A Modern Pain Free Brit

By Y. Aaron Kaweblum

I have been a “mohel” (person that has a rabbinic certification to perform Jewish ritual circumcisions) since 1980. I am also a Board certified pediatrician in private practice. Over the last decade I have noticed a trend among Jewish parents to have the baby medically circumcised in the hospital instead of fulfilling the biblical commandment of ritual circumcision or Brith milah. I believe that many parents think that a medical circumcision in the newborn nursery is medically more appropriate and/or that a “Brith Milah” is a barbaric tradition. The ceremony of “Brith Milah” dates back many thousands of years. It is probably on of the oldest rituals in human history. According to Jewish law, it takes place on the eight day of life, counting the date of birth as day one, assuming the baby is born before sundown. The Brith-milah could be postponed for health or other religious reasons, but it can never take place before the eight day. Scientific medical studies have shown that circumcised males have a lower incidence of penile cancer, and are less prone to acquire sexually transmitted diseases. Recent studies have shown that the baby’s ability to stop bleeding could be decreased during the first week of life. In some cases it is not until the eighth day that the factors required to stop bleeding reach normal level. Approximately ten years ago, the AAP (American Academy of Pediatrics) demonstrated that a newborn baby feels the SAME level of PAIN as an adult, and strongly condemned the practice of surgery on a baby without using proper pain control. From the religious prospective, Rabbi Tendler from Monds NY, a famous orthodox “posek” (a Rabbi that has gained the trust and respect of the religious community and writes answers to difficult religious issues) wrote that doing a Brith-milah without pain control, is against Jewish principles. In 1997 a study published in JAMA (Journal of the American Medical Association) showed that only the injection of local anesthesia was effective in controlling pain during newborn circumcision. That same study probed that the user of “EMLA” (topical cream for pain) was useless and even dangerous. In my personal case, as an orthodox mohel and a pediatrician I have been using local anesthetic on my newborn babies for over 15 years. I even perform Brith-milah ceremonies in babies as old as nine months or 16lb. In the USA it is against the law to do any kind of surgical procedures on laboratory animals without anesthesia. I still don’t understand why the law allos Rabbis and physicians to do surgery in human newborns without a local anesthetic. Therefor, if you are expecting a baby boy, don’t turn back on the biblical commandment of Brith-milah. The torah and modern science are on your side. Y. Aaron Kaweblum M.D is currently practicing in Miami, Florida. This article is being published with the consent of Y. Aaron Kaweblum M.D.