peaceful parenting: December 2011

Acetaminophen (Tylenol) and Ibuprofen (Motrin) Dosage Charts for Babies and Children

Acetaminophen (Tylenol, etc.)

Due to a confusion in dosing (and many cases of overdose leading to ill infants, and even death due to liver failure from overdose) new across-the-board concentrations of "Infants'" and "Children's" strength acetaminophen is now being stocked on drug store shelves.

While the change takes place (2011-2012) many families will still have older, higher-concentration bottles in their home medicine cabinets. For this reason, it is important to note the precise concentration (160 mg per 5 mL is new; 80 mg per 1 mL or 80 mg per 0.8 mL are old bottles).

Below is a chart to know exactly how to dose by weight of your little one, should you elect to use acetaminophen (Tylenol). Note that using your child's weight to dose is significantly more accurate than using his/her age. Giving too little is unlikely to reduce pain; giving too much can cause severe health concerns, and even death in overdose-toxicity cases.

Every 6 hours as needed:

Quick List

Weight: 6-11 pounds = 1.25ml

Weight 12-17 pounds = 2.5ml

Weight: 18-23 pounds = 3.75ml or 1 1/2 children's chewables

Weight: 24-35 pounds = 5ml or 2 children's chewables

Weight: 36-47 pounds = 7.5ml or 3 children's chewables

Weight: 48-59 pounds = 10ml or 4 children's chewables

Weight: 60-71 pounds = 12.5ml or 5 children's chewables

Weight: 72-95 pounds = 15ml or 6 children's chewables

For further information see:

Know Your Dose: http://www.knowyourdose.org/sites/default/files/CHPA_Pediatrics_DosingChart_FINAL[1].pdf

WebMD: Dosage Change May Cause Confusion: http://www.webmd.com/parenting/baby/news/20111223/infant-acetaminophen-dosage-change-may-cause-confusion

Tylenol Dosing Page: http://www.tylenol.com/children-infants/safety/dosage-charts

Ibuprofen (Motrin, Advil, etc.)

Note that for babies over 6 months of age, ibuprofen may be more effective at reducing inflammation from teething and pain. Ibuprofen is more concentrated than acetaminophen, and less is needed per dose. For extreme cases, acetaminophen and ibuprofen may be alternated every 3-4 hours (i.e acetaminophen is taken at 12:00; ibuprofen at 3:00, acetaminophen at 6:00, ibuprofen at 9:00, and so on. Be sure you are charting dosages and times so that a mistake is not made if this is ever necessary). Dosing for ibuprofen is as follows:

Every 6-8 hours as needed with food or milk:

Infants' ibuprofen is concentrated at 40mg/1ml and is dosed as such:

Children's ibuprofen is concentrated at 100mg/5mL and is dosed as such:

Children's ibuprofen also comes in chewable tablets.

For further information see:

Dr. Sears on ibuprofen: http://www.askdrsears.com/topics/health-concerns/childhood-illnesses/medicine-cabinet/ibuprofen

AAP charts: http://www.healthychildren.org/English/tips-tools/Symptom-Checker/Pages/Ibuprofen-Dosage-Table.aspx

Motrin dosage charts: http://www.motrin.com/children-infants/dosing-charts?icid=home|tout|1

~~~~

How the Grinch Stole Breastfeeding

By Chuck Dufano, WIC breastfeeding coordinator with the Johnson County Health Department in Iowa City, Iowa (with thanks to Dr. Seuss).

Above: Emilee S.'s son, Noah, 11 months old, enjoys some Christmas Milk ❤

Every Who down in Who-ville liked breastfeeding a lot
But the Grinch,
Who lived just north of Who-ville,
Did NOT!

The Grinch hated breastfeeding -- no matter what season,
Now, please don't ask why. No one quite knows the reason.
It could be, he thought, there wasn't enough nourishment.
It could be, perhaps, to see it caused him embarrassment.
But I think that the most likely reason above others
Was he thought the Who-kids would love only their mothers.

And the more the Grinch thought all about breastfeeding
The more the Grinch thought, "I must stop this whole thing!
Why for fifty three years I've put up with it. Now,
I must stop these Who-kids from breastfeeding...but how?"

Then he got an idea.
An awful idea!
The Grinch
Got a wonderful, awful idea!

"I know just what to do!" the Grinch laughed in his throat.
And made a quick Santy Claus hat and a coat.
And he grabbed a big briefcase with great Grinchy pep.
"In this get-up I look like a formula rep!"

All the Whos were dreaming sweet dreams without care
When he came to the first little house on the square.
He climbed down the chimney while the Whos still slept
Then off to the nursery on his belly he crept.

He took all the bra pads and breast shells.
He took all the bags for expressed milk as well.
He took the diaper log and breastfeeding diary.
He took the La Leche League book from the library.

In their place he put powdered Enfamil cans
And Prosobee concentrate for soy-formula fans.
Next to it all with a great heavy lug
He placed a gallon store-bought filtered water jug.

"And NOW," grinned the Grinch, "the last thing to dump
Is the electric double breastfeeding pump!"
And the Grinch grabbed the pump, and he started to shove.
When he heard the small sound like the coo of a dove.
He turned around fast and saw a small Who.
Little Cindy-Lou Who, who was not more than two.

She stared at the Grinch and said "Santy Claus, why,
Why are you taking our breastpump, why?"

But you know, that old Grinch was so smart and so slick
He thought up a lie, and he thought it up quick!
"Why my sweet little tot," the fake Santy Claus lied,
"There's something wrong with the wiring inside.
So I'm taking it home to my workshop, my dear,
I'll fix it up there. Then I'll bring it back here."

But Cindy-Lou Who started to fret.
"Oh, my Daddy's going to be awfully upset!
He feeds baby mommy's milk when she is away,
He does this at least two or three times every day!"

"You mean your Daddy can feed baby breastmilk?"
The Grinch asked Cindy-Lou.
"Oh, yes," she replied,
"And he changes diapers, too!
He gives the baby a bath and they play peek-a-boo.
When mommy's nursing he brings her a cup of water or two!"

Now the Grinch stood puzzling and puzzling 'til his puzzler was sore.
Then the Grinch thought of something he hadn't before.
"Maybe breastfeeding," he thought, shouldn't make me moan.
"Maybe breastfeeding...perhaps...isn't mother's job alone!"

And now that his heart was no longer bitter
He became the official Who-baby sitter.
And to all those who listened to his heeding

He...he HIMSELF!
The Grinch encouraged breastfeeding!

Katie O. tandem nurses her 4-month-old sons. ❤

