Adversarial childhood events are associated with Sudden Infant Death Syndrome | Hacker News Reader

Adversarial childhood events are associated with Sudden Infant Death Syndrome

biorxiv.org

59 pointsMelchizedek53 comments

Performing unnecessary surgery on childrens genitals is pervasive and needs to stop.

Most horrific is female genital mutilation, which makes sex painful for women.

Also terrible are surgeries performed on intersex babies with genitals that aren’t male or female. Surgeons choose makethe babies genitals conform as closely as possible, but they often mess up - people end up with painful genitals or the wrong genitals. Most intersex people could grow up with their original genitals and be perfectly healthy.

And now it turns out circumcision kills baby boys. Maybe we could just stop with the chopping up kids genitals.

I think it’s kinda shoddy of the author to claim that “circumcision causes SIDS” on his twitter feed, while the abstract states there is merely a slight link “and is useful for generating hypotheses and nothing more”. The focus should be on are there other stressors to test for? There are infinite other possible links to stressors in an infants life. Responding to another thread, my children sleep in their stomachs because they scream bloody murder until you flip them over— which one would you say is a great or stressor, tummy sleep or kicking and screaming? I also found out today that HN comes out strong against circumcision, which is all good, I just wasn’t expecting literally every thread to be on MNC.

I’ve found, with baby parenting, there is an enormous amount of guesswork presented as fact, and this paper seems to push that. Case in point, Procedure for handling newborns at my hospital in Memphis TN has changed substantially with each of my kids over the course of 5 years. “Nurse: oh we don’t do that anymore, it’s not good for the baby”. Oh but it was fine for my first 2 kids?

*edited to clean up and fill out my intended points

Circumcision is one of those hot topics guaranteed to get dramatic, strongly held opinions for & against. I won't be surprised to see this thread drop quickly off the front page due to heated discussion.

> I’ve found, with baby parenting, there is an enormous amount of guesswork presented as fact, and this paper seems to push that. Case in point, Procedure for handling newborns at my hospital in Memphis TN has changed substantially with each of my kids over the course of 5 years. “Nurse: oh we don’t do that anymore, it’s not good for the baby”. Oh but it was fine for my first 2 kids?

That's not "guesswork pushed as fact", that's more information being discovered through research.

It's very hard to do research into this kind of stuff, and when you've done the research it's hard to take the stuff you've learnt across a population and apply it to individuals.

As a soon to be new parent, I've also found a tremendous anount of guess work presented as fact.

Research seems to be the area most susceptible to politics and willful misinformation. My wife and I just pick the safest perceived route, and only deviate from that when something seems like an unresearched old wives tail.

My child will sleep on his back, but I dont blame the OP for scratching his head and wondering what is worse?

Are we sure there isn't a relationship (or an overlap, specifically) between "parents who circumcise their newborns" and "parents who allow their kids to fall asleep facing down?" Because I'm pretty sure this debate was measurably settled in the late 90s.

https://www1.nichd.nih.gov/publications/pubs/documents/SIDS_...

I suppose a difference in discussion could be bodily harm vs. behavior monitoring/modification. Cutting your baby would be somewhat different than assisting a newborn in not killing itself, comparable to not having exposed 220v wiring within reach. However, I'm not sure how that 90s debate went.

I swear we had this discussion a few days ago.

Reddit also debunked this particular paper.

Here is the methodology:"In the 22 US states analysed where the health insurance Medicaid covers male circumcision, cot death is significantly higher"

That's it. Not exactly a well done study.

It turns out the author is also the same person making widely debunked "Jews are descended from Khazars" claims. They do not seem to be doing any sort of reliable science.

It was a bit of a cultural shock, coming to USA, and learning that huge population (apart from jewish & muslim) were being circumcised. Years later, when our son was born, it came to me again about this societal "norm", but didn't even think for a second that this needs to be done. I hope the society (apart from cultural/religious observations) changes.

I wonder why it's still allowed to modify the body of a minor for lifestyle reasons without their knowledge or consent. Seems a bit ridiculous to me. The article is somewhat larger than just Circumcision, but since the title mostly points to that, it's the comment you're going to get ;-)

It's still allowed because people are ignorant, and those who aren't ignorant are irrational and are extremely good rationalizing (like all of us are about some things).

