title: Timing of Circumcision and Breastfeeding Initiation Among Newborn Boys.
abstract: Newborn circumcision, particularly in the first 24 hours of life, has been thought to adversely affect breastfeeding initiation. However, no studies specifically support an association between early circumcision and difficulty with breastfeeding initiation or maintenance. This study was designed to determine whether timing of newborn circumcision affects rates of exclusive breastfeeding during the first 2 weeks of life.
  
  
  
  A retrospective study of 797 newborn boys and their mothers was conducted at a large military hospital. Exclusion criteria included gestational age <38 weeks, multiple delivery, NICU admission, and absence of maternal intention to breastfeed. Multivariable logistic regression models examined the relationship between time of elective circumcision and exclusive breastfeeding at 3 time points: hospital discharge and the newborn and 2-week outpatient visits.
  
  
  
  Mean infant age at circumcision was 29.7 hours. Thirty-one percent were circumcised at <24 hours of age. Rates of exclusive breastfeeding were 66.8%, 64.1%, and 63.7% at hospital discharge and the newborn and 2-week outpatient visits, respectively. In the multivariable model, time of circumcision was not significantly associated with exclusive breastfeeding at hospital discharge (odds ratio [OR], 1.01; 95% confidence interval [CI], 0.99-1.00; P = .54), the newborn outpatient visit (OR, 1.00; 95% CI, 0.99-1.02; P = .84), or the 2-week outpatient visit (OR, 0.99; 95% CI 0.98-1.01; P = .44).
  
  
  
  There was no significant association between timing of elective newborn circumcision and exclusive breastfeeding in the first 2 weeks of life. In this setting, early circumcision of otherwise healthy, term boys had no deleterious effects on breastfeeding initiation or maintenance.
authors.affiliation: Department of Pediatrics, Naval Medical Center, San Diego, California; lisamondzelewski@gmail.com.
authors.forename: Lisa
authors.initials: L
authors.lastname: Mondzelewski
authors.affiliation: Department of Pediatrics, University of California, San Diego, San Diego, California.
authors.forename: Sheila
authors.initials: S
authors.lastname: Gahagan
authors.affiliation: Department of Pediatrics, Naval Medical Center, San Diego, California.
authors.forename: Christine
authors.initials: C
authors.lastname: Johnson
authors.affiliation: Graduate School of Public Health, San Diego State University, San Diego, California; and.|Institute for Behavioral and Community Health, San Diego State Research Foundation, San Diego, California.
authors.forename: Hala
authors.initials: H
authors.lastname: Madanat
authors.affiliation: Department of Pediatrics, University of California, San Diego, San Diego, California.
authors.forename: Kyung
authors.initials: K
authors.lastname: Rhee
mesh_terms: D000328:Adult; D001942:Breast Feeding / Q000706:statistics & numerical data*; D002944:Circumcision, Male; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D012189:Retrospective Studies; D013997:Time Factors