Should I have my baby circumcised?

by Tripp Underwood on April 16, 2014

Baby_sleep_boyWhether or not you have your child circumcised is a deeply personal choice and deciding if its right for your family will require you to consider many factors. In addition to the personal, cultural and religious aspects associated with the decision, you may have medical questions as well. The following are answers to many of the most common questions that Richard Yu, MD, PhD, of Boston Children’s Hospital’s Department of Urology hears when counseling families on this matter.

Will circumcision make our baby healthier in any way?

Yes and no.  If your baby is circumcised, the penis becomes very easy to clean for parents and ultimately for the child and adult, which helps reduce the risk of infection from bacteria.  Circumcised infants also have a lower risk of urinary tract infections in the first year of life. However, if your child is not circumcised, but he is able to fully pull back his foreskin around the time of toilet training and takes care to keep the entire penis clean with soap and water every day, he also should do well.

How common a practice is circumcision?   

Circumcision is common. The Centers for Disease Control recently reviewed the current trends of newborn circumcision in the U.S., and the national rate was almost 60 percent. According to the data, circumcision rates are highest in the Midwest and Northeast and lowest in the West.

What are the risks associated with the procedure? How often do they occur?

The most common risks associated with circumcision are bleeding and infection, but this only happens in 0.2 percent of cases, or about 1 in every 500 procedures.

Are there any medical conditions that would make circumcision unsafe for my baby?

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If your baby has active issues with heart or lung function, or a bleeding disorder, circumcision may be unsafe and should be delayed. There are also congenital findings that may require more extensive repair. Circumcision should be delayed if the opening of the urethra is located on the bottom of the penis, the penis is notably curved, or the penis is relatively small. Always consult a pediatrician when weighing whether or not you wish to circumcise, or when establishing a timeline of when you wish to have the procedure done.

What does the procedure involve?

Most newborns are kept still by holding them or by placing them into a circumcision brace. The baby is comforted and may receive a local anesthetic (numbing medication) to reduce discomfort. The skin covering the head of the penis is removed with a protective device and then gauze with petroleum jelly or antibiotic ointment is applied. In older children and adults, the procedure is commonly performed under general anesthesia.

Is it extremely painful for the child?

Despite what many people may believe, this is not an extremely painful procedure.  If local anesthesia is given, the child will feel pressure and movement but not pain.  The child may be briefly upset while he is being held in place. If the circumcision is performed under general anesthesia, he will not experience any pain during the procedure. Once completed, the child will not have pain with urination since the urethra is left untouched during circumcision.

What is the recovery process like and how long does it last?

Newborns and infants recover very quickly from the procedure, usually within 12 to 24 hours. Young children recover in one to two days. Older children and young adults recover in three to four days. After circumcision, there may be temporary skin bruising or mild swelling that can last for one to two weeks.

Is it only done on newborns?
Circumcision can be performed at any age. Newborn circumcisions are normally performed while the child is awake. When the child is more than 3 months old, parents should consider having the procedure performed under general anesthesia.

If you would like to speak with an expert in Boston Children’s Department of Urology about circumcision, or any other urological concern, please visit their website or call 617-355-7796.

 

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Transplant medicine through the years: a brief timeline

by Tripp Underwood on April 15, 2014

NDLM_2014_FacebookProfile11April is National Donate Life month, when people come together to raise awareness about organ donation and encourage others to register themselves as donors.  Donate Life Month is in its 11th year, but organ donation itself dates back much further. In fact, in ancient Greek, Roman and Chinese cultures there are legends of transplants performed by gods and healers, proving that the concept of organ donation is at least thousands of years old. Here’s a quick look at how organ transplantation has progressed over the years: Full story »

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Why I’m running the Boston Marathon

by Boston Children's Hospital staff on April 14, 2014

This year’s 118th Boston Marathon represents many different things to the thousands of participants who will run 26.2 miles from Hopkinton, Mass. to Boston’s Copley Square. For some, it will offer closure—an opportunity to put the tragedy of last year’s events behind them. For others, it represents a new start—a chance to embark on a new path, inspired by those who have run before them.

Among those competing are several Boston Children’s Hospital employees, each with his or her own reasons for running…

Scott-Glynn “I’m running this year to complete my 3-year-goal of running a marathon, qualifying for the Boston Marathon and then running with the best runners in the world.”

Scott Glynn, Access Control Administrator, Security

 

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Lauren-Codd“I’m running for two reasons: to finish what I started last year and to push my own ability.”

Lauren Codd, MBA, Executive Assistant, Quality Program Department of Medicine

Full story »

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Disney, gender and the parent as gatekeeper

by Guest Blogger on April 10, 2014

Meaghan O’Keeffe, RN, BSN, is a mother, writer and nurse. She worked at Boston Children’s Hospital for nearly a decade, in both the Cardiac Intensive Care Unit and the Pre-op Clinic.  She is a regular contributor to Thriving.