Another big factor is that the medical community has absolutely dropped the ball here. I believe that any ethical doctor must refuse to do a circumcision without a valid medical reason. The Hippocratic Oath demands it.

Well I imagine an attempt to ban circumcision would be immediately called anti-Semitic and then it would never happen. And that’s something nobody even wants to be accused of, so there’s less pressure to do this than there otherwise might be.

I know plenty of people who support circumcision and exactly zero of them are Jewish. We would see a tremendous pushback on any attempt to ban it regardless of it's association with Judaism.

That's what happend here in Germany. There was a court case where male circumcision was ruled bodily mutilation. Afterwards they created a law to make it legal only as religious practice (after a lot of discussion).

The impression I've gotten from most American parents I've brought up the issue with in the past is that they believed it was more hygienic and better for the health of the child to be circumcised.

Nowadays, being much older and wiser, I've come to understand that to really mean circumcision eliminated the need to regularly clean the child's penis behind the foreskin and educate him on doing so. It simply eliminates the topic entirely.

There was a thread on 4chan.org/b of all places not long ago where a young man photo-documented the first time he had ever cleaned his uncircumcised penis. He claimed his parents never educated him on the subject, and never cleaned behind the foreskin for him. He only just discovered it now, at what appeared to be a quite mature age. The process looked brutal and disgusting, and it took him multiple days of incrementally removing a hardened shell of smegma by picking away at it, leaving a very raw-looking skin behind.

It was quite surprising, and I had never envisioned such an extreme outcome as possible in an uncircumcised boy's life. Some parents are incredibly incompetent when it comes to teaching their kids about anything related to genitalia/sex. Circumcision avoids the issue for those cases, and I assume the incidence of these problems is also higher in religious households where the topic of sex tends to be more suppressed.

My god.

There is no change in cleaning requirements for a young boy's penis whether it is intact or not. By the time a boy needs to clean under his foreskin, he will long have been doing his own baths. I guess make sure he has enough information by then on what to expect, but honestly I'm surprised that people don't naturally figure out how to clean their own bodies. Did we really have to be taught this a thousand years ago?

> Did we really have to be taught this a thousand years ago?

Pre-religion, no, I don't think so.

Some religious households are frankly insane and raise their young to specifically avoid such discovery and exploration of genitalia. Don't forget there are religions in the world where women's genitals are mutilated to such an extent as to remove the clitoris entirely.

There's also a somewhat common condition [1] of the foreskin where it's relatively small and too tight around the head to be pulled back and cleaned. Imagine a young man having such a condition in such a conservative household where nobody ever discussed his penis beyond the minimal potty-training.

The 4chan story I mentioned in my previous post appeared to be such a case of a tight foreskin, where he had simply never pulled it back because it didn't seem possible. The level of ignorance about his own anatomy was genuinely shocking, and if there weren't such obviously authentic amateur cell-phone photographs accompanying the whole ordeal I would have been certain it was fake.

[1] https://en.wikipedia.org/wiki/Phimosis

That circumcision is still practice is insane. What is the benefit of all of the aggressive moralizing that goes on towards all kinds gender and sex causes at this point, and yet first world genital mutilation of boys gets almost no attention while causing 14% of male SIDS. Do not care about religious freedoms at that point.

I don’t think it’s really a religious issue at all, the religious practice happens outside of the hospital afaik.

When we were asked at my sons birth, it was definitely just something part of the standard operating procedure.

All sorts of benefits. Just because this particular just cause has no chance of getting off the ground because no politician is willing to put themselves in the crosshairs of pretty much all Jews AND Muslims and a large amount of Christian hangers-on (religious liberty advocates), doesn't mean that other causes without such formidable impediments are somehow moot.

EDIT:

I think I was unclear. I am NOT defending circumcision, I don't think it's defensible. I was responding to the parent poster, specifically this:

> What is the benefit of all of the aggressive moralizing that goes on towards all kinds gender and sex causes at this point, and yet...

I was trying to say that just because we can't get anywhere in banning male circumcision, doesn't mean that "all kinds gender and sex causes..." have no benefit.

