Making The Cut
The circumcision debate
By Dana Podracky
For the parents of baby boys, the decision to circumcise often requires sifting through a myriad of medical, cultural and religious implications. By learning more about the procedure and the controversy surrounding it, parents will be able to make the decision that is best for their son’s future health and happiness.
What is Circumcision?
When males are born, the skin covering the shaft of the penis extends downward forming a double-layer fold called the foreskin. In adult males, it comprises roughly one-third to one-half of all the skin covering the penis. Circumcision is the surgical removal of this skin.
Circumcision became popular in the United States in the 1920s and was promoted as a way to curb sexual desires, specifically masturbation, which doctors mistakenly linked to a host of diseases like polio and tuberculosis. The procedure gained momentum through the 1900s, peaking at 79% in the early 2000s, before beginning a gradual decline to the current rate of 56%. Worldwide rates stand at around 30%.
Benefits –vs- Risks
The benefits and risks of circumcision are hotly debated within the medical community. According to the American Academy of Pediatrics (AAP) the benefits of routine-infant circumcision include a reduction of urinary tract infections (UTIs) in the first year of life, a lower risk of contracting sexually transmitted diseases for both men and women, and a reduced risk of penile cancer.
Researchers who oppose these claims assert that the studies are methodologically flawed. For example, studies linking circumcision with lower rates of STDs were conducted in sub-Sahara Africa among homosexual populations. In the United States where contraction occurs most among homosexual males or through the use of contaminated needles, there was no correlation between STD rates and circumcision. Additionally, doctors point out that both UTIs, easily treated with an antibiotic, and penile cancer are rare. Prevention should focus on proper hygiene and safe sex practices instead of the removal of healthy genital tissue.
The medical risks of circumcision are uncommon and generally short-lived. They include bleeding, infection, and irritation from exposure. More serious risks like damaging the urethra or amputation of the tip of the penis are even less likely and can be greatly reduced by having the procedure performed under the use of a local anesthetic by a trained doctor.
Beyond the physical risks, doctors who oppose the procedure assert that circumcision ignores the important physical and sexual functions of the foreskin. For example, the foreskin serves important lubricating functions during sex and reduces the risk of erectile dysfunction disorder. Other doctors cite psychological distress in both infants and adults as a reason to forgo the procedure.
Presently, the AAP states that the benefits outweigh the risks, but not enough to recommend routine infant circumcision. In many other countries, circumcision is viewed as medically unnecessary. The Central Union for Child Welfare in Finland goes so far as to call it a “violation of personal integrity” and ruled it unlawful in 2006.
When Culture and Ethics Collide
Maintaining religious tradition or cultural norms often influence parents’ decisions. Sometimes circumcised fathers do not want their sons to look different than them. Many cite fear of bullying and aesthetic preferences as reasons. Critics point out that this logic is superficial and not sufficient to perform an unnecessary procedure on a child unable to provide consent. Those most vehemently opposed compare circumcision to female genital mutilation.
As a parent it is your job to weigh the benefits and risks, consider the cultural implications and ethics, then make the best possible decision for your child.
Soothing Your Baby's Colic Symptoms
Ways to help your crying baby
by Roshan Kaderali
Crying is a baby’s way of getting our attention for a variety of reasons. When the crying becomes excessive and lasts for longer than three hours a day, however, this may be a sign that you have a colicky baby on your hands. When dealing with colic, mothers suffer just as much as their little ones; calming a seemingly inconsolable infant can be frustrating, and mothers will do anything to soothe symptoms, even if it means staying up all hours of the night. Whether you are new to motherhood or you are already a mother of four, it can be hard to know exactly what to do when colic strikes. Luckily, there are some easy solutions to help ease your baby’s pain and discomfort, and to help bring bliss back into your home!
White noise: Sometimes, all it takes to soothe a colicky infant is a little bit of white noise. The most popular white noise used to relax a baby during colicky periods is the vacuum; however a white noise machine, a recorded heartbeat, the sound of theshower or other household appliances have also been effective.
Massage and swaddle: Some soothing contact can change a baby’s whole mood. Try massaging them gently, or wrapping them tightly in a blanket to provide a safe, relaxing environment similar to the snug feeling your baby was used to inside the womb. Likewise, holding the baby will provide a similar feeling, and if one position does not work, try shifting to another.
Ease a gassy tummy: Colicky babies tend to swallow air while crying, which can result in painful gassiness. Try a natural supplement, gripe water or anti-gas drops containing herbs such as ginger, dill or fennel, which settle the stomach and help relax cramping muscles, while also being safe for your baby.
Keep an eye on your baby’s diet: Intolerance to certain foods or ingredients may upset your baby and cause tummy troubles as well. If you are breastfeeding, try switching out certain foods from your diet to see how your baby reacts. If your baby is on formula, it may be beneficial to switch to one with different ingredients – just be sure to talk to your baby’s doctor before making any significant dietary changes.
