At our hospital we generally do the circs the morning after babies (boys)
 are born.  Most of them go home later the same day.  One of our criteria
for sending moms home  in 24-48 hours is that they have achieved
successful breastfeeding, or breastfeeding has progressed to a point that it
 looks like it will be successful with a little more practice.  (or we send
them home on day three with a lot of follow-up in the home, if things are
still not falling into place.

We have observed that babies, as a rule, don't eat well following their circs.
They are generally pretty sleepy, well past noon, and sometimes don't
want to eat again until as late as 4 p.m.  The circs are done at 9:00 a.m.
 We  don't know if this is due to trauma, or due to the very sugary water
bolus that they are given just prior to the procedure (to sedate them).  Or
maybe they are just frustrated/uncooperative, because they were NPO
since 6:30 a.m.   We do know that whatever the cause or causes, it
interferes with breastfeeding, especially if breastfeeding is poor or tenuous.

At any rate, as a result of the babies' known, general reluctance or
disinterest in eating, most of us (RNs) will defer circs outright, or persuade
moms to delay the circs, when breastfeeding has not been going well.  By
well, I mean alert, vigorous babies, nursing with LATCH = 8 or better, for at
least two feedings directly prior to going for the circ.  If it is less than 8, the
baby better be losing points on TCH, not on L or A.

When moms worry about the delay, because they want to go home that
day, or for whatever reason, we point out that they have up to three weeks
to get the circ done, per our hospital protocols, but that the breastfeeding
needs immediate attention to maximize success.  We literally ask them, if
we have to, which is more  important to them -- that the baby is circ'd right
now, or that breastfeeding gets established as well and as quickly as
possible.  Usually, when it is asked like that, moms (and partners and/or
families) are much more willing to wait another day, or even a few days for
the circumcision, even though it means they have to get the circ done on
an outpatient basis  (which is far more hassle for mom/dad than doing it
right now).  In fact, I have personally never had a mom opt for the circ at the
potential cost of breastfeeding.

Two things bother me about our hospital's protocols regarding this whole
procedure:

One is that we keep the baby NPO for 2-1/2 hours prior to the
circ, because the peds don't want the babies to regurg during the
procedure.  But then they turn around and give them this bolus of
sugarwater right as the procedure is about to start!!  Which is more likely
to be regurgitated -- colostrum or sugarwater?  Which is more likely to be
caustic to their lungs, should they aspirate -- colostrum or sugarwater?
And which are they likely to have more of in the first two days of life,
colostrum in a feeding, or the sugarwater bolus?  Once again,
breastfeeding is being sacrificed, for NO GOOD REASON.  And all of this
in the face of studies that show that infants allowed to nurse before a
procedure will be more sedated and more content than the sugarwater will
make them anyway.  (Sorry, no references, I read this in Lactnet, and
elsewhere, before I started keeping cardexes)

The other thing that concerns me is that deferring the circ is still a nurse by
 nurse decision, so those who are not strong breastfeeding advocates, or
who don't "see" this relationship between circ and delayed feedings, don't
delay the circs in favor of BF, and moms end up staying in the hospital an
extra day anyway, but now it's our fault they have been delayed.

So that's my input, and my rant.  Sincerely,  Chanita, San Francisco