About a week ago I asked if anybody knew of any documentation that there is
increased drowsiness and/or poorer breastfeeding after a circ.  Thought I'd ask
one more time, to make sure there isn't *something* out there.

I received several email messages that echoed my observations, but the only
reference anyone suggested was the one in Pediatrics last year that compared the
use of Acetaminophen analgesia to no analgesia/anesthesia.  Since almost all the
circs here are done with nerve blocks, that doesn't help me.  An article in
Urologic Clinics of North America last year talked about behavioral changes
during and after circumcision without anesthesia, but didn't talk about any
changes if nerve block was done.  Why am I seeing babies that are out for most
of the day?  I admit to my prejudices, but the nurses who feel that circs are
the right thing to do make the same observations.

One of the people that emailed me thought it was best to have the circ done
during the sleepy recovery period after birth.  Any other thoughts on this?
I've tended to try to push it as late as possible to try to get several good
feedings first, but maybe it would be better to have one sleepy state rather
than two.  I don't know.  Thoughts?  References?

Becky Krumwiede, RN, IBCLC
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