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Similar to this question on Reddit, which asks for sources, I've heard various claims that during unanesthetized, ceremonial circumcision, the boy can go into neurogenic shock. For example, this article on DrMomma.org states:

Dr. Mark Reiss, long time physician and member of Doctors Opposing Circumcision, discusses ample research which shows us that even those babies who don't scream and cry while being cut apart - even the 4% who do receive anesthesia - still show significant and detrimental physiological changes in body and brain activity. Those who do not scream bloody murder show (on neurological scans) to be lapsing into a state of neurogenic shock and/or coma (which can sometimes occur immediately). To the untrained eye (i.e. the parent who says 'my baby didn't cry') it appears as though the baby has just fallen asleep... How blind we sometimes are.

It is not clear, however, what the "ample research" is or who performed the neurological scans and under what conditions.

Others have said that such claims are hyped up and that ceremonial circumcision is not harmful or very painful and that when babies cry little or not at all it's a sign that it's painful, and that most crying is just from the commotion surrounding the ceremony.

What's the real story?

  • How does one quantify how much pain a young child is in when they can't communicate it clearly? Some infants react to the procedure differently to others, which is probably expected as they may experience different levels of pain. Different infants (or adults) may also react to the same level of pain stimulus differently. I think this will be a very difficult one to answer unless someone has measured something scientifically. – jozzas Jan 6 '14 at 0:36
  • @jozzas I know that I've seen articles discussing quantifying it as in measuring heart rate or other metrics. There's a lot of literature on the subject but I need help sifting out the relevant and reliable information. – Uncle Jan 6 '14 at 3:02
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    The topic is not (any longer?) pain, but shock, which should be easier to measure. – Oddthinking Jan 6 '14 at 4:42
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    A circumcision study in 1997 was halted because babies were experiencing severe pain and trauma: cnn.com/HEALTH/9712/23/circumcision.anesthetic – pacoverflow Dec 7 '14 at 10:49
  • I know what shock is, but I've never heard of "neurogenic shock". Is this a recognized medical condition? – Nate Eldredge Sep 18 '15 at 7:57
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The search for "neurogenic shock circumcision" returns zero results on pubMed, which is the largest database of medical literature in English.

The closest thing I could find is "American Society for Pain Management Nursing (ASPMN) Position Statement: Male Infant Circumcision Pain Management," which states:

According to the AAP (AAP, 1999; AAP, 2005), there is solid evidence that male infants who undergo circumcision without the benefits of analgesia experience physiologic stress and pain. Unrelieved pain during circumcision can result in negative physiologic stress responses such as changes in heart rate and blood pressure, apnea, cyanosis, and decreases in cortisol level and oxygen concentration (American Academy of Pediatrics Task Force on Circumcision, 1999, Anand et al., 2005 and Berde and Sethna, 2002). In addition, male infants who are circumcised without analgesia may exhibit a stronger pain response to routine immunizations (Taddio et al., 1997).1

  1. http://dx.doi.org/10.1016/j.pmn.2011.08.007

Please note that this answer does not constitute medical advice. It is only meant to summarize published research related to the topic and limited to the cited sources. Consult your physician about what these results may mean for your health.

  • I would remove "in the US" from the first sentence, Pubmed is international. – nico Jan 6 '14 at 17:57

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