~~~~

German Factory Uses Infant Foreskin to Grow Human Skin

By Danelle Frisbie

An employee at the Fraunhofer Institute holds a culture plate with foreskin-grown skin samples.

We've watched before as human foreskin is harvested from infant boys in the United States and sold for use in cosmetics nationally and overseas. We've seen foreskin taken from infant babies and used in skin grafting for burn victims. Now a laboratory dubbed the "Skin Factory" at the Fraunhofer Institute in Stuttgart, Germany is using vorhaut von kindern - children's foreskin - to grow new skin samples for testing cosmetics and other products.

Project spokesperson, Andreas Traube, says researchers hope that this use of human foreskin could replace animal testing, and eventually be used in developing treatments for cancer, pigmentation diseases, and certain skin allergies.

The process itself takes six weeks to complete, and during this time 10 million skin cells are grown from one single boy's foreskin - to make new skin up to five millimeters thick. A machine is used to heat the foreskin to 98.6 degrees Fahrenheit (the temperature of the human body), and robotic hands extract cells from the organ. Scientists then take the extracted cells, mix them with collagen and connective tissue, and incubate them inside a petri dish lined tube, where they multiply at the same regulated temperature. This tube, approximately 22 feet long, 10 feet wide and 10 feet high, fosters the growth of the foreskin's cells into an epidermis layer of skin (the outermost skin on the human body). Three layers of this new skin are finally put together to create the end sample. In regards to the month and a half long time frame, Traube says, "We can't use the machine to speed up the process; biology needs time to take its course."

While European authorities have yet to authorize the Skin Factory for official use in product testing, new skin swatches from young human foreskin is begin produced at a rate of 5,000 samples per month and authorities are examining the factory to determine if the skin can be used commercially. "It's logical that we'd want to take the operation to a bigger scale," said Traube. And at least one German organization has already expressed interest in the machine. "I think the idea is a good one. I believe cells from artificially cultivated skin are indeed comparable with real skin," says Rolf Homke, spokesman for the German Association of Research-based Pharmaceutical Companies. "I do think it might take a few years to get up and running though. There are complicated international safety standards -- these procedures can't just be changed overnight."

One ethical problem in all of this? These harvested foreskins belong to babies and toddlers who are not yet able to consent to the organ's amputation from their own bodies. The Skin Factory uses foreskin only from newborn baby boys up to four years of age, and the goal is to gather as many infant foreskins as possible. "The older the foreskin is, the worse it performs," says Traube. And this foreskin (the prepuce organ) is one that all mammals are born with, male and female alike. It is on the human body for a purpose - it serves many important developmental, immunological, and sexual functions. Just as the foreskin is valuable to researchers when amputated from babies and toddlers, it is of even more value when it remains on the body to which it belongs.

Fraunhofer Institute for Interfacial Engineering and Biotechnology

Related Reading:

Huffington Post report on the skin factory:
http://www.huffingtonpost.com/2011/12/20/german-skin-factory-uses-baby-foreskin_n_1161384.html

New York Daily News report on the skin factory:
http://www.nydailynews.com/life-style/health/german-scientists-grow-artificial-skin-cells-baby-foreskins-article-1.994464

The Foreskins in Oprah's Face Cream
http://www.drmomma.org/2009/10/foreskins-in-oprahs-facecream.html

Article Asks, "Are Infant Foreskins the New Botox?"
http://www.drmomma.org/2010/04/article-asks-are-infant-foreskins-new.html

