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.

21 comments:

  1. Thank you for writing this! I do not support pro-circumcision folks and will not purchase her writings. I am a peaceful parent who has a master's degree in early childhood education and knows that babies do feel pain and they need their whole bodies to function. If Mayim chooses to acknowledge that circumcision is not necessary and is harmful then I would support her wholeheartedly. Let us also not forget that there were most likely one or more other family members who insisted on circumcision and not place the blame totally on her either.

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  2. Circumcision doesn't negate attachment parenting. Lots of parents practice attachment parenting philosophy without adhering to every single component that anyone might think one must do to be an attachment parent. Consider homebirthing, homeschooling, eating only vegan and organic, using only organic cloth diapers, etc. All of these have been touted as things "attachment parents" should do, but that doesn't make it so.

    It waters down the argument to use faulty logic. There are plenty of reasons to choose to not circ, but attachment parenting philosophy isn't one of them.

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    1. Detaching negates attachment. It's very, very simple. If one of the kid's first experiences is being genitally mutilated and in some cases, forcibly having their penis sucked by an adult male...all the breastfeeding, baby-wearing, co-sleeping etc will NEVER make up for the first experience of fear, pain and the risk of death.

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  3. Anyone who thinks circumcision is compatable with a secure attachment is a fool. It's a barbaric and damaging practice...and has no place in modern society, much less a supposidly "peaceful" AP family.

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  4. I always found it ironic that she is a neuroscientist and still cut her kid.

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  5. I don't think you guys understand how intrinsic circumcision is to be a part of Jewish culture and practice the religion. If she chose to not circumcise her children, they would be cut off from their culture and religion. She obviously made a choice, risk vs benefit and decided the benefit of her children being allowed to participate in their religion was more important. I don't blame her, I probably would have done the same thing and I am as anti routine infant circumcision as anyone. I do not think its appropriate to go after religious reasons. It truly borders on antisemitism.

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    1. I am an observant Jew, as is my entire family. Our son is intact, and was welcomed to the Jewish community with a brit shalom ceremony (we had over 50 in attendance, and not a single negative thing was said). We are not cut off from our religion and community. I am actually pretty vocal about my opinions on how wrong it is to circumcise children (boys and girls, for any reason). Yes, circumcision is very engrained in Jewish culture. But, very few people are actually cut off from their Jewish community for not circumcising their sons. And those who are can find another Jewish circle that will welcome them.

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    2. I agree.

      Jewish circumcision is not a medical procedure, it is a religious procedure. It really is not about medical interventions being justified or not justified. It is about a procedure that is CENTRAL to the Jewish faith and identity. (you are still considered Jewish without circumcision if your mother is Jewish, and there are Jews who do not circumcise).

      I am anti RIC, and believe that the Jewish community should be left to determine the legitimacy of bris milah. Painting Jewish people as anything negative for practicing their religion is a very slippery slope.

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    3. Andrew S. KohlerMay 2, 2012 at 11:01 PM

      "I don't think you guys understand how intrinsic circumcision is to be a part of Jewish culture and practice the religion. If she chose to not circumcise her children, they would be cut off from their culture and religion. "

      To hell with anyone who would exclude any person from anything based on what their genitals look like. Bullying and conformism, plain and simple. I'll not be talked to in that tone of voice. Fortunately, I have confidence that most members of the Jewish community would not be so callous.

      Regardless of the motivations for having a child circumcised, most of which (at least on the part of the parents) are good, the effect is equally destructive regardless. Thus, I do not see how one can differentiate between routine, religious, and otherwise ritual circumcision.

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    4. I'd like to point out that many religions find FGM also to be a central point in a woman's life within a culture and religion.

      Why is it a federal offense here in the US to even preform a ritual nick on females (far less invasive than male circumcision, and leaves no long lasting effects) for religious reasons, and yet male amputation of the foreskin is not only allowed but frequently practiced for even non religious reasons(!).

      This is entirely duplicitous, ethnocentric, and illogical. I do not support FGM nor MGM, and believe in genital integrity for all individuals, not just little girls. And I am NOT antisemetic.

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  6. I appreciate what you are saying and both of our sons are intact. However, they are just as aggressive and defiant as any other boys their age...angry we have escaped so far. As a striving to be peaceful parent, we discourage and redirect the aggression as much as possible. Nature is nature, though - there is no way around how different our boys are from our girls. All of them have been allowed to play with all the toys and activities in the house with no judgment - it just seems to be the way they are wired. I don't ask other parents of other active boys whether they are circumcised or not - part of it is just boys being boys.

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  7. As a religious person myself (Catholic) I can certainly empathize with those conflicts. But I do think it is appropriate to go after religious reasons; after all, is opposing the fundamentalist Muslim tradition of female circumcision anti-Islam?

