well, maybe not "the next big thing" but still something that I think hospitals in the US need to look at.  Please, before starting on the subject,  pay close attention to the following:  I am NOT asking for opinions or discussion of whether or not the procedure should or shouldn't be done.  Lactnet is not the forum to discuss circumcision benefits or risks.  I am simply concerned about TIMING of the procedure.   Our hospital has been doing very well skin to skin and delaying bathing.  Our exclusive rates are going up.  However, we have no protocol in place about delaying circumcision until baby has transitioned well into extrauterine life.... including establishment of good breastfeeding.  Circumcision separates baby from mother for a good bit of time (thereby disobeying one of the ten steps) and stresses infant even when anesthesia is used.  At our hospital, it is done to accommodate the obstetrician's schedule and while there are some who are sympathetic to the infants feeding needs and nurse's pleas, there are many who are not.  I was dismayed to see a set of 37 week twins who were less than 24 hours old and not feeding well being wheeled to the procedure room to be circumcised.  What happened next is predictable.  The babies go into shutdown mode and do not nurse well, get jaundiced and lose too much weight and get supplemented.  The OB said he was all booked up and would not be able to do the procedure again in the hospital.  If the family waits until the procedure is done in the doctor's office after discharge it costs considerably more money.  Most families don't recognize the importance of delaying the procedure and most OBs do not either.  
My questions are: Does anyone know of studies being done on this? (if so, references, please?)  Is anybody else recognizing this issue?  Any protocols in place?
Please help!  AGAIN : NO opinions of the procedure itself to be shared in this forum.
Thank you as always,
M Westra RN, IBCLC

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