Stealing Foreskins: The Science of Skin Grafting
http://www.drmomma.org/2009/12/stealing-foreskins-science-of-skin.html

~~~~

Urine Samples and Catheter Insertion for Intact Boys

We receive two common types of forced retraction reports from parents: those that happen at well-baby checkups in the United States, often before a parent even knows what is happening, and those that happen when a parent ends up in the hospital with a baby who is catheterized (due to illness or surgery).

Before we address catheterization specifically, and the correct way to catheterize an intact male baby or child, it should be noted that frequently there is truly not a need for catheterization in the first place. With some surgeries, and post-op recovery, it is going to be necessary. However, often, in surgical cases for babies and toddlers, simply wearing a diaper and having another couple ready for change during and/or post-OR, is another option, especially if the toddler will be under general anesthesia for less than 4 hours.

Urinary Tract Infection

Besides surgery, the most common reason for catheterization is to check for the existence of a urinary tract infection (UTI). UTIs occur with much more frequency in girls than they do in boys due to the short urethra and proximity to the anus (contamination with fecal matter or bacteria from the hands of a care-taker are the two biggest causes of UTIs). UTIs are easily treated with antibiotics, but they should not be ignored or left untreated because bacteria can quickly spread up the urinary tract, through the bladder, into the kidneys, and do serious or permanent damage. UTIs are bacterial infections and once they have taken hold, merely drinking cranberry juice will not kill off bacteria, as some pop parenting reports suggest. Regularly consuming 100% cranberry extract capsules (a much higher concentration than you would get from cranberry juice) for older children and adults can reduce the likelihood of UTIs in the future by priming the health of the urinary tract, but it cannot 'cure' an already established bacterial infection. Even if symptoms disappear, the strongest bacterial strains may remain, causing future kidney problems. Therefore, if you suspect UTI, do not wait, and do not mess around with treatment if a UTI is confirmed. If antibiotics are prescribed for a UTI, be sure your baby or child takes the full does, on time, and does not miss any days or stop early (which can also lead to the most powerful bacteria lingering on when the child is asymptomatic).

There are some children (girls especially) who seem overly susceptible to contracting UTIs and may have a bout with several each year until they are older, out of diapers, without parents' hands helping them to wipe, and always wiping themselves 'front to back.' While it is not a subject regularly brought up at the physician's office, self-touching or exploration of the genitals (masturbation) with hands that have not yet been washed and have fecal particles on them is another way that UTIs can be contracted - again, especially among girls whose urethra is shorter and less protected. This does not make masturbation 'wrong' or 'dirty' -- it merely is a reality that we need to wash our hands before and after changing or wiping babies or toddlers, and encourage them to do the same before they touch their own bodies. This is also one of the reasons masturbation and circumcision became intertwined in U.S. history in the first place -- it was theorized that if we remove the prepuce (which houses the most nerves of any male body part, and a relatively equal number to the female clitoris) we would thereby diminish boy's and men's sexual desire to masturbate, and in turn, we'd also see fewer UTIs (among other illnesses previously blamed on masturbation).

In reality, when forced retraction is not part of the picture, UTIs are no more common in intact baby boys (boys who have their full, intact prepuce and penis) than in circumcised boys. The prepuce, in fact, serves to protect against UTIs. Additionally, breastfeeding reduces the rate of urinary tract infection for both male and female babies, as human milk is powerfully charged with antibodies and white blood cells, among other protective, immunological features.

Urine Sampling

Today, the two most commonly used methods of collecting a urine sample from non-toilet using babies and children in U.S. emergency rooms are the "clean catch" and "bag specimen." Neither method is done without contamination of sample, but research suggests that between the two, clean catch is the way to go. (1, 2) Note: Studies do show that there is no significant variation between clean catch versus a standard urine sample obtained through other means for older children and adults who can urinate into a sterile cup on their own. (3, 4, 5, 6, 7)

A clean catch receptacle designed by UriAid especially for use with children, women, or little ones who may be laying down during urine sample collection.

A clean catch works by wiping down the genitals of an infant or child with sanitizing wipes (provided by the clinic), and holding a sterile specimen bottle under the stream of urine - after the baby/child has started to urinate. This is considered to be the 'gold standard' of non-invasive urine sampling, but is more difficult to time with babies. Breastfeeding may help to fill and release the bladder.

For older children who can tell you when they need to go, a clean catch can be done at home. Wipe down the outside of the genitals and the perineum (between the urethra and rectum) with a wet cloth. Have your child drink a lot of liquid or nurse, and stand by or sit on the toilet with the faucet water running (this helps to psychologically induce 'flow'). Your child may also want to stand over a cup in the bathtub if he is more comfortable with this. Write your child's name, date of birth, and the date and time the sample was taken on the outside of the cup. Take it to your local urgent care or emergency room within 2 hours of the time it was taken (if more time has passed, it is likely they will ask you to repeat the sample). If your child truly has a UTI, it may be difficult for them to push out urine even when they feel the intense urge to 'go.' This urgency and frequency, coupled with being unable to eliminate urine, is a key indicating factor that there is indeed a UTI present, and a full round of antibiotics are justified. Babies who cannot tell you that they desperately need to go, but cannot, and that it constantly hurts, and stings when they try, are those who we are especially concerned with - their cry of discomfort, fever to fight infection, and possible reduction in wet diapers, are the only indications we often have of a UTI.

