The controversy surrounding circumcision has revived the old debate on pain in infants. It is well established, however, that the newborn feels the pain.
Things Parents need to know about Pain in Newborn
Can an infant have pain? Ablation of the foreskin would be no or little pain in newborns. This is at least the argument advanced by proponents of circumcision to justify the practice of this operation live. According to this theory, the baby of a few days would not feel the pain because its “nerve endings would not be in place”. These explanations seem from another age. They are flourishing, however, with the debate over the Cologne District Court’s decision prohibiting circumcision when it is not practiced for medical reasons. Is it plausible? Barbara Wildhaber, Chief Medical Officer of the Pediatric Surgery Department at Geneva University Hospitals, explains.
Can we tell the infant that he does not feel the pain yet?
Barbara Wildhaber: It was once thought, but we know from the eighties that this is not the case, various studies have shown. Even a premature twenty-four weeks (six months of pregnancy) feels the pain; when he is pricked, he cries, he defends himself. I have used anesthetic puncture to babies for circumcision, they scream, they twist, it is sometimes upsetting! Some defend themselves less, that’s true, but that does not mean that they feel nothing.
Does this early experience of pain have long-term effects?
The system of pain can be changed indeed. Studies with circumcised boys showed that they reacted much more intensely to vaccinations than the uncircumcised: they showed more pain, they cried more, and so on.
Currently, in Switzerland, circumcision is performed under general anesthesia. Local desensitization is not possible?
It is not always very effective and the bite is done at the root of the penis, which is in itself very painful, even if one uses previously anesthetic cream and analgesics. We hear that babies howl because they are attached, but it’s wrong, they hurt. It is a trauma to live, for them as for us.
Is circumcision itself particularly painful?
The glans is much innervated, like the clitoris in women, moreover these are two similar areas from the embryological point of view. The sensitivity decreases after circumcision because the glans is deprived of its protection, its mucosa, always exposed, thickens.
Can we objectify pain in a newborn?
We use pain scales based on the age of the child. There is one that covers the period from birth to three months. It is based on the observation, according to precise criteria, of the facial expression, the movements of the members and the vocal expression. This allows us to arrive at an objective evaluation.
The hygienist argument long put forward to justify circumcision no longer valid?
No, just as the old habit, sometimes still recommended by grandparents, to decant the glans to clean it does not make sense in the child. There is a natural cleansing of this part of the body, thanks to secretions. In addition, the foreskin is too tight at birth, the decal is painful and can create scars. These scars can then make a circumcision necessary.