Wednesday, March 7, 2012
Beyond the Bris on Beyond the Sling (Mayim Bialik's New Book)
By Rebecca Wald
Jewish mother and actress Mayim Bialik has just released her new book on attachment parenting titled Beyond the Sling. I applaud her work in bringing sound natural parenting principles to a broad audience. Mayim’s down-to-earth and straightforward exposition of attachment parenting will resonate with many of today’s parents, and parents-to-be, who are interested in raising children in a way that is in harmony with the way nature functions.
Attachment parenting has always made a lot of sense to me, although I don’t consider myself an adherent to any particular method when it comes to raising my kids. I gave birth to both of mine with a midwife in a birthing center. No drugs! I breastfed them each for at least two years, and nursed them together (tandem nursed) for about six months. I wore them in slings a lot of the time when they were very small. I kept them close in my bed when they were infants but eventually they moved to their own beds. (Very often we all end up just sleeping together anyhow.) Despite being Jewish, I also refused to circumcise my son. I didn’t want to subject him to the pain; figured if he was born with a foreskin, he probably needed it; and didn’t want to risk diminishing his sexual sensitivity in adulthood.
In her book Beyond the Sling, Mayim Bialik calls upon her background in neuroscience (she has a Ph.D. in the field) to explain how attachment-parenting principles such as natural childbirth, breastfeeding and parent-caregiver bonding optimize children’s healthy brain and social development. She devotes a chapter to the principle that babies don’t need unnecessary medical intervention. However neither here, nor anywhere else in the book, does she mention circumcision or its deleterious effects on newborns and their development.
Indeed, circumcision has been shown to pose a significant trauma to the child in the first days of life (1), to impede early breastfeeding success (2) and to disrupt mother-infant bonding (3). It is exactly the kind of needless medical intervention Mayim writes about in Beyond the Sling but does not cite. Infant psychiatrists, developmental psychologists and neuroscientists have come to recognize that early infant trauma places newborns at risk for less than optimal development. Pain experienced by infants in the neonatal period has been shown to have long-lasting effects on future infant behavior. In one study, circumcised infants showed a stronger response to pain during later routine vaccinations than infants who were intact (4). I have often wondered if there a link between infant circumcision and negative childhood behaviors so often seen in American boys, such aggressiveness, defiance and anger. To my knowledge, no exploration of this has been undertaken by the medical community.
Many in attachment parenting circles have refused circumcision for all the reasons I mention here, and more. Mayim Bialik circumcised her sons because she is an observant Jew. Given her attachment parenting stance and her background in neuroscience, I doubt she would have circumcised him but for this fact. To her great credit, she does not defend or promote circumcision in Beyond the Sling. It is a step in the right direction but it is not enough.
In an earlier post titled Mayim Bialik, Circumcision and Destiny, I wrote about how Mayim’s decision to circumcise her own son is incompatible with the attachment parenting principles she preaches. As much as she would like to simply avoid the issue of circumcision altogether, the incompatibility stands. I believe her book Beyond the Sling does her readers an injustice by failing to address the destructiveness of circumcision. I would like to do this now.
Until recently, physicians knew very little about how newborns experienced pain or its consequences on the youngest among us. They long assumed newborns did not feel pain at all because of “undeveloped” nervous systems. This was often cited as a rationale for not providing anesthesia during infant circumcision. As late as the 1980s, open-heart surgery in the U.S. was routinely performed on newborns that had been chemically paralyzed but not anesthetized. They were aware of, and felt, everything.
Of course, sensitive mothers through the millennia have always known that infants not only feel pain but also are more sensitive to it than older children and adults. It has taken modern medicine a long time to begin catching up with the obvious, and it still hasn’t fully. Infants undergoing open-heart surgery are now anesthetized but not so for many babies undergoing circumcision. While there has been a move toward providing anesthesia for hospital circumcisions, individual practice varies among doctors and many newborn boys suffer the procedure with nothing more than a pacifier dipped in sugar water. This is so despite circumcision being described in the medical literature as one of the most painful procedures performed in neonatal medicine.