Meaghan_OKeeffe_1Not a single temper tantrum was thrown during our recent week-long Disney World vacation.

And my children were pretty well-behaved too.

My husband and I aren’t really “Disney people,” but, like most children, our kids are. So being the bigger people, (literally and figuratively) we headed to Orlando armed with good attitudes, determined to enjoy our time there and experience our children’s excitement.

But I also went to Disney with a certain degree of curiosity. As the mother of a little boy and girl, I wanted to see how much of our Disney experience centered on gender. Full story »

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Adapting the parenting playbook for each child

by Guest Blogger on April 8, 2014

By Daniel Epstein, MD, vice president of the Pediatric Physicians Organization at Boston Children’s. Epstein practices at West Cambridge Pediatrics, in Cambridge Mass. and is an Assistant Clinical Professor of Pediatrics at Harvard Medical School.

crying-babyKids are different.  From one another, I mean. When my daughter was 4 or 5 or 6 or even 7 years old, she could lose it, big time. Unable to contain her emotions, she’d do what children do and have a tantrum.  She’d kick and scream and bang and cry and shake. Eventually, I’d get behind her and, positioning her in front, facing forward, get her arms in a kind of straightjacket, and like Odysseus grabbing Proteus, hold on until she calmed down.

The Hero, Odysseus, trying to find his way home, learns that Proteus has important information for the journey. Apparently, not big on sharing knowledge, Proteus would not answer questions without a struggle.  Odysseus was instructed to grab Proteus and hold on for dear life.  Proteus was a shape changer, and when held, would turn into beasts or water or smoke, you name it. The trick was not to let him go until he resumed his usual form, at which point he would answer your questions.

For children, this idea is straight out of the children’s book, The Runaway Bunny – wherever you go, there is stability following you. I have you, and in my calmness, I demonstrate that I can handle your emotions. With my gentle strength, I show that I can contain the physical expression of your inner turmoil. I will not let you hurt yourself or break things. You are safe from the rampages of yourself.

And just like for Odysseus, where, eventually, Proteus returns to his normal appearance, after 10 or 25 minutes, my daughter (the beast, infant, princess, lioness, ragdoll, monster) eventually would be herself and in a calm voice say, “I’m OK now dad.  You can let me go.” Full story »

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This blog was createdby Boston Childrens Hospital Neighborhood Partnerships through its partnership with the Boston Public Schools and made possible with support from the Patriots’ Day Project, a charitable Fund established by Fidelity Investments® employees in an effort to help our community heal.

empty schoolWith the one-year anniversary of the Boston Marathon bombings approaching, it’s likely that the wave of media coverage recalling the tragedy could raise questions or concerns in children. Of course, parents will play a large role in helping answer these questions and letting children know they’re safe, but teachers also will be very important in reassuring children.

School should be a safe haven for children—a place to talk to peers and trusted adults about what they are seeing and hearing—which helps them process the world around them. When that world seems frightening or overwhelming, educators know that they need to do everything in their power to support students. Full story »

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Keeping children safe around grandma’s medicine

by Tripp Underwood on April 4, 2014

Grandmother-and-grandaughterMulti-generational parenting is becoming more common, as the number of children living with grandparents—or receiving regular care from them—continues to rise. And according to reports, this generation of seniors is healthier, better educated, living longer and more financially secure than those of the past.

In other words, today’s Nana and Granddad are ready for the job.

But, as shown in this report from Safe Kids Worldwide, when grandparents become more active in child care, it carries a safety concern: increasing kids’ access to the grandparents’ medication and pills, and potentially serious cases of medication poisoning.

Safe Kids data shows that almost 64,000 emergency department (ED) visits in 2012 were related to a child swallowing medication not meant for her. That’s an ED visit once every 8 minutes, for an accident that is completely avoidable. Full story »

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Honoring Tim

by Tripp Underwood on April 3, 2014

Timbo-and-Mom

Tim Packhem touched—and saved—a lot of lives. It’s an impressive thing to say about anyone, but the fact that Tim could affect so many, in so short a time, is what makes him truly special.

Those close to him affectionately knew him as “Tim-bo”—a friendly goofball who was quick with a joke or a hug. The kind of guy who walks up to you on your first day at a new school and invites you join him and his friends at the lunch table.

At 16 years old, when Tim died from severe brain trauma after falling off a skateboard, the number of people who appreciated his carefree attitude became heartbreakingly clear. Almost his entire school came out to honor his memory at the wake. The line, stretching long and silent, snaked slowly past his casket with hundreds of people wanting to tell him goodbye, thank you, or both. Full story »

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