Roshan Kaderali was a Registered Nurse, Certified Nurse Midwife, Certified Lactation Educator, and is now the founder of Mommy’s Bliss. Working with an FDA-registered current good manufacturing practice laboratory, she developed the first all-natural gripe water for the market in America.
The Baby Blues
An unexpected outcome of childbirth
By Erin Marsh
Having a baby is an incredibly draining experience for a woman, both physically and emotionally. After childbirth, the body changes rapidly. Hormone levels drop and the body begins to repair itself, whether from a vaginal birth or a caesarean. Add to that the new responsibilities and pressures of having a newborn, plus the exhaustion of little to no sleep, and it’s no surprise that many women experience negative emotions after the joyous birth of a baby.
People often confuse the “baby blues” with postpartum depression, even using the two terms interchangeably. The baby blues are the least severe form of postpartum depression (PPD) and typically only last a few days to a week or two. Some of the signs and symptoms include inexplicable sadness, mood swings, anxiety, impatience, irritability, weepiness, poor concentration, and trouble sleeping (even when baby is sleeping). Postpartum depression, on the other hand, persists over time and includes more intense symptoms: insomnia, loss of appetite, fierce irritability/anger, extreme exhaustion, loss of interest in things that previously brought joy, severe mood swings, feelings of shame or guilt, withdrawal from family and friends, and difficulty bonding with baby.
I know from experience that the signs and symptoms of baby blues/PPD don’t always neatly fit into one category. After the birth of my first child, I experienced the baby blues, but my symptoms did not improve in a couple of weeks as expected. Thankfully, I had no trouble bonding with my son, but my uncontrollable mood swings, fits of crying, poor concentration, difficulty sleeping, and general sadness were overwhelming. My OB/GYN prescribed me a low-dose antidepressant, assuring me it was safe while nursing, but I was hesitant to take it nonetheless. I worked on improving my mood the best way I knew how: I started exercising again, continued healthy eating, and enlisted the help of my husband with nighttime feedings so that I wasn’t waking every 2 hours all night, every night. It took a couple of additional months, but finally my mood stabilized. For me, I know it was a combination of hormonal changes, lack of sleep, and stress over being a first-time mom. I’m hoping that after the birth of my second, I won’t encounter the same issues, but at least this time I know that the mild depression will subside over time.
Trimester by Trimester
What to expect during pregnancy
by Erin Marsh
First Trimester: Weeks 1-13
What to expect: Each woman’s pregnancy is markedly different, so the first trimester of pregnancy will vary, but because the first trimester is a time of rapid growth and extreme hormonal changes, many women experience nausea and fatigue. If this is your second pregnancy, Dr. Bob DeRosa, MD with Sunforest OB-GYN, advises, “The second pregnancy is harder than the first because you already have a kid. The first pregnancy is all about you; if you’re tired, you can go home and rest. You can’t do that with number two because your focus is on the first child.” Some common signs of early pregnancy include breast tenderness, hormonal shifts, change in frequency and/or color of urination, light implantation bleeding/cramping, nausea/vomiting, and strong food aversions. Dr. DeRosa adds, “And cravings–strange cravings.”
Baby’s development: The fertilized egg grows into a microscopic ball of cells (blastocyst), which implants on the wall of the uterus (this implantation can sometimes cause light bleeding and/or cramping). The third through eighth weeks of growth are called the “embryonic stage,” and the embryo develops most major organs. By the ninth week, the embryo becomes a fetus and is a little more than one inch. The first trimester is a time of rapid growth and amazing development; the embryo starts out looking like a tiny speck, then a tadpole with a tail, and finally the fetus begins to look more human.
Common complaints: Dr. DeRosa explains that, for many women, “the first trimester is the worst.” Women go from feeling normal to nauseous and exhausted, among other things, and it’s a difficult adjustment for many. Other common complaints include light bleeding (about 25% of women experience this), breast tenderness, constipation or diarrhea, frequent urination, headaches, heartburn, discharge, weight gain, and moodiness.
Positives: While many women are too tired/nauseous/hormonal to enjoy the first trimester, one of the positives is that you can continue most activities with little to no changes.
Second Trimester: Weeks 14-26
What to expect: Theoretically, morning sickness and pregnancy exhaustion should subside around the start of the second trimester, but many women experience these common symptoms well into their second trimester. However, overall, women seem to classify the second trimester as the “easiest” of the trimesters. This is also the trimester when you can find out the sex of your baby (if you so desire), which is usually around week 20, give or take a couple weeks.
Baby’s development: During the second trimester, the fetus works on gaining weight and increasing in size. For women experiencing their first pregnancy, they may begin to feel the baby’s movements between weeks 18-22; women who have been pregnant before may feel the kicks slightly sooner, around 16 weeks.
Common complaints: In addition to or in lieu of the common complaints of the first trimester, women may experience lower back pain, hip discomfort, round ligament pain, breast enlargement, congestion and/or nose bleeds, hair growth, acne, stretch marks, and spider or varicose veins.