Urine collection pad kit.

The National Institute for Health and Clinical Excellence (NICE) suggests that the use of urine collection pads is the next best method of urine collection in a non-toilet using baby or child. This is a special pad made specifically for collecting urine that is placed into a baby's diaper after a wipe-down with a sanitizing wipe. The pad needs to be changed every 30-40 minutes (whether the child wets or not) so as to reduce the rate of contamination. (8) One reason that we see higher rates of UTIs in the first place during the first year of life is due to the diapering of our babies - a situation that helps to move fecal bacteria from the anus to the meatus (urethral opening). The same is true for collection pads - it is merely contact with the perineal area that increases contamination of sample - so change often. (9)

Pediatric urine collection bag.

Another form of urine collection (which sees no less contamination of sample than the urine collection pad, and is more cumbersome, so may not be the method of choice) is the urine collection bag. The bag has a U shaped sticky area (similar to a bandaid, but with less adhesive) on the round opening that is placed over the genitals after they are wiped down. The bag lays out of the way (to the top or bottom of baby's genitals) as urine is collected. A diaper can be put on over the the collection bag. If being used at home, the urine from the collection bag can then be transferred to a sterile collection cup and submitted to your local urgent care or emergency room within 2 hours, just as it would be with a clean catch. A 2009 study published in the Journal of Pediatrics found that bag-obtained specimens produced a significantly higher number of false-positive results (parents were told their child had a UTI, when in fact, he did not). In addition, there was a higher number of false-negatives (parents were told their child did not have a UTI, when he in fact did). (10)

Infant with urine collection bag in place.

Neither pads or bags may be left on a baby for more than 40 minutes or it will increase the likelihood of a bacterial infection even if your baby does not already have an infection. Leaving babies in diapers all day also increases infection potential - so give your little one some 'diaper free' time whenever you are able. Babies who are not yet crawling can do tummy time on a waterproof mat with a towel or cloth diaper laid out under him/her. Many parents today incorporate 'elimination communication' into their routine as well, which also reduces time in diapers.

Catheters

Occasionally, medical staff will suggest they need to collect an uncontaminated sample, or verify the results of a sample previously obtained through non-invasive means, with catheterization.

Adult intact male with Foley catheter in place to demonstrate how the catheter would appear inside your son. Infants and children have a shorter urethra (and shorter penis) which is one reason they have a tendency to get more UTIs. Therefore, the catheter itself will be smaller and shorter, without as far to go to reach the bladder. The balloon you see here (for the Foley) would be present if your son is catheterized for a surgery, but not present for a brief urine sample. The catheter goes directly from the urethra to the bladder - above the prostate gland that you see pictured here between the penis and bladder.

There are two types of catheters that are most commonly used with infant or young boys: the Foley catheter and the intermittent or Robinson catheter. The Foley catheter is used most often during surgery when the instrument needs to stay in place. This is done with a small balloon at the tip of the catheter that is inflated with sterile water once inside the bladder. The intermittent/Robinson catheter is a flexible catheter that is used most often when medical staff are checking for urinary tract infection. It is designed for the brief drainage of urine - to obtain a quick sample - and cannot stay in place without being held.

When an intact male baby or child is catheterized, retraction of the prepuce (foreskin) is not necessary or indicated.

In the United States there is quite a well founded concern that forced retraction will come into play when an intact male child is catheterized. However, it is the female patient for whom catheterization is actually more diverse and confounding. Age, weight, childbirth, past surgeries, female genital cutting, and many natural variations in the female body make catheterization of a girl or woman much more complex than catheterization of a boy or man, intact or otherwise. In general (unless hypospadias is a factor) the meatus (urinary opening) is going to be somewhat centrally located directly behind the opening to the prepuce, and fairly easy to 'hit on feel.'

The prepuce will typically be tightly adhered to the glans (penis head) of a baby or young toddler with little slack or room for movement, as seen in the photograph below. Even in boys as old as 10 years, many will still not have a retractible prepuce. In Pediatrics, Rudolph and Hoffman note, "The prepuce, foreskin, is normally not retractile at birth. The ventral surface of the foreskin is naturally fused to the glans of the penis. At age 6 years, 80 percent of boys still do not have a fully retractile foreskin. By age 17 years, however, 97 to 99 percent of uncircumcised males have a fully retractile foreskin." The average age of retraction is 10 1/2 years -- some will retract naturally, on their own, sooner, and some later. Each is within the range of normal, but no one should retract a baby or child except for the boy himself when he chooses to do so.

In their bulletin, Care of the Uncircumcised Penis, the American Academy of Pediatrics stresses, "...foreskin retraction should never be forced. Until natural separation occurs, do not try to pull the foreskin back - especially an infant's. Forcing the foreskin to retract before it is ready may severely harm the penis and cause pain, bleeding and tears in the skin."

