In my area, the circ rate is high, but the physicians who previously did them in hospital now prefer to do them in the office by the end of the first two weeks. The cost in the offices is less than the cost of one done as an inpatient, so this is easier on the parents, esp. if they do not have insurance that pays for it. Only if the parents insist because their insurance only pays IN hospital do the MDs do them there.Some use Lidocaine, some do not. Lidocaine does not ALWAYS work well as a block for circs, and does have risks of its own, but I still favor its use. TAking babe out to nurse immediately can help soothe him also! Denise Mollenkopf, RNC, IBCLC [log in to unmask]