Another baby almost died as a result of his brit milah. The article in Yeshiva World News recently reported: “‘Three days following the bris a number of marks were detected,’ [the mother] explained during a special Knesset committee discussion initiated by MK (Meretz) Michal Rozen. ‘We thought it was diaper rash. Then we followed with a blood test and spinal puncture, which led us to learn the child was suffering from herpes, from the mohel who did Metzitzah b’Peh [direct oral suction on the wound]. The child could have died. The complaint was forgotten, and nothing was done. Three months passed, and [the Rabbinut] still did not speak with the mohel, who continued practicing.’ “
Who is to blame in a case like this? Is the Rabbinut at fault? The mohel? Perhaps the parents? Or is the blame shared in some way?
Part of the problem here is that Metzitzah has become so controversial.
Metzitzah is the process of drawing blood out of the circumcision wound. This part of the brit milah procedure was instituted for the child’s well being. In the time period of the Talmud, Hazal were greatly influenced by Greek medicine. The Greeks believed that coagulated blood, if left to collect, was extremely dangerous and could cause (what we call) an infection and could result in the child’s death. Rav Papa in the Gemara, Mesechet Shabbat, clearly states that Metzitzah is necessary because, if it’s not done, the child is in life-threatening danger. Performing Metzitzah is so important, in fact, it is done on Shabbat, even though it could easily be construed as a Shabbat violation. And if a Mohel intentionally doesn’t perform Metzitzah he is not allowed to be a mohel.
So where does the controversy come in? The Gemara never states how to perform Metzitzah but the tradition developed to draw blood out of the wound by direct contact between the mohel’s mouth and the incision. The problem is the mouth can harbor everything from germs to full-blown Herpes or even HIV. And while some of these may have little to no effect on the host, when they are transferred to an eight-day-old baby, they can result in infections, brain damage or even death. So, in effect, Metzitzah b’Peh has done a complete 180. It has gone from being a life-saving measure to life-threatening process, if done orally. And I think we would all agree that Rav Papa would not stand for this.
The key is for all mohalim to use a pipet when doing Metzitzah and for parents to require them them to do so. The pipet has a few benefits. The lack of direct contact insures that both parties are safe from infectious transfers and it’s halachically equivalent to doing it orally. It’s the best possible scenario because we can continue the tradition in a way that’s safe for all parties involved. If your mohel refuses to use a tube then find another mohel.
So in this most recent case, we’re forced to ask who’s to blame? There is no doubt in my mind that any mohel who performs Metzitzah orally should not be allowed to practice milah and I am not alone in this thinking. To name just a few, the Hatam Sofer, Rav Samson Raphael Hirsch, Rav Yosef B. Soloveitchik, Rav Hershel Schachter, the Rosh Yeshivah of Yeshivah University, and Rav Moshe Tendler, one of the leading professors of Jewish medical ethics, all agree that MbP is forbidden. In fact, Rav Tendler went so far as to say that the asserted requirement for MbP is a “prefabricated lie.”
But in some circles our opinion is the minority. In fact, the Rabbunit HaRashit took a surprising stance on the issue in 2013. Instead of coming out strongly against MbP, the Rabbinut went in the opposite direction, stating that the practice is preferred.
Any rational parent would think that they could rely on a Rabbinut certified mohel to keep their child safe. That’s what the certification is for, after all. But in this instance, they would be horribly wrong. The Rabbinut, as evidenced by this most recent near death case, is not helping the parents or protecting the newborn babies. So that leaves it up to us.
Parents — the days of keeping your head in the sand about what happens at a brit milah ends now. You need to know what’s happening because you must be advocates for your children. If your child were undergoing heart surgery, God forbid, you would become experts in the basic details of the operation. It needs to be the same with brit milah. Parents have to know what a mohel should and shouldn’t be doing with their baby because it’s clear no one else will do it for them. But up until this point, there was no central agency to help guide parents through this stressful period.
A new organization is starting, whose sole function will be to educate both parents and mohelim, as well as advocate for all issues brit milah related. It will be called Safer HaBrit. All those who wish to help build this movement please be in contact with me at saferhabrit.com It is my hope that one day soon there will be no more finger pointing because a child has been put in danger. We must all work together to make brit milah safe once and for all. I hope you’ll join me.
Hayim Leiter is a rabbi and mohel for the greater Jerusalem area. He can also be reached at firstname.lastname@example.org