Simply put, there is never a reason to forcibly retract the prepuce. Writes Doctors Opposing Circumcision in their article, Forced Retraction of Intact Boys: An Epidemic:

Only in the instance of significant hypospadias or epispadias (congenital malposition of the urethral opening) might retraction be necessary, and even then only if it is unavoidable collateral damage for which there should be specific follow-up care.

If your son has already been the victim of forced retraction, see Forced Retraction: Now What? for more information on how to handle things from here on out.

Intact baby boy and where the catheter will go.

If retraction of intact boys is not going to take place for catheterization, how then should it be done? By feel alone.

Nurse K. at Johns Hopkins Hospital in Baltimore, Maryland (top ranked urology hospital in the nation), writes,

I know for certain as a result of working with many intact boys that the catheter can be inserted without retracting the foreskin. There is no reason whatsoever that the foreskin would need to be retracted for a simple catheter insertion procedure. The catheter used on an infant will be tiny and should be easily slipped into the small opening at the tip of the foreskin, right into the meatus. Parents: be firm and tell others that retracting the foreskin is not acceptable! Not even 'just a little.' If you must, you be the one to hold your son's penis and slide the catheter into place. They can take it from there. Or, specifically ask for someone who has catheterized an intact baby without retraction.

Just as the skilled hand of a midwife can determine a baby's position by feel alone, without need for seeing or intervention, so can a nurse or practitioner catheterizing an intact boy without laying eyes on the meatus itself. There is simply no need to see the meatus in order to 'hit' it with a catheter. With one hand on the penis for steadying, the small tube can gently be moved into the prepuce, and pressed against the glans, so it will either hit the spongy tissue of the glans, indicating the need for ever-so-slight readjustment, or it will glide smoothly into the urethra. With a small amount of patience and practice, nurses can become skilled in catheterizing an intact boy so that it rarely takes more than the first try to get it.

Because the prepuce on an infant boy is typically quite stationary and non-mobile, there is not much prepuce slack, and there are not many places to 'go' with the catheter. If the first try does not work, a mere glance to the right or left, up or down, will. In an older, retracting child, after separation from the glans has started to occur naturally, he may wish to retract his foreskin enough on his own for a catheter to be inserted directly into the meatus (if he is awake during the procedure). But even for older children, simply holding the penis steady with one hand, while gliding the catheter into the prepuce opening, until it touches the glans where it can be pressed into the urethra, works quite well and uneventfully. If your practitioner is not willing to take the extra moment to catheterize without forced retraction, ask to see another staff member, or request a set of sterile gloves, while you take your son's penis, and his health, into your own hands.

For additional resources on raising intact boys see: How to Care for Your Intact Son
Medical Professionals for Genital Autonomy

Catheterization Without Retraction in Canadian Family Physician. 2017 Mar; 63(3): 218–220. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5349724/ • FULL TEXT

Image from Catheterization Without Retraction, 2017, sited above

REFERENCES

1) Hardy JD, Furnell PM & Brumfitt W. Comparison of sterile bag, clean catch and suprapubic aspiration in the diagnosis of urinary tract infection in early childhood. British Journal of Urology1976;48(4):279-83.

2) Alam MT, Coulter JB, Pacheco J, Correia JB, Ribeiro MG, Coelho MF & Bunn JE. Comparison of urine contamination rates using three different methods of collection: clean-catch, cotton wool pad and urine bag. Annals of Tropical Paediatrics. 25(1):29-34, 2005 Mar.

3) Lohr JA, Donowitz LG & Dudley SM. Bacterial contamination rates for non-clean-catch and clean-catch midstream urine collections in boys. Journal of Pediatrics 1986; 109:659-660.

4) Lohr JA, Donowitz LG & Dudley SM. Bacterial contamination rates in voided urine collections in girls. Journal of Pediatrics 1989;114:91-93

5) Bradbury SM. Collection of urine specimens in general practice: to clean or not to clean? J R Coll Gen Pract [Occas Pap] 1988;38:363-365.

6) Morris RW, Watts MR & Reeves DS. Perineal cleansing before midstream urine: a necessary ritual. Lancet 1979;2:158-159

7) Immergut MA, Gilbert EC, Frensilli FJ & Goble M. The myth of the clean catch urine specimen. Urology 1981; 17:339-340.

8) Rao, S. et al (2004). An improved urine collection pad method: a randomised clinical trial. Archives of Disease in Childhood. 89: 8, 773–775.

9) Rao, S. et al (2003). A new urine collection method; pad and moisture sensitive alarm. Archives of Diseases of Childhood. 88: 9, 836.

10) Welch, Thomas R. Bagging the Bag. Journal of Pediatrics 2009; 154(6):A1.

Australian urine collection instructions.
Note that (1) a clean catch sample by bag is perfectly acceptable and
(2) NO retraction should take place for an intact male.

United Kingdom urine collection kit. Includes:
• collection sheet • collection pad • plastic bottle • 5ml syringe

Danielle, who shared this photo (above) writes:
I hear so many stories of doctors wanting to cath babies for a urine sample, so I thought I'd show you the UK way! The sterile pad goes inside the diaper (nappy) and we use a syringe to draw out the urine, and put it into the specimen bottle. No cath needed! Ever!

Are YOU Paying for Infant Circumcision?

By Danelle Day © 2010

According to the American Academy of Pediatrics, routine infant circumcision (RIC) surgery alone costs taxpayers close to $70 million annually. Costs are much greater when payments for post-op complications and extended hospital stays are included in the circumcision surgery figures. (1)

The Centers for Medicare and Medicaid Services (federal program) has defined elective circumcision (ICD-9-CM V50.2) as medically unnecessary - the amputation of the prepuce organ is therefore a cosmetic, irreversible, surgical body modification. And it is one that is being done to infant boys with your tax dollars in 33 U.S. states and among TRICARE covered military families.

