This is a very exciting time for you and your family. While you may be anxious about the upcoming Brit, it is a joyous occasion.

As it is written: “May your mother and father rejoice, and may the one who bore you thrill with joy.” (Proverbs 23:25) The following is information regarding Ritual circumcision. Please read the material carefully, as it will detail the pre and post circumcision care of your baby. Once you have read the information, please feel free to contact me with any questions. Please call me as soon as possible after the birth of your son to book the brit. The Brit (Brit Milah) Circumcision is one of the only mitzvos practiced by all Jews regardless of their level of observance. It is the sign of the covenant that Abraham made with G-d, and is an indelible sign of our eternal bond with G-d. This commandment is written in the Torah in the book of Bereshis (Genesis), “and you shall be circumcised in the flesh of your foreskin, and it shall be a sign of the covenant between Me and you.” (Genesis 17:11) Timing of the Brit The timing of the Brit is also prescribed in the Torah: “he that is eight days old shall be circumcised among you, every male throughout your generation.” (Genesis 17:12). Therefore, the Brit must occur on the eighth day of life even if this is Shabbos or Yom Tov. Once we have set the date of the Brit, it is appropriate to announce this to relatives and friends. Honours at the Brit The Sandek is the one honoured with holding the child at the Brit. This is considered one of the greatest honours in Judaism. The Sandek may be any male, but traditionally this honour is given to a grandfather, family member, friend, or a Rabbi. Only a Jew may undertake the role of Sandek. The Sandek must wear a tallis during the ceremony. Kvatter & Kvatterin: This honour is one given to both a man and a woman (family members or friends). They are responsible for bringing the baby into the room where the Brit is to be performed, and in cases where the mother does not wish to be present, return the baby to her after the Brit. Some have the custom to bestow this honour on a couple that desires to have children, but this is not necessary. Others increase the number of those honoured by having many people participate by passing the child from one to another until the child reaches the site of the Brit. Kiseh shel Eliyahu (Chair of Elijah): A special chair is set aside at every Brit for Eliyahu Hanavih, the Angel of the Brit. Jewish tradition states that Eliyahu Hanavih attends all Brit’ to ensure the wellbeing of the child, and to report back to G-d that His people are still carrying out the mitzvah of Brit Milah. The one so honoured places the child on this chair from which the father will take the baby and place him on the Sandek’s lap as a sign of appointing the Mohel as his shaliach (representative) to do the brit. Standing Sandek: The person given this honour holds the baby while the blessings after the Brit are recited. Second Standing Sandek: The person given this honour holds the baby during the naming ceremony. It may be combined with the Standing Sandek honour. The Mohel is a specially trained individual, in the practice of infant circumcision. The mohel is a Sabbath observant Jew who must attend to the medical and halachic aspects of the brit as well as the emotional and spiritual needs of the parents. Naming the Baby The baby is given his name after the circumcision. It is traditional, but not mandatory for the child to be named after someone in the family. Ashkenazic Jews do not name children after living people; however some in the Sephardic community do so. The Ceremony Candles are lit at a Brit without saying a blessing. One or more people may be honoured to do this. A Seudat Mitzvah (meal that accompanies the performance of a mitzvah) is served at the time of the Brit, with the exception of fast days. There are many laws and customs surrounding the Brit Milah. Should you wish further information, I would be happy to provide you with some references for further reading. The Blessings

The mohel recites the blessing, “Baruch atah A-donay, Elo-heinu Melech Ha’Olam, asher kideshanu bemitzvotav vetzivanu al Ha Milah”,  “Blessed are You, L‑rd our G‑d, King of the universe, Who has sanctified us with His commandments and commanded us concerning circumcision.”

Then he begins the circumcision.

The father recites the blessing, “Baruch atah A-donay, Elo-heinu Melech Ha’Olam, asher kideshanu bemitzvotav vetzivanu le-hach-ni-soh bivrito shel Avraham Avinu“, “Blessed are You, L‑rd our G‑d, King of the universe, Who has sanctified us with His commandments and commanded us to enter him into5 the Covenant of Abraham our father.”

Those present respond:

“Ke-shem she-nich-nas la-brit kein yi-ka-neis le-to-rah le-choo-pah oo-le-ma-a-sim to-vim.”– “Just as he has entered into the Covenant, so may he enter into Torah, into marriage, and into good deeds.”