Aren't the only benefits a slight decrease in STD transmission + easier cleaning of smegma? I think it remains mostly due to status quo bias. I can't imagine the medical community recommending another body modification with only two things that minor in favor of doing it.

Also, the STD transmission angle is suspect. Last I checked, a lot of it was based on studies out of Africa. There are lots of reasons to think that is apples to oranges. Comparing to other modern Western nations with a very low circumcision rate yields different conclusions.

Indeed. A study in Africa I read about halted the trial part way through on ethical grounds because the STI contraction rate in the circumcised cohort was so much lower. However I found no evidence that they had taken into account a healing penis wound causing less frequent (zero?) intercourse for this group.

> The allostatic load hypothesis posits that SIDS is the result of perinatal cumulative painful, stressful, or traumatic exposures that tax neonatal regulatory systems.

If true, this would mean that babies can literally be "stressed to death". Wow. I wonder what the age is when this begins to taper off.

Also, circumcision for babies and children should be outlawed. All freedoms are subject to limitations, including religious ones.

> Wow. I wonder what the age is when this begins to taper off.

Never? Stress causes heart attacks, suicide, overeating, etc. in adults. For example: https://www.mayoclinic.org/diseases-conditions/broken-heart-...

Why? From what I read:

Easier hygiene. Circumcision makes it simpler to wash the penis. However, boys with uncircumcised penises can be taught to wash regularly beneath the foreskin. Decreased risk of urinary tract infections. The risk of urinary tract infections in males is low, but these infections are more common in uncircumcised males. Severe infections early in life can lead to kidney problems later. Decreased risk of sexually transmitted infections. Circumcised men might have a lower risk of certain sexually transmitted infections, including HIV. Still, safe sexual practices remain essential. Prevention of penile problems. Occasionally, the foreskin on an uncircumcised penis can be difficult or impossible to retract (phimosis). This can lead to inflammation of the foreskin or head of the penis. Decreased risk of penile cancer. Although cancer of the penis is rare, it's less common in circumcised men. In addition, cervical cancer is less common in the female sexual partners of circumcised men.

That's roughly what I was told when we made the decision to circumcise our son.

Having read more, later in life, about the history and origins of the practice, it's a decision I really regret.

There's a lot of conflicting/unclear research and it's my understanding that there's not much solid evidence in either direction on most of this stuff. Small studies, questionable causation, etc.

That said, the hygiene argument is insane to me. Anyone who can be taught to wipe their ass can be taught to clean their penis.

Especially since pre-puberty, boys should be taught not to try and retract their foreskin for cleaning. It's not necessary, and forcing it might very well cause damage. From the perspective of a five year old, cleaning a circumcised penis and an uncircumcised penis is exactly the same.

>Easier hygiene. We could also cut out all our teeth, so we don't ever get cavities!

The problem with the rest of everything you mentioned is that the effect sizes for those things are tiny. Your chance of getting penis cancer when circumcised is 1 in 10,000,000, and if you don't its 1 in 10,005,223. This sort of tiny effect can just come from confounding variables, like "people who circumcise tend to be Jewish and American so they eat better food and get cancer less in general."

Maybe you should cite your sources because that is a lot of bullshit.

"Among the few alleged benefits of circumcision that are of actual relevance to children, the most prominent is the claim that it protects against urinary tract infections in the first year of life. The degree of relative risk reduction for circumcised boys is most often reported as 10-fold (over a small absolute incidence), based on retrospective data.[22] However, a large prospective cohort study – a more reliable research design – reported a relative risk reduction in hospitalization for UTI of 3.7-fold.[23] Furthermore, in this study, when all outpatient UTIs were considered, the relative risk reduction dropped to 1.73-fold.[23]

To put UTIs into perspective, a study from Sweden, where boys are not circumcised, found that, over the first six years of life, the absolute risk of UTIs in boys was low, at 1.8% versus 6.6% in girls, and that UTI infection in boys was rare after the first year of life (0.1-0.2%).[24] Another investigator found a UTI rate of 0.08% in males >1 year old.[25] When UTIs do occur, they respond rapidly to antibiotic therapy.[26-28] UTIs in the first months of life are less likely to involve the kidneys,[29] and UTIs rarely, if ever, result in hypertension or end-stage kidney disease.[30-37]"

https://www.doctorsopposingcircumcision.org/for-professional...

