Health Psychol. 2002; 7: 329-343https://doi.org/10.1177/135910530200700310
        • American Academy of Pediatrics
        Report of the task force on circumcision.
        Pediatrics. 1989; 84 (388–91. Erratum in: Pediatrics. 1989;84:761)
        • Marshall R.E.
        • Stratton W.C.
        • Moore J.A.
        • et al.
        Circumcision I: effects upon newborn behavior.
        Infant Behav Dev. 1980; 3: 1-14https://doi.org/10.1016/S0163-6383(80)80003-8
        • Anders T.F.
        • Chalemian R.J.
        The effects of circumcision on sleep-wake states in human neonates.
        Psychosom Med. 1974; 36: 174-179https://doi.org/10.1097/00006842-197403000-00009
        • Müller M.E.
        A questionnaire to measure mother-to-infant attachment.
        J Nurs Meas. 1994; 2: 129-141https://doi.org/10.1891/1061-3749.2.2.129
        • Müller M.E.
        Prenatal and postnatal attachment: a modest correlation.
        J Obstet Gynecol Neonatal Nurs. 1996; 25: 161-166https://doi.org/10.1111/j.1552-6909.1996.tb02420.x
        • Kavlak O.
        • Şirin A.
        The Turkish version of Maternal attachment Inventory.
        J Hum Sci. 2009; 6: 188-202
        • Sharara-Chami R.
        • Lakissian Z.
        • Charafeddine L.
        • et al.
        Erratum to: combination analgesia for neonatal circumcision: a randomized controlled trial.
        Pediatrics. 2017; 140 (https://doi.org/10.1542/peds.2017-1935. Pediatrics. 2018; 141:e20180500. https://doi.org/10.1542/peds.2018-0500)e20171935
        • Anand K.J.
        • Brown M.J.
        • Causon R.C.
        • et al.
        Can the human neonate mount an endocrine and metabolic response to surgery?.
        J Pediatr Surg. 1985; 20: 41-48https://doi.org/10.1016/s0022-3468(85)80390-0
      2. Circumcision Information and Resource Pages.circumcision vs. child Health, Breastfeeding and Maternal Bonding; 2005. Available from: http://www.cirp.org/library/birth. Accessed 28 Jul 2006.

        • Marshall R.E.
        • Porter F.L.
        • Rogers A.G.
        • et al.
        Circumcision: II. Effects upon mother-infant interaction.
        Early Hum Dev. 1982; 7: 367-374https://doi.org/10.1016/0378-3782(82)90038-x
        • Dixon S.
        • Snyder J.
        • Holve R.
        • et al.
        Behavioral effects of circumcision with and without anesthesia.
        J Dev Behav Pediatr. 1984; 5: 246-250https://doi.org/10.1097/00004703-198410000-00004
        • Fergusson D.M.
        • Boden J.M.
        • Horwood L.J.
        Neonatal circumcision: effects on breastfeeding and outcomes associated with breastfeeding.
        J Paediatr Child Health. 2008; 44: 44-49https://doi.org/10.1111/j.1440-1754.2007.01202.x
        • Gattari T.B.
        • Bedway A.R.
        • Drongowski R.
        • et al.
        Neonatal circumcision: is feeding behavior altered?.
        Hosp Pediatr. 2013; 3: 362-365https://doi.org/10.1542/hpeds.2012-0082
        • Hill G.
        Breastfeeding must be given priority over circumcision.
        J Hum Lact. 2003; 19: 21
        • Lee N.
        Circumcision and breastfeeding.
        J Hum Lact. 2000; 16: 295
        • O'Mara P.
        Circumcision: the rest of the story.
        Mothering Magazine, Santa Fe, NM1993
        • Kaplan H.I.
        • Sadock B.J.
        • Grebb J.A.
        Kaplan and Sadock's synopsis of psychiatry: behavioral science and clinical psychiatry.
        7th ed. Williams & Wilkins, Baltimore1994: 161-165
        • Ainsworth M.D.S.
        • Blehar M.C.
        • Waters E.
        • et al.
        Patterns of attachment: a psychological study of the strange situation.
        Psychology Press, London2015