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Sunday, July 25, 2010

Timing the Bris

The Bris takes place in daylight hours of the eighth day of the baby’s life. The day of birth is considered the first day of life, unless the baby is born after sunset, in which case the following day is considered the first day.

While a bris is never performed earlier than the eighth day of a baby's life, a bris may be delayed under very specific circumstances:

a. If the baby was born by ceasarian section and the eighth day is the Sabbath or a Festival

b. A baby who contracts an illness must be completely healed before he has his bris.

c. A premature or otherwise very small baby will wait until he achieves a suitable weight for him to withstand the stress of the bris.

While there is no exact definition of a healthy size, many mohels arbitrarily follow a five pound range (give or take a couple of ounces) as a minimal weight upon which to circumcize. Doctors will often clear the baby at lower weights, but when a mohel is uncomfortable due to size reasons it is better to be safe than sorry. Once the baby reaches five pounds, however, if the mohel continues to push it off, it is worth seeking another mohel so as not to continue delaying this important, timely mitzvah.

ps. When a baby is being circumcised for the sake of conversion (most typically on account of adoption - though some mohels will do such when the baby's mother is not Jewish), it need not take place on the eighth day of his life because there is no "mitzvah" to circumcise him. In this case, the circumcision should take place sooner than later, but the timing will be determined based on when the baby arrives at his adoptive family, and when they are ready to have his circumcision.

Why We Name the Baby at the Bris

[Subsequent to writing this, I wrote an article on this subject which appears in my other blog]

There is no Biblical injunction to name a baby boy at his bris. It is clear that when the forefathers were born they were named immediately - Yitzchak was given his name first (Genesis 21:3), THEN he was circumcised in the following verse (21:4).

When Yitzchak's sons were born, they were named immediately (25:25-26). Each of Yaakov's sons was named as soon as he was born (Chapters 29-30).

[Full disclosure: God changed Abraham's name from "Avram" to "Avraham" after he circumcised himself.]

So why do we name the baby at the bris?

This leads into a larger question of why we do all the things we do at the bris? Why does the ceremony look the way it does now? How much of it is rooted in Kabbalistic practices? Medieval practices? European practices? Middle Eastern practices?

After all, the Torah only commands that the baby be circumcised on the eighth day, and perhaps a celebration should accompany the circumcision. But there is no mention of a sandak, Elijah (who of course had not been born yet), or the formalized ceremony we see today, including the naming taking place after the circumcision.

What if the bris is postponed for health reasons, or not performed at all because of a history of hemophilia in the family? Is the baby not named? Of course the baby is given a name! Which would indicate that naming at the bris is not all that significant.

So why do we name the baby at the bris?

Here are a few ideas I have found in researching this question

A. When Elijah the Prophet is present

In Genesis 2:19, the Torah says וכל אשר יקרא לו האדם נפש חיה הוא שמו. That after meeting all the animals, Adam gave each one a name.
I read somewhere that the acronym of the first five words of this phrase are the letters of the name אליהו - Eliyahu/Elijah. The first letters of the next three words, נ, and ח, and ה have a numerical value of 63, which is the same as the word נביא - prophet.

The last word is
שמו, which means "his name," and we have found our significance. When Elijah the Prophet is present, that is when "his name" is proclaimed.

B. Completing a Jewish Identity

Some will argue that the bris is the final step in making a baby a Jew, and so his name comes at this highly significant moment. I have already debunked this myth.

More palatable, the name is a completion of the individual's identity. If the bris completes his physical body (as Abraham is told in Genesis 17 to "walk before Me and become complete" through the act of circumcision), it is only after the bris that his name can be given to him. (Rabbi Menachem Azariah deFano (1548-1620), "Mamaarei Rama MiPano")

C. Tumah/Tahara
Until the bris he was uncircumcised – which is not the ideal state of a male Jew. Any name he may have had until his bris was unbecoming to his identity as a Jew – so he receives a Hebrew name at his bris, in celebration of his new physical status.


