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Thursday, February 18, 2016

Is Metzitzah Right For You?

Before the year 2000, metzitzah was a practice only people in the observant community knew about. When stories came out about babies contracting herpes after a bris, including some babies who died from the virus, metzitzah became a household word, and knowledge of the practice (even among those who couldn't recall the word) became a matter of concern.

What is metzitzah?
Metzitzah is understood to be the act of drawing blood "from distant places" out of the circumcision wound immediately after the removal of the foreskin. The word itself has many possible translations. Of course, technically any drawing of blood can be done with a gauze pad or sponge, or through a tube (such as is done when blood is taken for a blood test or for a blood bank), or, as is the "traditional" way through vacuum-suction as created by the power of the mouth. In this latter formula, there are two ways this has been done: a. through the medium of a straw, sterilized pipette, or inverted syringe, or b. through direct oral contact of the mouth. See both methods in this video (link is to youtube)

Is Metzitzah Necessary
There is no question that while the Talmud lists metzitzah as one of three steps of a traditional circumcision, that the practice of drawing out blood reflects the medical knowledge of the time, and that any vestige of metzitzah is a nod to an ancient tradition. 

However, as we don't take medical advice from the Talmud some of the great rabbis of today and yesteryear suggested that metzitzah in any form is unnecessary מעיקר הדין, as an absolute obligation (Rabbi Joseph B. Soloveitchik, Rabbi Herschel Schachter). Certainly there is no justification for putting a mouth on an open wound, knowing what we know of today in terms of hygiene and bacteria. 

If Unnecessary, Why Do It?
Since the Talmud says to do it, many traditional mohels will still do metzitzah via the alternative method which does not put the baby (or the mohel!) in danger. It fulfills tradition without any harm as the only things touching the baby are sterilized in the same machine as the surgical instruments.

I always do metzizah with a sterile pipette. Of late, when families specifically request "no metzitzah" I have been ready to accomodate them in light of the teaching of Rabbis Soloveitchik and Schachter.

For more on Metzitzah, see the Metzitzah Page

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