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Petition to LLL: Inform Mothers of Effects of Circumcision on Breastfeeding

post #1 of 12
Thread Starter 




To:  La Leche League

I firmly believe that parents should be made aware of any interventions, including circumcision, that may impact breastfeeding. In the 1981 edition of The Womanly Art Of Breastfeeding under a section called "Elective Surgery for You or Your Baby," there was mention of circumcision as well as tubal ligation. However, the LLL omitted it in all subsequent editions, claiming “… circumcision to be outside the realm of our expertise in La Leche League. Other organizations can do a better job of educating parents about circumcision than LLL…” (from this link: http://www.llli.org/llleaderweb/LV/LVOctNov00p94.html

I firmly believe that it's is a hugely relevant breastfeeding issue, & the 1981 edition was neither harsh nor judgmental. I believe that the LLL should reevaluate its official stance and that the text regarding the effects of circumcision on breastfeeding from the 1981 edition of the The Womanly Art Of Breastfeeding should be re-inserted into all future editions, failing which I will have to reconsider my support of your organization, and encourage a boycott of this otherwise very useful book. Most lactivists are also intactivists and do not support routine hospital infant circumcision, which is risky, non-therapeutic cosmetic surgery. The LLL has a duty to inform new mothers about the breastfeeding issues that may arise with circumcision. Tell them the truth! 

Furthermore, I hereby ask the Board of Directors to issue a policy statement about circumcision’s effects on breastfeeding. As from the LLL'S aforementioned link, “The mother may have questions as to whether or not the separation such a procedure requires will interfere with establishing her milk supply. There can be the issue of trauma to the baby which may result in difficulty comforting the baby enough to get him to nurse. The mother may become anxious, resulting in problems with let-down or the baby picking up on her anxiety.” These are only SOME of the issues that are very likely to arise if a baby is circumcised. Leaders should be able to counsel mothers accordingly. 

Text from the 1981 edition of the The Womanly Art Of Breastfeeding: 


If you are going to be in the hospital anyway for the birth of your baby, you or you doctor may suggest that you have some other medical matter attended to. Examples of elective surgery for the mother include... stripping the legs of varicose veins or tying the fallopian tubes (tubal ligation). As for the baby, it may be considered almost routine to circumcise boy babies when they are only a few hours or days old. But circumcision is an elective surgery and you have a choice of whether or not to have your baby circumcised. You can also choose to wait a while before having this done. We bring these subjects up because, physically and emotionally, these procedures all take their toll on mother and child. Since they represent elective surgery, their appropriateness at this critical time must be questioned. 

Circumcision is as painful a procedure to a newborn as it is to an adult. As a religious rite, circumcision is not performed until the baby is eight days old, when he is less apt to hemorrhage. The reasons given in the past for non-religious, almost routine circumcision of the newborn were generally hygienic and are no longer accepted by many physicians and parents. If you're interested in learning more about this subject, see the Book List at the end of this book. 

The most important reason for siding against elective surgery following childbirth is that it interferes with a mother and her new baby being together and getting to know each other. While a mother may feel very good following the birth of her baby, her body nevertheless has some recovering to do. Adding the strain of recovering from a surgical procedure might lessen her enjoyment of these early days with her baby. 
In regard to tubal ligation, there can often be an unexpected emotional reaction in the mother. When it dawns on her that the baby in her arms is her last, there may be feelings of deep sadness. It might become difficult for her to keep a normal perspective on her mothering of this baby. She may become exceedingly anxious about doing everything just right. 

Whatever the inconvenience you may experience by postponing such operations for you or your baby, it is slight compared to the upheaval such surgery can cause in your life at this time." 


The Undersigned




post #2 of 12

Thanks for posting this!

post #3 of 12

This is so important, mothers should have all information available to them.  I signed!

post #4 of 12

Terrific idea! Thanks for doing this. LLL should be sure to inform mothers of anything that can affect their breastfeeding relationship, and circumcision is a big one in those early days.

post #5 of 12
Thread Starter 

There are some big AP names on board!

post #6 of 12

As one of the three authors of the 8th edition of the Womanly Art of Breastfeeding (WAB), I want to address the breastfeeding community directly about this petition.  I will tweet a link to this response to #breastfeeding, #bfing (from @dianawestibclc) and encourage all of you who read it to do the same or RT mine so we can reach all those who care so much about this important issue.