Infants undergoing circumcision have been shown to have significantly increased levels of cortisol, a hormone released into the blood during stress. In fact, circumcision has long been the model for analyzing pain and stress in newborns. In one study, researchers concluded the pain was persistent and severe. Newborn heart rates have been demonstrated to soar. Infants have experienced heart attacks and strokes during circumcision or immediately after, although these are rarely attributed to the procedure itself but to existing "defects" in the newborn's body.
Sometimes medical literature isn’t sufficient to describe the whole picture. Here is one nurse’s experience of watching a hospital circumcision:
We students filed into the newborn nursery to find a baby strapped spread-eagle to a plastic board on a counter top across the room. He was struggling against his restraints—tugging, whimpering, and then crying helplessly. No one was tending the infant, but when I asked my instructor if I could comfort him she said, "Wait till the doctor gets here." When he did arrive, I immediately asked the doctor it I could help the baby. He told me to put my finger into the baby's mouth; I did, and the baby sucked. I stroked his little head and spoke softly to him. He began to relax and was momentarily quiet.
The silence was soon broken by a piercing scream—the baby's reaction to having his foreskin pinched and crushed as the doctor attached the clamp to his penis. The shriek intensified when the doctor inserted an instrument between the foreskin and the glans (head of the penis), tearing the two structures apart. (They are normally attached to each other during infancy so the foreskin can protect the sensitive glans from urine and feces.) The baby started shaking his head back and forth - the only part of his body free to move - as the doctor used another clamp to crush the foreskin lengthwise, which he then cut. This made the opening of the foreskin large enough to insert a circumcision instrument, the device used to protect the glans from being severed during the surgery.
The baby began to gasp and choke, breathless from his shrill continuous screams. How could anyone say circumcision is painless when the suffering is so obvious? My bottom lip began to quiver, tears filled my eyes and spilled over. I found my own sobs difficult to contain. How much longer could this go on?
During the next stage of the surgery, the doctor crushed the foreskin against the circumcision instrument and then, finally, amputated it. The baby was limp, exhausted, spent. I had not been prepared, nothing could have prepared me, for this experience. To see a part of this baby's penis being cut off—without an anesthetic—was devastating. But even more shocking was the doctor’s comment, barely audible several octaves below the piercing screams of the baby, “There's no medical reason for doing this.” I couldn't believe my ears, my knees became weak, and I felt sick to my stomach. I couldn't believe that medical professionals, dedicated to helping and healing, could inflict such pain and anguish on innocent babies unnecessarily.
Despite that Mayim Bialik and I are on different sides of the fence on circumcision, I’m glad she is doing the work she is. More people need to know about best childrearing practices and she is facilitating the spread of important information. She is a smart lady and I like her style. I enjoy reading her Raising Kvell posts on Kveller.com and hold out hope that one day she will have a change heart about the necessity of Jewish circumcision. Mayim—We can be fully identified Jewish women and reject this practice! I urge anyone reading this who is in the anti-circumcision camp to please treat Ms. Bialik with respect in all Internet forums.
1. Dixon S, Snyder J, Holve R, Bromberger P. Behavioral effects of circumcision with and without anesthesia. J Dev Behav Pediatr 1984; 5(5): 246-50.
2. Howard CR, Howard FM, and Weitzman ML. Acetaminophen analgesia in neonatal circumcision: the effect on pain. Pediatrics 1994;93(4):641-646. (“Feeding behavior deteriorated in breast- and bottle-fed infants in both groups, and acetaminophen did not seem to influence this deterioration.”)
3. Marshall RE, Porter FL, Rogers AG, et al. Circumcision: II effects upon mother-infant interaction. Early Hum Dev 1982; 7(4):367-374.
4. Taddio, A., Katz, J., Ilersich, A.L., & Koren, G. (1997). Effect of neonatal circumcision on pain response during subsequent routine vaccination. Lancet, 349, 599–603.