Natural Circ Care for client

[Chronic Chrissy]

I have a doula client who is very insistant on having her son Circ'd for religeous reasons, even though she doesn't like the procedure at all. We have a great relationship and I don't want to push her away by beating a dead horse, but I would like to provide her with natural alternatives to help her son before, during, and after the procedure. She is very open to Homeopathics and herbs, as well as the use of teas, and does plan to breastfeed. Also are there some things that can help her comfort her son while it is happening?

[MCatLvrMom2A&X]

I sent you a PM.

[liseux]

Probably people who do choose circ might have answers, if I were her, I would just ask others in her religious group.

I think its ironic how people will be into herbs and homeopathics but choose surgery. Its definitely surgery, whether its done at home or in a hospital. I would recommend ditching the herbs and give the poor guy narcotics and never let his diaper get wet (or EC?) so he's never got to have urine on an open wound. If a mom with a c section can breastfeed with narcotics for 2-3 weeks, circed babies should get more than herbs.

[georgia]

Moving to Spirituality because we do not host any religious discussion or reference in TCAC.

Please note that Spirituality is a non-debate/support-only forum. Please post only if you are interested in providing the OP with helpful information and support.

[Magelet]

Catlover,
I would love it if you would pm that info as well, if it was helpful info. I just finished pp doula training, and am hoping to work a lot in my local jewish community. However, in the training, circ care, much less as holistic as possible circ care, really wasn't covered by the trainer, because she said in many years she's only worked with one family who circed, and also was very anti-circ. However, if I'm to focus on working with jewish families, which i'm interested in doing (not sure if it will happen, but it may. Shul is one of the natural places for me to network, of course), knowing circ care will be important.

[umsami]

Definitely breastfeeding... before and after... during if she's comfortable with that.

You could also use some Rescue Remedy after the procedure.

We religious circ...and among Muslims in the States, it's pretty standard to do it in the hospital. So, anesthesia (ring block or penile block)is used. If she is Jewish, she could ask her pediatrician or OB for a Rx for EMLA...as it can be used as a topical anesthesia. She should tell her pediatrician what it's for, so she can get accurate instructions for its application. (Normally, EMLA is covered w/ a dressing after application, but I don't believe it is for genital use.) She could also administer a bit of Infant's Tylenol about 20-30 minutes prior to help w/ pain.

[mama24-7]

Originally Posted by umsami

If she is Jewish, she could ask her pediatrician or OB for a Rx for EMLA...as it can be used as a topical anesthesia. She should tell her pediatrician what it's for, so she can get accurate instructions for its application. (Normally, EMLA is covered w/ a dressing after application, but I don't believe it is for genital use.) She could also administer a bit of Infant's Tylenol about 20-30 minutes prior to help w/ pain.

i've heard/read before that while EMLA cream is used, it is against the manufacturer's recommendations that it is (if i were suggesting this to someone, i'd also check the FDA's suggestions too first since the manufacturer says not to). if you read this insert for the cream, under #3 "how to use EMLA cream," it gives a list of don'ts: on the genitals of children. you can read it here.

there is a short thread discussing EMLA here in the case against circ.

sus

[umsami]

There have been a few studies done on EMLA...and while not as effective as a dorsal block... it still helps:
http://parenting.ivillage.com/newbor...,,3q4z,00.html

It's also recommended by the AAFP
http://www.aafp.org/afp/2004/0215/p909.html

Your link is from the UK, not the U.S.
In the US patient-insert from Astra-Zeneca, there is nothing about it not being recommended for circumcision.
http://www1.astrazeneca-us.com/pi/EMLA.pdf

They mention a study of 105 infants...using it for blood drawing and circumcision. They also mention 2 cases of blistering from application under adverse reactions.

I wonder if the issue is that your link is from the UK, where RIC is uncommon?

In this UK AstraZeneca P.I., they also do not say anything about not using EMLA. To the contrary, they mention studies where it was effective.
http://emc.medicines.org.uk/document...documentId=171

In two randomized, double-blind, placebo-controlled studies in full-term neonates aged 1 to 4 days EMLA Cream (0.5 or 1 g) was applied on the prepuce for one hour before circumcision, covered with an occlusive dressing...
EMLA significantly reduced the pain during parts of the circumcision procedure, as demonstrated by less facial activity, reduction in duration of cry and lower heart rates. No differences were found for oxygen saturation, respiratory rate and Neonatal Infant Pain Scale (NIPS) – which includes facial expression, cry, breathing pattern and state of arousal

If one isn't supposed to use it on the genitals of infants, then I find it strange that it is recommended by AAFP...and that in both the US and UK inserts, they cite studies showing that it is effective in circumcision. :

[umsami]

As far as circ care, I would not recommend putting any herbs on the actual penis itself. Circ care is pretty simple--and involves petroleum jelly (Vaseline) and gauze. The caregiver just puts some Vaseline on a piece of gauze, and then folds it over the top of the penis. (Some docs say to simply put vaseline on the head of the penis... but I was taught to use gauze.) S/he does this every time a diaper is changed. Usually for about a week to ten days. I'm sure that whomever is doing the procedure, will instruct the Mom on how to take care of it.

Honestly, breastfeeding is one of the best things she can do to comfort her son. Remember, it does have anesthesia properties. So I think whatever you can do to help/encourage her with that--is the best thing you can do. If she's Jewish, and the procedure is happening after a week, then hopefully she will have a good breastfeeding relationship established by then. If she's Muslim, and the procedure will likely take place in the hospital, anything you can do to help her establish a relationship... or even hook her up with the hospital's Lactation Consultant.. would be great.

Edited to add.. I know there are some natural non-petroleum versions of Vaseline. You could try researching those, as something she could use in after care.

http://www.handmadenaturals.co.uk/sh...ion=full&id=42

http://www.kerrysherbals.com/herbalsalves.shtml

http://www.unpetroleum.com/

[mama24-7]

more later...

[Chronic Chrissy]

Sorry I didn't share earlier but they are jewish and a Rabbi will be doing the cerimony outside the hospital. Also she is a naturalpathic doctor with no prior experience treating newborns or children.

[merpk]

Seconding umsami's comments about nursing before & after.

Also, it's not uncommon in Orthodox communities to give the baby something soaked in wine to suck on once the proceedings get under way, before the circumcision itself. Keeping in mind that while the bris involves a fair amount of prayer first, and then (again, speaking about Orthodox brissim), the actual circumcision portion of it takes less than a minute (with my sons, from removal of the diaper to replacing the diaper was under two minutes, for each of them, as timed by a friend), the whole thing is very quick.



Good luck. And it's kind of you to be approaching it like this.






liseux, there's no irony at all. Life isn't an all-or-nothing kind of thing. Just because someone holds with herbs and homeopathy, does that mean they won't use any standard medications? Or choose other "unnatural" things in their lives?

[liseux]

I did make my comment before it got moved from TCAC to here, but I agree, of course life isn't all or nothing. Maybe a better word would be interesting instead of ironic.

I am a good example of that too, I was a homebirther who had horrific complications so now I am a C section mom. Which makes me think even more that a baby recovering from surgery should get the same drugs he would get through breastmilk if his mom had three weeks of narcotics after a c section. ( I know not all moms take narcotics).

[tutucrazy]

A ring block (not dorsal) is the best way to ensure he feels minimal pain. I don't think anything natural will be humane, the pain will be extraordinary without a ring block.