A study (2009) published in the American Journal of Public Health demonstrates that infant circumcision declines in those areas where Medicaid no longer covers the surgery (graph below). (2) As a result, many human rights activists believe that the key to granting all boys and men their right to bodily integrity lies in a nation wide end to Medicaid funding of RIC.

Members of GI: Genital Integrity for Military Families Abroad are equally concerned with ending TRICARE 's coverage of RIC for babies born to military personnel both in the States and abroad. In the Netherlands, where several GI volunteers work, the national medical society, KNMG, takes a firm stance against infant circumcision:

The official viewpoint of KNMG and other related medical/scientific organisations is that non-therapeutic circumcision of male minors is a violation of children’s rights to autonomy and physical integrity. Contrary to popular belief, circumcision can cause complications – bleeding, infection, urethral stricture and panic attacks are particularly common. KNMG is therefore urging a strong policy of deterrence. KNMG is calling upon doctors to actively and insistently inform parents who are considering the procedure of the absence of medical benefits and the danger of complications.

The International Coalition for Genital Integrity and Colorado's National Organization of Circumcision Information Resource Centers offer the following reasons to stop Medicaid funding of RIC:

* Infant circumcision is not recommended by the American Academy of Pediatrics (3) or any national medical organization in the world.
* Circumcision is considered medically unnecessary by all major medical organizations.
* Circumcision does not contribute to health, and deters from health.
* Nearly 70% of American parents do not want their boys (or their girls) circumcised.
* Routine circumcision of newborns has been abandoned in all English-speaking countries. (It has never been customary in most of the world.)
* According to comprehensive analysis, infant circumcision is not cost-effective. (4)
* Those choosing circumcision for themselves may pay privately if they desire as consenting adults.
* Medicaid savings will average $1 million annually for each State.
* Medically necessary programs need this money.

Currently, Medicaid does not cover infant circumcision in the following 18 states. Each state is listed according to the year in which tax payer funding of RIC ended in the state.

California - 1982

North Dakota - 1986

Oregon - 1994

Mississippi - 1998

Nevada - 1998

Washington - 1998

Missouri - 2002

Arizona - 2002

North Carolina - 2002

Montana - 2003

Utah - 2003

Florida - 2003

Maine - 2004

Louisiana - 2005

Idaho - 2005

Minnesota - 2005

South Carolina - 2011

Colorado - 2011

For further information and to become involved see:

Medicaid and Circumcision File (pdf)

Circumstitions: There's Money in Circumcision

ICGI: Medicaid Project

End Medicaid Funding of Infant Circumcision Facebook Page

End Taxpayer Funding of Routine Infant Circumcision Facebook Group

Find Your State's Medicaid Funding RIC Facebook page here

Medicaid Sample Letters to send (from 4Eric.org)

(TRICARE) GI: Genital Integrity for Military Families Abroad

References:

1. Mansfield CJ, Hueston WJ, Rudy M. Neonatal circumcision: associated factors and length of hospital stay. Journal of Family Practice, 1995;41(4):370-376.

2. Arleen A. Leibowitz, Katherine Desmond, Thomas Belin Determinants and Policy Implications of Male Circumcision in the United States. American Journal of Public Health, 2009;99(1):1–7.

3. American Academy of Pediatrics Task Force on Circumcision. Circumcision policy statement. Pediatrics. 1999;102(3):686-693.

4. Van Howe RS. A cost-utility analysis of neonatal circumcision. Medical Decision Making. 2004;24:584- 601.

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The 'Circumcision Song' Hits Airwaves Across Africa Thanks to Bill Gates' Funding

Max Chiwara, Oliver Mtukudzi, Enoch Piroro and Strovers Masobwe on stage together this fall.

It is difficult for me to temper the sick feeling rising up as I listen to the lyrics of this 8 1/2 minute recording and picture the multitudes of African men (and their unknowing partners) who are being blindly hoodwinked by the new "Circumcision Song" playing everywhere that money will buy air time across southern Africa.

Production and recording of the song was funded by the Bill & Melinda Gates Foundation and is performed by three of Africa's well known musicians - legendary singer/guitarist, Oliver Mtukudzi from Zimbabwe, and pop stars, Winky Dee, also of Zimbabwe, and Vee from Botswana. Backup musicians for the song were gathered and coached by Kumbirai Chatora from PSI/Zimbabwe. PSI and the Champions for an HIV Free Generation in Botswana coordinated production and recording (including the final choice of lyrics).

The song launched live at the International Conference on AIDS and Sexually Transmitted Infections in Africa (ICASA) in Addis Ababa, December 4-8. [See program here.] The reception was lead by former president of Botswana, Festus Mogae, and in attendance were the many donors and stakeholders pushing the "Voluntary Medical Male Circumcision" act as a vaccine of sorts for HIV.

During the opening reception for the song's release, over 200 individuals dressed in suits got up out of their chairs and danced away to the tune, chanting with the lyrics..."If you know you are a champion...get circumcised!"

The entire ordeal is heavily reminiscent of the Tuskegee studies - only we've transported the racist 'medical' acts to another nation where they cannot be under public informed U.S. scrutiny. This time, instead of pushing black men into vaccine/disease trials through exclusive print advertisement, or telling these same men they 'must' participate, or simply lying to them face to face, or doing something to them without their knowledge or consent, we are manipulating entire nations into a decision that not only impedes their normal sexual functioning (and that of their partners) but also deceives them into believing they are somehow now protected against HIV and other sexually transmitted infections - a misconception that is costing more lives, not less, each year in areas where mass circumcision takes place and HIV is rampant.

