EDITOR:—Gatrad & Sheikh¹ take little notice of the importance of breastfeeding in providing emotional comfort to an infant although this has been recognized by authorities.² More attention to breastfeeding might do much to relieve persistent crying.

We question Gatrad & Sheikh’s comments regarding phimosis. Non-retractile foreskin is the normal condition in the infant. Imamura reported that 88.5 percent of 1 to 3-month-old boys have non-retractile prepuce.³ This should not be a cause for pain.

We are surprised that Gatrad & Sheikh fail to mention circumcision status. Circumcision of infants may be uncommon in the UK, but it remains prevalent in Australia, Canada, and the United States, despite warnings of medical authorities. Circumcision is a primary source of severe and long-lasting pain.⁴ Taddio et al. have shown that circumcision produces hypersensitivity to pain even six months after the circumcision.⁵ When searching for a cause of pain, circumcision status should be considered.

For severe long-lasting pain and many other reasons, Doctors Opposing Circumcision recommends that circumcision be avoided by parents and medical practitioners.

George Hill
Executive Secretary
Doctors Opposing Circumcision
Suite 42
2442 NW Market Street
Seattle, Washington 98107
USA
Web: http://www.doctorsopposingcircumcision.org

References:

1. Gatrad AR, Sheikh A. Persistent crying in babies. BMJ 2004;328:330.

[Full Text]

• Work Group on Breastfeeding. Breastfeeding and the use of human milk. Pediatrics 1997;100(6):1035-39. [Full Text]
• Imamura E. Phimosis of infants and young children in Japan. Acta Paediatr Jpn 1997;39(4):403-5. [Abtract]
• Howard CR, Howard FM, and Weitzman ML. Acetaminophen analgesia in neonatal circumcision: the effect on pain. Pediatrics 1994;93(4):641-6. [Full Text]
• Taddio A, Katz J, Ilersich AL, Koren G. Effect of neonatal circumcision on pain response during subsequent routine vaccination. Lancet 1997;349(9052):599-603. [Full Text]

Competing interests: None declared