How Much Does It Hurt?

The same baby pictured in this story, mid-bris. Photo: Amy Arbus

Conventional wisdom once held that because an infant’s nervous system was not yet fully developed, he wasn’t fully capable of experiencing pain. Modern research, however, suggests otherwise.

In a study conducted at Rochester General Hospital in 1994, researchers used heart rate, breathing, and reactions like crying and making eye contact to quantify infant pain. They came to the conclusion that infant Tylenol, the customary pain reliever used in most hospitals, was not nearly enough to do the job.

Three years later, a University of Toronto study suggested that the pain experienced in the course of a neonatal circumcision may even have long-lasting behavioral effects. During a trial of a numbing cream, the scientists discovered that circumcised babies show stronger pain response to subsequent routine vaccination than uncircumcised ones, even after four or six months. (This study employed a technique called neonatal facial coding, which gauges pain from such indicators as “brow bulge,” “nasolabial furrow,” and “eyes squeezed shut.”) The paper concluded that the findings might “represent an infant analogue of a post-traumatic-stress disorder.” The American Academy of Pediatrics has since formally recommended the use of anesthetic in circumcisions.

Advocates of circumcision insist that the above studies rely on circumstantial evidence. They note that many medical procedures are painful, and that infants’ kicking and screaming comes as much from being restrained as it does from the cut.

All that may be true, but the scientific community seems to have reached a new consensus: While the consequences of infant pain are still not fully understood, circumcision hurts plenty.

How Much Does It Hurt?