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During the first year of life, an uncircumcised
boy is 10 times as likely to develop a kidney infection
as is a circumcised infant. These serious infections are
caused by fecal bacteria binding to the moist undersurface
of the foreskin and moving up the urinary tract. The predominance
of kidney infections in uncircumcised infants was first
described in the 1980's coincident with an increasing
move from cloth, to paper-lined to super-absorbent polymer
diapers. Leakage of loose stools, common with cloth and
paper-lined diapers, is prevented by the new polymer diapers.
Superior fluid absorption means that
the diapers remain dry longer, necessitating less frequent
diaper changes. Infective fecal bacteria are thus kept
closely in contact with the foreskin for a longer period,
increasing the chance of infection. Kidney infections
in uncircumcised infants below the age of 1 year can result
in kidney scarring and abnormal kidney and hormonal function.
Further, the infection can spread to the bloodstream and
have fatal consequences, particularly in babies below
the age of 2 months.
The health risk of efficient absorption
of body fluids was pointed out over 20 years ago, following
an outbreak of "toxic shock syndrome", a severe
often fatal infection. It was noted that this disease
followed the introduction of super-absorbent vaginal tampons,
which promoted longer retention of the tampon in the vagina.
Pathological bacteria were given more time to grow and
produce dangerous toxins, resulting in shock, and death
in some cases. The super-absorbent tampons were recalled
from the market.
There is evidence that the risk
of kidney infections in uncircumcised infants is increasing.
In the 1980's it was found that about 1% of uncircumcised
infants developed kidney infection. Recent studies from
California and Sweden indicate that this has risen to
2% of uncircumcised infants. Can this disturbing trend
be tied to the increasing use of super-absorbent polymer
diapers? Answering this question may prove to be difficult,
given the continued efforts of the multibillion-dollar
disposable diaper industry to develop increasingly absorbent
diapers (New Yorker magazine, November 26, 2001) and the
current absence of relevant research studies on this issue.