There are differences of opinion as to when girls are named in relation to their birth, but everyone agrees that a girl is given her name on a day when the Torah is read, when her father is called for an aliyah or some other Torah reading participatory role.

For more on this subject - regarding boys and girls, see this article

Wednesday, July 21, 2010

Don't Use the Mogen Clamp!

An article in the Atlanta Journal-Constitution has reported on a lawsuit against the makers of the Mogen clamp. (text of article produced below)

I have never been a fan of this clamp (see method 1 here), and even the FDA has issued warnings against clamps because of their potential of irreversible damage

Simply put, no step in the circumcision procedure should be irreversible until the actual removal of the foreskin. Once the shield is in place, it is important to double check that the proper area of skin is ready to be excised. In the event the shield was initially applied incorrectly, it can simply be removed and repositioned - no harm done.

Once a clamp is put in place, anything in its clamping mechanism is essentially dead skin, and the excision/amputation which follows is irreversible.


Atlanta lawyer wins $11 million lawsuit for family in botched circumcision
By Ty Tagami

The Atlanta Journal-Constitution
Monday, July 19, 2010

The maker of an instrument used in circumcisions claimed that injury was impossible with its use, but after an infant lost a portion of his penis during an operation with the Mogen clamp, a judge awarded $10.8 million in damages against the company.

The judgment handed down Friday in New York involves an Atlanta lawyer who has been crusading against circumcision as a dangerous and unnecessary practice.

Attorney David Llewellyn won a similar case in Atlanta last year and the injury behind that prior lawsuit in Fulton County Superior Court put the New York clamp manufacturer on notice about the danger of the device, his current lawsuit said.

The baby in the current case, identified in court documents only as L.G., lost the entire glans, or head, of his penis after it was pulled into the jaws of the clamp, according to a federal magistrate's order. On Friday, U.S. District Judge Jack B. Weinstein ordered Mogen Circumcision Instruments of New York to pay $10.8 million in compensatory and punitive damages to the Florida boy, now 3, and his parents.

The parents "are extraordinarily distraught and angered that this company tells people it can't happen," Llewellyn said.

It's unclear whether they will ever collect the money. Mogen is already in default on a $7.5 million judgment in 2007 from a Massachusetts lawsuit, Llewellyn said.

The company is going out of business, according to a woman who answered the phone at its Brooklyn headquarters Monday. The woman, who said she was a secretary and would identify herself only as D. Rotter, the person whom Llewellyn said was served papers in the lawsuit. She said increased competition has undermined their business.

"It's just kind of dwindling down to nothing," she said, adding that the phones at the Mogen office were scheduled to be disconnected Tuesday. Mogen didn't defend itself in court, and Rotter said it was because the company couldn't afford it.

She said the Mogen clamp is "painless and safe" when used properly. The case involving the Florida boy was "unfortunate," she said, adding that "any medical mishap is unfortunate."

In this case, a New York mohel, or Jewish ritual circumcisor, performed the operation in the baby's home, Llewellyn said. The mohel negotiated a separate settlement, the terms of which Llewellyn would not disclose.

Llewellyn won another circumcision case in 2009 over an operation at South Fulton Medical Center. In that case, which involved a baby identified only as D.P. Jr., the mother contended that the doctor who circumcised him removed too much tissue and that his pediatrician failed to respond when a nurse complained of excessive bleeding.

The tip of the penis was placed in a biohazard bag and might have been reattached if he'd gotten attention in time, Llewellyn said in 2009. His lawsuit in New York says D.P. Jr. lost a third of his glans.

The jury found that both the pediatrician and the physician who performed the circumcision were negligent, and awarded $2.3 million to the plaintiffs. South Fulton Medical Center was absolved of liability.

In Friday's decision, the court determined that Mogen had to pay for medical expenses and for the years of psychotherapy that will be needed. The boy suffers pain when he urinates, the court order says. He will eventually be able to have sex, but he is likely to be embarrassed and will likely have trouble forming "meaningful" relationships with girls, it adds. "At 3 years old, L.G. is aware that he looks different from other boys based on both his own observations and comments from other children which make him feel inferior ."