It's tough to convince adult men to amputate the best part of their most cherished member... some have suggested this is the reason 32% of Americans continue to cut newborn babies instead - they cannot fight back. There is no 'convincing' them - no one who can verbally say 'NO' with anything other than torrential screams and kicks. Today, instead of following the voluntary circumcision proposal for adults, some African nations are beginning to follow suit, like the districts' hospitals in Uganda where all baby boys will now be cut at birth - no questions asked. Grown men should have every right to make informed decisions about what they do or do not do to their own bodies. Babies, male or female, are also deserving of that same basic level of autonomy over their bodies - to have the option for decisions to be made when they are adults, and not have that choice stolen from them.

But the tune is catchy.

The musicians are some of the biggest and best in Africa.

The money is flowing in.

And, besides, you're a smart man! You're a bright man! The African ladies love a circumcised man! You want to be cool, and clean, and healthy! And if you'll really be a champion...why not cut off a part of your penis?

The Circumcision Song
[Listen Below]

What are you waiting for?
It's cool. It's clean.
It protects. It saves lives.
Get Circumcised!
What are you waiting for, Zimbabwe?
What are you waiting for, Botswana?
What are you waiting for, Lesotho?
Get Circumcised!

What are you waiting for?
It's cool. It's clean.
It protects. It saves lives.
Get Circumcised!

See a brighter destination!
(Are you a bright man?)
And a smarter generation!
(Are you a smart man?)
If you know you are a champion!
(Get circumcised!)
Get Circumcised!
[Repeated several times.]

You have to remember -
Male circumcision can be healthier,
Protect against penile cancer,
Protect against HIV.
The spreading of the virus, rise of me tempa -
So, let's go, Africa! Let's go.

Africa, let's get circumcised!
I got me emphasize:
The spreading of the virus, night and day,
Cannot be justified.
Let them know it is clean and simple.
Get Circumcised African people!

We live by example, so -
Let's go, Africa! Let's go.

See a brighter destination!
(Are you a bright man?)
And a smarter generation!
(Are you a smart man?)
If you know you are a champion!
(Get circumcised!)
Get Circumcised!
[Repeated several times.]

What's up my brother?
Let me tell you a secret -
In Africa -
They love circumcised men.
Please do it: make 'em well.
Please - it's quick and simple.
They don't feel it...
It's quick and simple.
African men: invest in your lives!
Let's treat it well.
Invest in protection against HIV and STI by 60%.

African Men! African Men! African Men!

See a brighter destination!

(Are you a bright man?)

And a smarter generation!

(Are you a smart man?)

If you know you are a champion!

(Get circumcised!)

Get Circumcised!

[Repeated several times.]

If you know you are a CHAMPION!

Say Goodbye to Croup Cough with Homeopathy

By Joette Calabrese, HMC, CCH, RSHom(Na)
Excerpt from Joette’s latest book, How to Raise a Drug Free Family, which she’s currently using to teach her first webinar course for mothers. Posted on DrMomma.org at author's request.

Croup Cough: This is my favorite kind of cough. Why? It has been shown that the degree of relief is dramatic whenever treated with homeopathic remedies.

But before embarking on the remedies and their differentiation, let’s make certain that you know what a croupy cough is like. Croup has that distinct sound. It sounds exactly like a seal barking. And for that reason, it is an alarming sound that can frighten both the parents and the child suffering from it. However, the results of choosing the correct remedy are so striking that it’s a pleasure to learn these remedies.

Croup is an illness that usually afflicts children from ages 1-4. It is one result of a minor respiratory infection followed by laryngitis. What often results is a horrible seal-bark cough that develops at night.

Dr. Boenninghausen, a famous German homeopathic doctor, was renowned for his simplification of this cough by addressing it with one of two remedies. I love when, in homeopathy, we can distill a remedy choice to simply one of three choices.

The first remedy to consider is Aconitum. This is not difficult to understand, because Aconitum is a remedy for a quick onset and needs to be used within the first 12 to 24 hours of affliction. Often another indicator for the use of Aconitum is that the child is frightened and restless with anxiety. This is the very picture of Aconitum. Give Aconitum 30 each hour, but if there is improvement, prolong the dosage frequency, so that it is only given every 2 hours. When improvement is obvious, stop. Sleep is considered to be "good improvement." So if your little one falls asleep, go right back to sleep with him. The event is likely over.

If not, and the cough persists, follow your last doses of Aconitum with Spongia tosta. And continue using it until he either falls asleep or the cough is finished. If it reaches the wee hours of the morning, and your babe is still coughing, or the breath doesn’t have a velvety quality to it, as it should, then give Hepar sulph 30.

It is encouraging to note that in most cases, a child will not need anything more than Aconitum. Job well done!

Joette Calabrese, HMC, CCH, RSHom, is certified classical homeopath who teaches and consults with moms the world over via phone and SKYPE.

For a free download of 10 Toxins and How to Antidote Them With Homeopathy go to www.homeopathyworks.net and find it on the “Free Downloads and Articles” section of the homepage. Then, consider scheduling a free 15 minute conversation with Joette to see if homeopathy is a fit for your, or your child’s, health strategy.

The information provided in this article is for educational purposes only and may not be construed as medical advice. The reader is encouraged to make independent inquires and to seek the advice of a licensed healthcare provider.

Radiation and Strontium Found in Japan's Baby Formula

By Danelle Frisbie

An artificial baby food manufacturer in Japan that makes up the sales of 40% of Japan's formula market has announced the recall of 400,000 cans of its formula containing traces of radioactive cesium 134 and 137 due to the nation’s recent nuclear plant meltdown. The same company exports formula to Vietnam under a different label.

