Putting on my asbestos suit before commenting. I think circumcision (pro and con) is possibly even more controversial and inspires more frothing at the mouth on the part of pediatricians, ob/gyns and family practicioners (not to mention parents, babies and all sorts of otherhealth providers). This is my opinion as a "circumcision neutral" pediatrician--one who performs circumcisions (with local anesthesia and pacifier in babes mouth) after extended counseling of the parents. Please also bear in mind that the American Academy of Pediatrics is also circumcision neutral. Circumcision (in boys--I'm not even going there with female circumcision--I do not support that) is done mainly for religious and cultural reasons. The medical indications are very controversal (both sides will argue with studies that suport their viewpoints--however I must note I have never treated a circumcised infant male for Urinary Tract Infection in my 15 years of experience). In my experience if a family wants their boy circumcised and have strong opinions about it-I have very little success changing their minds. As for painful procedures and breastfeeding. Yes infants feel pain--that's why I use local anesthetic when I do the procedure. However they scream as they are being put in the circ restraint board, as they are being cleaned and draped. The other thing I have noticed anecdotaly that these babies suck and feed like there is no tomorrow after being "circ'ed." I know from my post doc days studying infant taste and smell that sucking (of any kind nutritive and non-nutritive ) is key for an infant's habituation, soothing and pain relief. Having taken care of many infants who had to stay in NICU and had painful procedures done eg spinal taps, IV's , multiple blood draws and the like, I know that breastfeeding can be successfully done with the appropiate support. What do I do in my clinical practice? I prefer doing circumcisions in the office when an infant is 3-5 days old. That way I can spend more time talking with the parents, and also have a better feel for whether or not the babe has any medical problems. However many insurers will pay for circumcision ONLY if done in the hospital or the parents push to have it done before discharge. Under those circumstances I will do a circ in hospital when the infant is about 24 hours old. In our hospital normal newborns are discharged at about 24 hours of age (and yes this is another thread that will induce frothing at the mouth on the part of many participants). What did I do with my son? Yes Josh had his circumcision at 4 days of age under local anesthesia with a pacifier (sucrose soaked--analgesic per Dr. Shoen's study). He is half Ethiopian Coptic Christian--infant males are circumcised per cultural and religious traditions as Coptic Christians have similar traditions to Judaism. His Buddhist (me) mommy had to flee the room (my pedi partner thought I would want to be there...NOT). After the circ, Josh breastfed like a champ! In fact I was in the office an extra half an hou r to finish feeding him. Yes, I felt somewhat guilty but I also reminded myself of the thousands of cath urines in full septic workups (blood, spinal tap and urine cath with 48-72 hours of IM or IV antibiotics) I have done in the past on febrile infants. Yup, I'm a mean unfeeling pediatrician and mom! I'm also pragmatic. Enough for now! Flamesuit will remain on for now:)! Pierrette Mimi Poinsett MD FAAP Modesto CA