On June 7th, I uploaded a manuscript to bioRxiv that describes an ecological study between two common infant phenotypes (male neonatal circumcision (MNC) and prematurity) and Sudden Infant Death Syndrome (SIDS). The paper is currently under review in a medical journal. Very briefly, SIDS is the death of a healthy <1 year old infant whose cause of death could not be ascertained in a postmortem examination. The current paper followed my previous 2016 paper where I proposed the “wear and tear” hypothesis. I summarized it here.
Illustrating how SIDS is explained by the allostatic load (“wear and tear”) model for males and females. From Elhaik 2016.
The current paper showed that MNC and prematurity are correlated with the rate of SIDS in both international and US national databases and that their combination explains SIDS better than these two factors apart, in support of the “wear and tear” model. Within a couple of weeks the paper ranked in the top 1% of most-read papers in bioRxiv, and with that arrived some not unexpected criticism.
This one is from Prof. Dr. Heymans, an emeritus professor of pediatrics. Prof. Heymans has been described as one of the Netherlands’ foremost pediatricians who for decades had worked at the Amsterdam Academic Medical Centre and was the chairman of the medical committee for many years, accompanying circumcisions of young boys. Impressive credentials, let’s hope that Heymans will make it interesting. Heymans was interviewed and described my study as “nonsense” for the following reasons:
Criticism 1 – Repeating the obvious
Elhaik looked at how often cot death occurs in fifteen countries and among white Americans and Hispanics as part of his studies. In this way he found a “strong statistical connection” between circumcision and cot death, about seven to eighteen weeks after the intervention took place. His conclusion: “Circumcision may increase the risk of cot death as a stress factor.”
I find that conclusion very short through the bend. There is a sea of other factors that can play a role and that can influence its outcomes. Elhaik also admits this himself when he states that although he finds a statistical connection, he might completely overlook another causal relationship. In my view, this opportunity is indeed life-sized. If you compare hispanics and white Americans, the differences are immediately obvious: socio-economic factors, eating habits and the like.
That there are many factors that increase the risk for SIDS is not in doubt, this is the essence of the “wear and tear” model (see the above figure). Reporting the conclusion of my studies as criticism of them is not very convincing.
Criticism 2 – The Salsa factor
SIDS has very clear characteristics that separates it from random deaths by all these multitude of factors. SIDS is male predominant and occurs during the very first weeks from birth. White infants die more than Hispanic infants and most death occur at the winter time. Heymans explained that the differences between Whites and Hispanic people are:
immediately obvious: socio-economic factors, eating habits and the like.
It may surprise Heymans to know that Hispanics in the US are not exactly on top of the SES. In fact, Hispanics are fairly similar to Blacks and both have lower SES than Whites. Yet less Hispanic infants die than Black and White infants. Why? Let’s consider the second “obvious” factor “eating habits.“ It may surprise Heymans to know that eating habits are irrelevant for SIDS as most death occur before a baby eats solid foods. Does Heymans propose that something like salsa, consumed by the mother and passed through the milk, protects infants from death?
Criticism 3 – Montana, where no Jew has gone before
From eating habits, Heymans expands to geography
Elhaik himself writes that SIDS is the least common in New York and most often in the state of Montana. While in New York a lot of circumcisions take place because many Jews live there. Then of course you want to know: how does that work? Starting from the stress hypothesis, significantly more cases of cot death should occur in New York than in Montana. In short, questions about this research.
First, we are studying SIDS, not deaths due to circumcision or complications following circumcision. These were studied extensively by other groups (see references in both my papers). My study researched new factors associated with SIDS (death due to known risk factors, such as suffocation, would not be labeled as SIDS) and concluded that MNC was one of the risk factors.
Second, circumcision is very common in the US among all non-Hispanic non-Asian populations, even in Montana. It is irrational to conclude that more Jews equal more circumcision, however, it does raise an important question – are Jewish infants more likely to die from SIDS? We do not have enough data to answer this question as SIDS records do not include religion. However, as I have shown in my previous study and in the current one, using the Lilith motif, Jews have always suffered from “unexplained” infant deaths following circumcision that they embedded it into their culture as caused by a demoness. I realize that Heymans may believe that these deaths are due to Jewish eating habits, including the unexplainable consumption of bagels or matzah balls (that I personally cannot digest), but evidence awaits.
Lastly, the population of New York is x8 times larger than the population of Montana. When dealing with small numbers, outliers tend to occur. It’s called the law of averages. To avoid these we consider the whole sample (in this case, all US states) for which data are available rather than pick the points that we like the most. We also do not look at whole numbers, but rather rates. When we understand these basic statistical principles, we can repeat the analysis using the scripts provided in the paper and see that the results are statistically significant.
Criticism 4 – The fear factor
Heymans finally states that:
The scary thing about this type of research and the tendentious conclusions is that opponents of circumcision use such a publication as an argument to substantiate their position. Such complications are worse than the rare risks that the intervention itself entails.
This statement simply doesn’t fit with Heymans other assertion that “Jewish parents have nothing to worry about”. Pick one and stick with it.
Prof. Heymans and the like are taking advantage of the trust and medical ignorance of the public. Unfortunately, ignorance is not always a bliss and more often than not it serves those who proclaim superior knowledge to satisfy their religious beliefs and greed (MNC is a huge money-maker, both for hospitals and cosmetics). They are used to playing roulette with the life of infants, upset when their toy is taken away, and play the victim card. They should be scared, but not of the opponents of circumcision.
Today, 8 more perfectly healthy American infants will die, 5 of those are boys at least 3 of whom were circumcised by a provider who probably did not inform parents that the surgery may result in death. The official cause of the death would be SIDS, cot death, SUID, unknown or some other “natural cause,” although there is nothing natural or even supernatural about the death of a healthy infant.
It is my work and those of other scholars that establish the legal ground for the one single thing that scare charlatans – lawsuits. Perhaps the next time that infant will die after circumcision, like Amitai Moshe, the court will not rule that it was of “natural causes.”
One thought on “A response to criticism for the Elhaik 2018 SIDS study”
When will societies wake up and realize that male circumcision began as an ancient tribal identification and rite? Circumcision, male or female is really genital mutilation, done on a neonatal being who has no knowledge, understanding or awareness of what is being done to her or him and cannot make an informed choice, for or against.
Regarding SIDS, for most people, the current understanding for all life and of humanity, is that there is only the physical being. My view is that a person has a physical body, an Astral body, a Mental body, an Emotional body, an Intuitive body, a Spirit and a Soul. These are called the seven levels of consciousness. My opinion is that physical life is NOT possible without a spirit and soul, or any of the other bodies. For most human beings, the spirit and soul enter the physical body of a new born, just before or just after the physical birth. Most every human being has lived, near countless lifetimes, in previous bodies. Sometimes, when a spirit and soul incarnates in a newborn physical body, that spirit and soul may not like the circumstances of the new body or the life that they find themselves in and may decide to leave. If the spirit and soul leave the physical body, the connection with the Universal Life Force energies is gone and this may be part of the cause or the main cause of SIDS.
This would be difficult to research from a physical perspective.