Parents have flooded the Tokyo based Meiji Company with calls and emails, concerned about the impact it will have on their babies. Meiji said Wednesday that they do not know how much of the tainted formula has actually reached the mouths of little ones - the milk was manufactured in March and April and shipped soon after.

The formula contains approximately 31 becquerels (measurement of radioactive intensity) of cesium per kilogram, which is below the allowable limit of 200 becquerels per kilogram set by the Japanese government.

On March 11th of this year, the Fukushima Daiichi nuclear power plant was struck by an earthquake-triggered tsunami that damaged its cooling system and led to several nuclear reactor core meltdowns, spewing radiation into the air, water and soil of the surrounding landscape. Approximately 45 tons of radioactive water leaked from the filtration system at the atomic plant, and it was estimated that some of this water reached the Pacific Ocean not far from the plant.

Plant officials confirmed Wednesday that 150 liters of this water had indeed reached the ocean, yet other independent researchers estimated over 300 liters had actually run into the nearby Pacific. This poisonous water contained not only cesium, but also strontium - another toxic isotope. Strontium, unable to be cleaned from the water, is a carcinogen that accumulates in the bones of humans and animals and is believed to lead to bone cancers and leukemia.

Some experts have said the impact on human health will be negligible - others are suspicious that the clean up and control which is said to be taking place is not actually being followed through with. Parents are also concerned specifically with the strontium, which is believed to stay in the body much longer than cesium and as a result, presents a more vital health hazard, especially to babies who have been exposed during their newborn stage of rapid cell growth and development.

Radiation detection devices used in Japan to monitor radiation in vegetables and seafood are unable to identify strontium. “It’s expensive and difficult to detect strontium,” said Vande Putte, a radiation protection expert for Greenpeace. “If this stuff gets into the food chain, it would present complications of mammoth proportions.”

Radiation has been detected in a large amount of foods and drinks in Japan, including vegetables and fish, but this is the first time the poisonous matter has been found in artificial baby foods.

Despite the heavy concern on the part of formula feeding parents, who are not only using the formula, but also mixing it with local water, the Japanese government has downplayed the findings, saying that because contamination is within government set limits, there is nothing to worry about. It is unlikely, however, that government limits have been tested on the smallest of human newborns.

Greg McNevin, a Greenpeace spokesman in Tokyo, commented on Japan's reaction, “Even if the radiation levels in the formula are low, children are more at risk than are adults of getting cancer and other illnesses from radiation exposure. Any exposure to radiation is a risk, especially for infants. This isn’t something newborns should be faced with. For them, the risk should be zero.”

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Breastfed Babies Are Not Stronger Babies

By Danelle Frisbie

While we don't appreciate all the infant health advertisements that have come out of the city of Milwaukee, Wisconsin in recent months (their safe sleep campaign needs some real research-based help), this ad is more along the right track. It was developed by the City of Milwaukee Health Department (individual credits below) and printed in the Milwaukee Journal Sentinel by the Partners for Humanity.

The City of Milwaukee Health Department's Maternal and Child Health (MCH) Division has the following goals:

To reduce racial and ethnic disparities in infant mortality.
To improve school-readiness of pre-school children.
To reduce teen pregnancy and improve access to reproductive health services.

This breastfeeding ad supports at least the first two goals, and gives parents another reason to consider providing human milk for their human baby.

However, in reality, while may not make for positively-spun, feel-good advertising, it is not that breastfed babies are stronger - they are merely baseline in terms of natural human strength and body/brain development. Those who do not receive human milk, unfortunately, tend to be below baseline in terms of bone mass, muscle mass, core strength, and body/brain development and functioning. Breastfed babies are not stronger than the human norm; Artificially fed babies are weaker. There are always individual exceptions to this (or any) norm, but when we are speaking from a quantitative, sociological standpoint, across the board, human infants who receive human milk develop as they are meant to develop as human beings -- they exhibit the expected outcome level for our species of carry mammals -- and those who do not receive human milk are at a disadvantage.

In any given area, Milwaukee included, if artificial feeding is more common (more typically seen) than normal feeding, this does not negate or change the baseline level of human health/development when human beings have access to those basic things they were meant to receive. It merely means more people fall below this line. Even in the midst of fun advertising, we need to remember to watch our language... Breast isn't best: It's baseline.

AD CREDITS:

AGENCY:

Serve Marketing

http://servemarketing.org/

CREATIVE DIRECTOR:

Gary Mueller

ART DIRECTOR:

Mike Scalise

COPYWRITER:

Mike Holicek/Kelly Hardwick

ACCOUNT EXECUTIVE:

Heather Aldrich

PHOTOGRAPHER:

Eric Sahrmann

RETOUCHER:

Abe Finklestein

Breastfeeding Resource Page

(books, websites, articles for nursing mothers)

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Don't Retract Pack

Acetaminophen (Tylenol) and Ibuprofen (Motrin) Dosage Charts for Babies and Children

How the Grinch Stole Breastfeeding

German Factory Uses Infant Foreskin to Grow Human Skin

Urine Samples and Catheter Insertion for Intact Boys

Are YOU Paying for Infant Circumcision?

The 'Circumcision Song' Hits Airwaves Across Africa Thanks to Bill Gates' Funding

Say Goodbye to Croup Cough with Homeopathy

Radiation and Strontium Found in Japan's Baby Formula

Breastfed Babies Are Not Stronger Babies

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