Your Baby’s Health Care System

Your newborn and infant need special health care services. By their very nature, newborns and infants are highly dependent life forms. They need the services of health care providers who have been trained to care for their special needs. Although they are pretty tough little critters, compared to young children and adults, a newborn’s first year of life is full of opportunity for poor health.

Seek the care of a qualified pediatrician, family practitioner, pediatric nurse practitioner, or pediatric physician’s assistant for your newborn and infant. It is important to find a clinician whom you trust and like. As a parent, your instinctual protectiveness for your baby can be the grounds for quite a bit of anxiety. Having a clinician whose advice you respect and whose demeanor is reassuring can alleviate some of this anxiety.

Newborns and infants can become ill quite suddenly. Over the course of a few hours their physical condition may deteriorate rapidly. Do not be reluctant to consult your clinician if you are uncertain about your baby’s health. The tendency for some new parents is to overutilize the services of their baby’s clinician. That’s OK……the system is used to parents like that. Many pediatric services have set up group services, nurse hot-lines and other related services to deal with the volume of questions which new parents generate. The only problem is that sometimes these services present the first barrier to services for problems which may be urgent or becoming emergent. Not that most parents need the prompting, but if you suspect that your newborn or infant is seriously ill and have been advised to “take 2 aspirins and call me in the morning”, don’t ask to be seen, take your child to a place where an expert can examine your child. Parents should not have to expect to be health care experts.

Immunizations

The American Academy of Pediatrics recommends that your baby receive immunizations
for:

  • Hepatitis B (the first of three doses is recommended shortly after birth)
  • Diptheria
  • Tetanus
  • Pertussis (whooping cough)
  • Hemophilis influenzae
  • Polio
  • Rubeola (measles)
  • Mumps
  • Rubella (German measles)
  • Varicella (chicken pox)

These immunizations are administered at various times throughout your baby’s first year of life and on through childhood at particular ages. In addition, the AAP recommends that your newborn receive a shot of Vitamin K shortly after birth.

Circumcision

Here’s a list we printed earlier on this website,

  • % of infant males circumcised in the U.S., 1995- 64%
  • % of infant males circumcised in Canada- 48%
  • % of non-Jewish/non-Muslim men circumcised on this planet- 1%
  • RISKs of circumcision-
    • overall risks:

      • 0.2-0.6% (according to the American Academy of Pediatrics)
      • 3% (according to the American Urological Society)
    • risk of death- 4 in the U.S. in the last 45 years (a number highly suspected
      as far too low by circumcision opponents)
  • RISKs of not circumcising
    • Risk of hospitalization for urinary tract infection in male infants
      • Circumcised- 2/1,000
      • Uncircumcised-7/1,000
    • lifetime risk of penile cancer in uncircumcised men- 1-10 per 100,000
    • lifetime risk of penile cancer in circumcised men- 1-3 per 100,000

Circumcision is the procedure which removes the foreskin on the head of the penis. The foreskin is a hood which covers the head of the penis. When performed on newborns this procedure is simple, quite low-risk and may have some health benefits.

Bring up circumcision as a topic of conversation and watch the dogma fly. No other topic hits new parents below the belt as soundly as circumcision. Generally, if Dad is circumcised, so goes Junior’s foreskin. If Dad is not circumcised, usually Junior keeps his foreskin. If one or the other grandfathers is a World War II vet, one gets the U.S. Army’s view of male-hygiene-in-foxholes lecture (supported by recent data from U.S. Army hospitals). If one’s grandfather is any other nationality besides American, he wonders, “What’s the fuss? Why would one want to cut off a piece of one’s penis?”……unless he’s Jewish or Muslim. Religious circumcision for Jewish babies is a practice dating back…..well, to the beginning, huh?

Circumcision is a common practice among American, Jewish and Muslim men of the world. For the rest of the world, it is all but unknown except for a few primitive tribes in Africa and South America. The overwhelmingly large majority of men in the world are not circumcised. However, rates of circumcision in the U.S. are declining slowly and slightly. But the overall rate is still above 70%.

The American Academy of Pediatrics (AAP) states that:

“Newborn circumcision has potential medical benefits and advantages as well as disadvantages and risks. When circumcision is being considered, the benefits and risks should be explained to the parents and informed consent obtained.”

Unfortunately, informed consent cannot be obtained from the patient. This is a argument of those who are against routine circumcision…….this and the “risks” part. Although almost always a brief, routine, relatively benign procedure, circumcision is not without slight risks……including disfigurement, and extremely rare cases of loss of the penis and death. But the risks are rare and usually time-limited and not very serious…..but they do occur. Actually, the most common “complication” is cosmetic and comes from parents who are dissatisfied that “not enough” or “too much” (of the foreskin) was removed.

The AAP’s statement is somewhat of a cop-out (as is the American Urological Association [AUA] which states that, “neonatal circumsicsion has potential medical benefits and advantages as well as disadvantages and risks”). Both groups refuse to recommend or discourage circumcision (though their recommendations read as though they do recommend it). So, they take the pragmatic and scientific way out, falling back on a “lack of evidence” as a reason that they cannot say whether or not your son should be circumcised. They list the following as RISKs and BENEFITs of circumcision:

RISKs

 BENEFITs
hematoma
prevention of infection of the head of the penis skin
necrosis
prevention of penile cancer local
infection
prevention of urinary tract infections
bleeding
prevention of sexually transmitted disease
death
prevention of cervical cancer (in female partners)

One of the best statements from the experts is this one from the AUA: “The risks and disadvantages of circumcision are encountered early whereas the advantages and benefits may be prospective”. This means that if your son is circumcised the relatively rare complications of the procedure occur almost immediately and then there are no more risks; whereas, the benefits may last a lifetime in terms of most infections (including sexually transmitted viruses) and prevention of rare cancers.