First, those supporting the petition are absolutely right that there are medical and psychological consequences to circumcision that clearly have the potential to negatively affect breastfeeding simply because most circumcisions are performed in the first week when breastfeeding is particularly vulnerable and research has clearly shown that pain negatively affects breastfeeding.  I haven't yet dug into the research -- is there any particular to this issue?  If so send to me at dwest@bfar.org -- but pain from circumcision is documented as an impediment to effective breastfeeding in Nancy Mohrbacher's excellent textbook "Breastfeeding Answers Made Simple" (2010, Hale Publishing, page 114t, 116).  So for this reason, I and my co-authors Diane Wiessinger and Teresa Pitman absolutely agree that it should have been included in the 8th edition of the WAB. 


So why wasn't it???  No conspiracy here.  We simply (to our shame) did not think of it.  As you can see from the size of the book, we tried to include every single thing we possibly could think of, but that one honestly just slipped by us.  We are really very, very human authors (just ask our families!).  Also, Nancy's book was published at the exact same time as ours, so we didn't have it as a reference when we were in the writing stage.


We, of course, completely understand that mentioning circumcision in the WAB could be construed as mixing causes, but in light of the new documented information we now have about the negative effects of circumcision on breastfeeding, we absolutely will include it in the next edition ***if we are the authors,*** framing the discussion in terms of the documented medical and psychology contraindications in the context of breastfeeding FOR THOSE WHO CHOOSE TO CIRCUMCISE FOR NON-RELIGIOUS REASONS so as to avoid mixing causes.  It would not be our intention to comment on religious circumcision, but only on the objective effect of the procedure relative to breastfeeding when it is done for reasons OTHER than religious. 


So please forgive us for not mentioning this important issue in the 8th edition.  It was really just a human error and we are very sorry for it.  Thankfully, there will always be future editions of the WAB because it is a uniquely "living" and ever-evolving book, so we'll absolutely have an opportunity to fix this oversight.


In the meantime, if there are other changes that you'd like to see, feel free to send them to me at dwest@bfar.org.  We can't promise all issues will be so easy to fix or that we'll agree with every suggestion, but we absolutely want to hear your thoughts and ideas. 


Finally, we want you to know that we appreciate the support of the breastfeeding community more than we can express.  Your warm reception of our complete re-write of this revered breastfeeding icon has been so touching to each of the three of us.  We thank you all for your passion and dedication to helping breastfeeding mothers and babies.  Together, we'll build even better resources for future mothers.


<Please note that this post was not reviewed or approved by La Leche League International -- they have final say on the content of the WAB -- and speculation about the content of any future editions is constrained by the reality that it is premature to assume that we three authors of the 8th edition would be authors of the next edition.>


Diana West, IBCLC

La Leche League Leader



Edited by DianaWest - 3/1/11 at 11:25am
post #7 of 12


Originally Posted by DianaWest View Post

<Please note that this post was not reviewed or approved by La Leche League International -- they have final say on the content of the WAB -- and speculation about the content of any future editions is constrained by the reality that it is premature to assume that we three authors of the 8th edition would be authors of the next edition.>

Thanks for posting, but I'm not sure this is so reassuring as I'm wondering if the disconnect lies more within the administration of LLL than within the individual leaders.



post #8 of 12

Please remember that there is no debate in Activism. :) 

post #9 of 12

Diana, I am so thrilled by your reply!  The WAB is just fantastic, thanks for that too!

post #10 of 12
Thread Starter 

Thank you so much for your response, & I'm glad to see 'the new guard' is willing to right the wrong that occurred when the material was deleted. Can the new editions have an 'errata' note included? 

post #11 of 12

Can we please have a confirmation from the LLLI that they adhere to your position? It seems that the info on circumcision was actually removed quite some time after the 1981 edition, possibly in the edition of 2004, which immediately preceded this year's edition...AAn edition I have from 1999 still includes the info on bf and circ.


Will the LLLI change its "official stance"on the "mixing of causes" (see this link: http://www.llli.org/llleaderweb/LV/LVOctNov00p94.html

and the right of mothers to know the truth about how circumcision affects breastfeeding?


Also, if it was just an omission, is it possible to please insert an "addendum" into the books that have not yet been sold?


Thank you!

post #12 of 12

Unfortunately, as of this date we still have NO REPLY from the LLLI. This is extremely unfortunate. Until the LLLI promises to rectify the situation in an acceptable fashion, then we have no choice but to continue to share the petition, and to collect more signatures. It should be noted that the part of the book that was removed that was first in the 1981 edition, REMAINED there for decades. Ironically, it is only recently that this important information regarding the effects of circumcision on breastfeeding has been deleted.

We also invite you to "LIKE" our Facebook page dedicated to bringing about positive change in this regard:



Help spread the message to the LLLI. Thank you!

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