Positives: Dr. DeRosa refers to this trimester as the “honeymoon.” He expounds, “You have more energy, your sex drive is back, you can eat again because you’re not nauseous and vomiting, and you get that pregnancy ‘glow.’” This is the trimester many pregnant women enjoy the most. Energy levels are typically up, morning sickness usually subsides, and your growing belly hasn’t yet become too uncomfortable or cumbersome.
Third Trimester: Weeks 27-40
What to expect: The third trimester is a challenging one. You’re huge, physically limited, and exhausted. The most simple tasks, such as putting on shoes, become painful undertakings that leave you short of breath. Your appetite may still be normal, but there’s no room left in your torso for your stomach, so you can only eat small amounts (or suffer the wrath of heartburn/reflux). No bedtime position is truly comfortable, so sleep is fitful. The third trimester is just generally miserable. I know some women run marathons in their third trimester, but they must secretly be superheroes. Dr. DeRosa elaborates, “Around weeks 34-36, those first trimester symptoms can return–nausea and exhaustion–and they just want a baby. Many first-time moms also experience a lot of anxiety concerning childbirth.”
Baby’s development: Dr. DeRosa calls this stage the “fattening up time.” The fetus grows larger and the organs mature during this final trimester. The baby moves frequently during this stage, although as the due date nears, s/he will have less space to move around and usually settles in a head-down position, which can cause some pressure/discomfort. While a woman’s “due date” marks the end of the 40th week, a baby is considered full-term when born between weeks 37-42.
Common complaints: The issues experienced during the first and/or second trimester may continue into the third trimester, and some additional discomforts may also surface. Braxton Hicks contractions (mild contractions that prepare your body for delivery) are fairly common during the third trimester. They can be uncomfortable, and sometimes even painful, but they normally don’t last too long. As your due date nears, you may also experience some nipple leakage (a yellowish liquid called colostrum). Other common complaints include hemorrhoids, shortness of breath, swelling, and a general feeling of discomfort.
Positives: This is the home stretch. If you have had an absolutely miserable pregnancy, you are almost to the end. Whether your pregnancy was painful or easy, you’re about to meet your new baby, and that’s what makes the journey of pregnancy bearable. Also, since you’re noticeably pregnant by this stage, you may get a little extra pampering…even if it’s just that strangers open doors or help you with your groceries. If this is your second (or third or fourth) pregnancy, you can also expect the birth process to be a little easier, according to Dr. DeRosa. If nothing else, “you know what to expect.”
Pregnancy Faux Pas
What NOT to say to a pregnant woman
by Erin Marsh
There’s something about pregnancy that strips friends, family members, and strangers of their societal niceties. Strangers will ask to touch your belly, friends will compare your belly size to theirs (and yours will always be SO MUCH BIGGER), and family suddenly has more unsolicited advice than you thought was possible. Here are some of the cringe-worthy remarks my friends and I heard during our pregnancies.
“You better sleep now because you won’t sleep again once the baby is born!”
While this observation may be true for many new mothers, we hate to be reminded of this likely possibility. Parenthood is frightening enough without the frequent admonition that sleep will forsake us once the baby is born (if it hasn’t already during pregnancy). Plus, we all wistfully hope that our child will miraculously sleep through the night after only a few weeks. Don’t burst that bubble.
This exclamation, along with the comparable phrases “Your belly is really big for X months” or “You are much bigger than so-and-so was at this stage,” seem like obvious things NOT to say, but most of us have heard something along these lines. Maybe we should start replying with retorts such as “So is your beer belly!”
“You must be having a girl, girls strip all the beauty from their mothers.”
I’m not making this up; this was actually said to a friend of mine–a beautiful, thin, pregnant friend of mine. Similarly, I was warned in the early stages of my pregnancy that “You better hope you’re not having a girl because you’re going to carry the weight EVERYWHERE.” We have all heard these old wives tales, so even an innocent prediction of a baby girl can send us spiraling into self-loathing.
“You know, you shouldn’t eat/drink/exercise that way while you’re pregnant.”
Pregnancy is emotionally and physically draining, and sometimes we need to indulge to keep our sanity. There are so many common items we renounce during pregnancy, and if we occasionally satisfy a craving for a piece of sushi or a sip of coffee or a rigorous workout, then the last thing we want to hear is condemnation from an observer.
“Are you going to deliver naturally?”
This is often a loaded question, depending on who is asking. Some moms judge others for not choosing an epidural, while others imply that women who succumb to medical interventions are weak. Some women create and closely follow a birth plan; others encounter medical emergencies that negate the best of intentions. Instead, people should focus on babies being born healthy and safe, not how they are delivered.
Erin Schoen Marsh, writer and yoga teacher, resides in Sylvania and is the mother of Dexter, 2, and she is expecting a new bundle of joy this summer.