Baby boys experience excruciating pain during circumcision without local or general anaesthesia

Anatomical, neurochemical, physiological and behavioural studies confirm that newborn responses to pain are 'similar to but greater than those in adult subjects'. Infants circumcised with no anaesthesia (reflecting common practice) experience not only great pain, but also physiological stress and an increased risk of choking and difficulty in breathing. Increases in heart rate of 55 bpm have been recorded, i.e. 1.5 times the baseline rate. After circumcision, the level of blood cortisol increased by a factor of 3-4 times the level before circumcision. As a surgical procedure, circumcision has been described as 'among the most painful performed in neonatal medicine'. Investigators reported, 'This level of pain would not be tolerated by older patients'. Using a pacifier during circumcision reduced crying but did not affect the hormonal pain response. An infant may also go into a state of shock to escape the overwhelming pain. Therefore, while crying may be absent, other body signals show that severe pain is always present during circumcision.

Preliminary studies suggested that pain experienced by infants could have long-lasting effects on the infant's future behavior, so researchers decided to study circumcision. They took two groups of infant boys, similar except that one group was circumcised and the other was not. They followed them months down the road until their 4 and 6-month vaccinations. Would the circumcised babies be so traumatized by their circumcision that they would show a stronger pain response to the injections? Using standard pain indicators - infant facial action, cry duration, and visual analog scale pain scores - they did indeed show a significantly different response to pain based on whether they were circumcised or not at birth. The study concludes, "Circumcised infants showed a stronger pain response to subsequent routine vaccination than uncircumcised infants.