    I am not sure what I would have done were I Jewish, and I'm not completely sure how Jews justify it (I know that the Judaism in both the Hebrew Bible, and the New Testament of the Christian bible do not exist today in those forms). But I have heard that circumcision at that time was a much different, less invasive procedure, and it wasn't until people got these ideas about cleanliness and sexual purity that it became what it is now.

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  8. I don't think that children should be 'initiated' into religion in any case. I think they should be able to learn and be a part of it (if it is the families religion) but make the choice themselves when they are old enough. No 'God' I have heard people speak of would turn away a child because his parents didn't remove his foreskin or didn't splash some water on his forehead during some ceremony, nor will circumcising a young woman yeild a good crop. It is an abuse of power to force anything on anyone without them having the understanding to accept or reject the notion. Circumcision of minors (infants in particular, as I know teens who made the choice for themselves with SOME understanding) is child abuse and should be illegal.

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  9. I disagree. How can it be antisemetic to want to save Jewish babies? Also why is it okay to pass a law that states no female cutting of any kind is legal not even the pin prick. Yet it's okay for Jewish people? Those people have deeply held religious beliefs for wanting to cut their girls - why is it different for boys? Why is it okay for the Jewish religion but not other religions?

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    1. It is antisemetic as you are trying to prohibit a religious ceremony that is central to Judaism. If you are not Jewish, this is problematic given the history of the Jewish people and attempts to cut them off from their religion by Christians in the past. By prohibiting ceremony/food choices etc that are central to religious observance.

      If you are Jewish, this is an important conversation to be having with other Jews.

      Which other religions are you aware of that mandate male or female circumcision in the religious text? I am asking this as I want to highlight the difference between a religious requirement and a cultural practice.

      I find the idea of Jewish babies being saved rather offensive.

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    2. "Saving" Jewish babies was perhaps a poor word choice by Pinky. The goal is to protect the basic human rights of ALL children to bodily integrity and genital autonomy, regardless of sex or into which cultural or religious community they are born. Human rights are not relative, but absolute.

      Laws protecting only the genital integrity of girls, without religious exemption, are inherently discriminatory. If they are changed to include boys, but exempt those born to Jewish families, it's also discriminatory.

      I understand the slippery slope argument that banning circumcision of boys can be seen as anti-Semitic, but it's also a slippery slope to recognize children's inherent rights to bodily integrity and autonomy and then exempt Jewish boys.

      If we exempt Jewish boys from these inherent human rights, what other human rights of Jews can we choose to ignore?

      The law must decide whose rights take precedence, the parents' or the child's. Common sense and fairness would favor the one who has to live with the long-term adverse physical, sexual and psychological consequences, which are being documented by the Global Survey of Circumcision Harm [circumcisionharm org].

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  10. I am anti-circ as well, and while it does cause me to pause for a second, I will not judge Mayim because of this choice. NO ONE but her was in her head to make this decision. And why are we perpetuating the very non-peaceful practice of judgement, especially against other mothers. Not one of us makes perfect decisions all the time...and women are in this together as Mamas. We should NOT be judging eachother and outting eachother down. The best way to promote your beliefs is to do juat that....promote them, speak of them, but NOT by judging others...

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  11. In the latest ATP newsletter: "There are some parenting choices that Attachment Parenting International does not take a stance on. Vaccinating, cloth diapering, *circumcising*, educational choices, elimination communication, and others are often quoted by some parents as part and parcel to Attachment Parenting. Attachment Parenting, itself is not a checklist of practices but encompasses parenting that promotes and are most likely to positively influence the "parent-child attachment quality"."

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  12. I am a Catholic, but I just do not understand though how you can justify a permanent alteration of your child's body in the name of religion. In fact, it is illegal for parents in other religious groups to deny life-saving medical treatments or blood transfusions to their children even though their religion mandates it. The amputation of a healthy, functional body part should be included. No baby boy has ever consented to circumcision for himself in the name of religion or any other reason.

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  13. roger desmoulinsJune 26, 2012 at 5:47 PM

    The future of brit milah has to be decided within the Jewish community.

    Intactivism does not advocate making bris illegal, but deferring it until after the 18th or 21st birthdays. Thereby making it an informed adult choice, a formal commitment to Jewish tradition and a sign of Jewish loyalty. If this were done, I suspect that quite a few North American Jews would opt for circumcision before starting to date Jewish women seriously with a view to getting married.

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  14. She is an extreme hypocrite with questionable grammar. Muslims also mutilate boys, nearly wholesale. Are we anti-Islamic if we object to that?

    Anti-Islamic if we object to female circumcision? I do not care which Sky Bully people are using as an excuse to genitally mutilate their children. It's simply cruel, wrong and a violation of basic human rights.

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