Items To Be On Hand at the Brit A table large enough for my instruments and the baby (bridge table). Two chairs; one for the Sandek, and one for the Kiseh shel Eliahu One pillow in a pillowcase. Kiddush cup filled with kosher sweet wine(Manischewitz, Carmel, etc.) . Two candles in candlesticks and matches. (Not on Shabbos or Yom Tov) Disposable diapers and diaper wipes. A small waste paper basket with plastic bag. Three tallises; one each for the father, Sandek, and Standing Sandek. 30g tubes of Polysporin Complete. Three (3) boxes of 4″x 4″ (10cm x10cm) gauze pads. One receiving blanket. Pre Brit Care Finish feeding the baby one full hour before the circumcision. This avoids painful indigestion from a recent meal, though is not so long that your baby will be overly hungry. Then give your baby 0.5 ml of infant acetaminophen solution (Tylenol/Tempra) approximately one hour prior to the circumcision. For the circumcision, your son should be dressed in short T-shirt, socks, and wrapped in a flannel receiving blanket.  After preparing the baby Dr. Greenberg will administer the local anesthetic. Post Brit Care – First three days Keep your son snugly swaddled. The less he moves his legs the less discomfort he will have. With each diaper change (no more than 4 hours in between.) Squeeze a mound of Polysporin Complete, about the size of a Loonie onto the centre of a sterile 4″ x 4″ gauze pad and set to the side. Remove the dirty diaper, clean the baby, and place a clean diaper underneath the child. Remove the existing 4″ x 4″ pad by gently peeling from bottom up. Expect to find some light blood stains with the first few changes. They should lighten with each subsequent change. Inspect the area for fresh blood. If there is no new bleeding, place the new gauze pad over the penis so that the mound of ointment is applied directly over the tip of the penis and then close the diaper. Post Brit Care – General Expect your son to be a little irritable for about one day. Most babies like to nurse in a quiet environment following the circumcision. Babies who cry for more than a few minutes are usually suffering from air swallowed during the procedure and need to be burped. Most babies sleep quite well following the circumcision. The best sleeping position for your baby is on his side, supported by a blanket roll. Healing is promoted by keeping the area clean and dry. Warm water and a soft cloth are preferred for cleaning the area around the penis. Avoid pre-moistened towelletes, alcohol, powders, and lotions as they may cause irritation. Disposable diapers are strongly recommended for the first week as they tend to be less irritating and are much drier than cloth diapers. Avoid unnecessary travel as car seats can be irritating to the newly circumcised baby, and can delay healing. Do not bathe your baby for the first 3 days after the Brit. Sponge baths are allowed. Continue with the Polysporin Complete dressing for 3 days after the Brit. Have your son examined by your Family Doctor or Paediatrician within one week of the Brit. Bleeding IF THERE IS ACTIVE BLEEDING You treat bleeding on the penis the same as you would for the tip of a finger. If this occurs: Apply pressure to the penis for 3 minutes. Do this by grasping the penis between two or three fingers over the 4″ x 4″ gauze pad. DO NOT REMOVE THE PAD as this may cause more bleeding. Inspect the area for continued bleeding. Continued bleeding will be evident if the gauze pad continues to become redder with blood. If bleeding continues, apply another 4″ x 4″ gauze pad over the existing one and repeat step 1. When the bleeding stops, leave the pads on the penis and close the diaper. IN ALL CASES OF FRESH BLEEDING, PLEASE CALL ME IMMEDIATELY FOR FURTHER INSTRUCTIONS. Healing Process Healing is usually rapid and can be viewed in several stages. It should be remembered that this is like any other cut and that there are many factors that influence healing; but most importantly every child heals differently. First, the cut edge seals and bleeding ceases within minutes. Within hours, maybe a day, the area just behind the glans (especially the underside) will become swollen. This inflammation subsides within a week or two. One to two days following the circumcision there may be an off white or yellowish, patchy appearance of the glans. These patches are a type of scab and are associated with normal healing. You will also notice that the glans is red and glossy. This is because the skin covering the glans of an uncircumcised penis is mucous membrane (like the inside of your cheek). Once exposed, the mucous membrane will toughen (a process called keratinisation), and in time will take on a normal appearance. The penis should take on a “normal” appearance within about one month’s time. Circumcision is associated with few and infrequent complications, though as with any surgical procedure there are occasional problems. The most common complication is bleeding. In most cases, bleeding is controlled by direct pressure as described in a preceding section. There are reported cases of infection, although these are rare in this setting. Common signs of infection include a pus discharge, a foul smell, excessive swelling or redness, local warmth, fever or rash in the penile area. With development of any of these signs, please call me immediately and I will give you further instructions. Some infections which do not cause a fever, but only mild symptoms, can usually be treated with a topical antibiotic ointment. Final appearance of the penis is dictated by many factors. The final appearance of the penis is the greatest cause for concern amongst parents. It should be remembered that everyone’s anatomy is different and as such, penises come in all shapes and sizes. The result of one circumcision cannot be identical to the next. While most penises begin to look “normal” within days of the procedure, some do not take on a completely “normal” appearance until after the penis begins to grow. Furthermore, the penis may look smaller after the circumcision. On occasion, a poor aesthetic result occurs when too little or too much foreskin is removed or more likely when the cut edge of the skin attaches too high or too low along the length of the penis. The latter is sometimes caused by a penile erection or hydrocele. In nearly all cases, the penis will heal properly and in time take on a “normal” appearance. Any concerns should be brought to Dr. Greenberg’s attention, as early treatment, if needed is always best. In case of emergency, Dr. Greenberg can be reached by cellular phone at 416-702-8990. Bris (Brit Milah) follow up is provided by Dr. Greenberg in his office or in his home 1-2 days following the bris.  Dr. Greenberg will remove the bandage and ensure that the healing process is proceeding normally.  The follow up visit takes between 10-15 minutes.  Some Mohalim do not provide direct in person follow up. Dr. Greenberg believes that an in person follow up is an essential part of the duties of a Mohel.