>Easier hygiene. Circumcision makes it simpler to wash the penis.

Totally false. You can teach your kids to peel and wash properly it's not hard at all. It's like washing behind your ears.

Don't fall for this and mutilate your children for no reason.

There's a ton of stuff we could do to to babies that has a lot better of a record on preventative effects.

Calm down folks, the paper is a preprint, it hasn't even been peer-reviewed nor published yet.

Repeat after me, correlation =/= causation.

Also, whether it causes SIDS or not, infant circumcision is horrible.

What I've always found ironic about circumcision is that it is done mostly by religious folks who consider humans to have been created by God as God wanted.

So, by circumcision in a way they're trying to fix a God's mistake!

No, it’s God’s plan, he sent the choice here to test you.

Don’t worry if you make the wrong choice though, it’s all God’s plan! Actually do worry because you’ll suffer all your life and go to hell if you screw up. But it’s all for a reason, you wouldn’t understand it. Stop questioning and do as I say.

But, sorry, pedantry, circumcision was done to distinguish a group of people as God's people.

personally i find even very selfish from parents piercing girls ears for earrings (like at least 80% parents do here around me), chopping skin of my son would be even crazier idea

if she wanna wear earrings or he wanna be circumcised they can make their choice when the time is right, but it's not up to me, i think same even about parents forcing their own religion onto their children and baptizing them

and i am not some theorist, i have actually both of those children

According to the annual UNICEF report Israel has a lower infant mortality rate than most of Europe not to mention the US and it’s pretty much a country where everyone gets circumcised.

Also in the US according to the CDC the demographic which has the highest SIDS rates is Indian Americans (not native Americans) and they have the lowest rate of circumcision amongst the US population.

Is there a difference in SIDS between boys and girls?

Yes, SIDS is more common in boys.

I didn't know that circumcision was a thing till I moved to a country where its the default. One girl even commented its "strange" to not be circumcised, no its "strange" to chop off a body part.

Don't know why people downvoted you but I felt the same. In my country or even in my area no one is circumcised (except for medical reasons, but even in that case is done ONLY if there is really no other solution and as last try for things like Phimosis) and until I discovered in USA is common practice I thought, and was instructed in school, that only some Orthodox jews did it as a standard practice for newborns.

We detached this subthread from https://news.ycombinator.com/item?id=17638716 and marked it off-topic.

Important to note this bit:

> Ecological analyses are useful to generate hypotheses but cannot provide strong evidence of causality.

https://xkcd.com/882/ and http://tylervigen.com/spurious-correlations may be relevant here as a result.

There is the whole, reduces your chances of contracting HIV thing...

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1127372/

https://www.scientificamerican.com/article/fact-or-fiction-c...

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5594533/

Edit: for those down voting, please see child comment with additional studies that are also current and cover multiple populations. HN is generally opening to arguments backed by peer reviewed research, I don’t know why this topic would be any different. Also, DannyBee’s comment is interesting, regarding this article having been previously debunked

Chopping the whole thing off would reduce the risk of HIV even further.

I actually don’t understand why providing links to articles with scientific research spanning a decade that backs up a hygiene practice that reduces the costs of one our lifetimes worst global health epidemics would elicit such snarky sarcasm. I actually don’t

Please be aware how much of that research sources back to a few studies in Africa. There are a few essential differences between the US and Africa beyond foreskin.

How about a study published this month:

http://journals.plos.org/plosone/article?id=10.1371/journal....

Or one that considers multiple countries:

https://europepmc.org/abstract/med/7974070

Or a 2010 article about men in the United States:

http://journals.plos.org/plosone/article?id=10.1371/journal....

I’m literally finding this stuff by googling on my cell phone, so clearly you’ve not bothered to check yourself. Given the costs in dollars and lives I don’t understand the biases toward writing this off.

I apologise for the snark. However there are other much more effective forms of HIV prophylaxis, such as condoms. I find it hard to imagine that any adult would choose to circumcise themselves because they were worried about HIV.

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