How do I locate a Mohel who will perform a circumcision for a non-Jewish family?
The best way is by word of mouth. You (or an eager future grandparent) may have attended a Jewish Bris and taken the Mohel's card. Or your pediatrician or obstetrician may have a referral. Most often, one family will pass the Mohel's name onto the next and so on.
Do I have to appoint godparents?
No. The appointing of godparents is optional. You may appoint as many godparents as you wish or none at all. It is up to the individual discretion or custom of the parents. It also has nothing to do with legal guardianship.
Do you have to be rabbi to be a Mohel?
No. I happen to be a cantor and there are many rabbis who are also mohels. One doesn’t have to be a rabbi or a cantor to be a mohel.
How did you become a Mohel?
I apprenticed to the Chief Mohel of Jerusalem in 1977. I studied the laws, participated in setting up the instruments, changed bandages, and by the end of my apprenticeship, performed a number of circumcisions, first under very close supervision and then "solo." Once he was satisfied with my abilities, he certified me. Since then, I have performed more than 20,000 circumcisions.
Why should I use a Mohel instead of having my baby circumcised in the hospital or using a doctor/mohel?
A Mohel is a traditionally observant Jewish individual, specifically trained in both the religious and medical aspects of this ceremony; a doctor is a medical professional. In hospitals, circumcisions are usually done in the nursery, and parents often do not even know when the surgery takes place nor will they be allowed in to observe or be with their baby. Once parents learn how hospital circumcisions are performed, they often will contact me to perform their son’s circumcision. Pediatricians, obstetricians and urologists routinely call upon me to perform circumcisions for their children, grandchildren or their patients’ children. Indeed, many of my referrals come from the medical community.
When a circumcision is performed by a doctor in the hospital or by a non-traditional doctor/mohel, the baby will most likely be strapped to a cold, molded plastic body board. The procedure can take anywhere from twenty to forty-five minutes, depending upon the skill of the individual performing the circumcision. Frequently the device used with this method is the Gomco circumcision clamp. In addition to increasing the baby’s discomfort significantly, there are many who consider the use of the Gomco clamp unacceptable. It is recommended that the person chosen to perform the circumcision be a practicing, observant and experienced Mohel.
OTHER REASONS TO USE A TRADITIONAL MOHEL INSTEAD OF A DOCTOR OR DOCTOR/MOHEL:
The traditional mohel is a super-specialist, an expert at his profession, who possesses more experience at performing circumcisions than most doctors. A mohel may have the opportunity to perform more circumcisions in a month than some doctors do in an entire year. Availability:
Doctors may be called away on a medical emergency or have to cancel their participation in your child’s circumcision at the last minute. There have been occasions when I have been called in to perform circumcisions on behalf of doctors who have cancelled due to a sudden medical emergency. Tradition:
Brit milah (ritual circumcision) is an ancient Jewish ritual, and being a mohel is a time-honored profession. If doctors were routinely to perform a mohel’s function, a spiritually rich and important Jewish tradition might eventually be lost. Many families seek out a mohel because they want the circumcision to be performed properly by someone who is spiritually connected. They don’t want a clinical procedure. Technique:
When a doctor or a non-traditional doctor/mohel performs a circumcision, the baby may be strapped down to a cold, molded plastic body board. The procedure can take up to forty-five minutes depending on the ability of the individual doing the circumcision. The device that is used is called the Gomco circumcision clamp. It is a very clinical procedure and very difficult for the baby.
The technique that I use is very different. The baby is not strapped down. Instead he is placed on a cushion and held by warm, loving hands. The technique that I use takes forty seconds or less. The device I use is called the Mogen circumcision clamp. I autoclave (heat-steam sterilize) my instruments, wear gloves and follow the same techniques of sterilization that doctors use.
How much pain does the baby feel?
Simply put, we really don’t know. There is clearly some discomfort. Many studies have been done trying to ascertain how much pain the baby feels. These studies, however, reflect the clinical experience of hospital circumcisions, not circumcisions that were performed by traditional mohels. A baby will cry during the circumcision when his diaper comes off and he is exposed and cold and he will probably cry when his legs are held, as well.
I believe the reason that this question is asked with such frequency is because of the non-traditional circumcision techniques that are used today by doctors in hospitals or by non-traditional mohels. The circumcision takes a long time, the device used is much more painful than what I use and the lack of experience all contribute to this discussion.
Is there any anesthetic that can be used?
This is related to the previous question. There are a number of possibilities, but all of them have some drawbacks. Also, this question seems to come up in relation to hospital or doctor circumcisions where the procedure takes so long. Again, the circumcision I perform takes under thirty seconds!
Topical anesthetics like EMLA or LMX, need to be applied about an hour before. Topical anesthetics are not recommended on newborns under three months. They can cause significant swelling of the tissue that may prevent the circumcision from taking place. They often act as a vasodilator that can cause much more bleeding and, although rare, if the child has an allergic reaction to the ingredients, it can cause seizures or cardiac arrest. The following is a quote from the insert that comes with the EMLA cream: "Due to the potential risk of methemoglobinemia and the lack of proven efficacy, EMLA Cream is not recommended for use prior to circumcision in pediatric patients."
Cetacaine or Lidocaine in spray or ointment form may not work on this type of tissue. Also, while toxicity and/or the possibility that it may be absorbed is remote, if it is, it could cause seizures or cardiac arrest.
A penile block consists of multiple injections of Lidocaine in and around the base of the penis. I never really understood why anyone would do this. I have personally observed the injections being administered and it seemed to me that the pain of the injections was greater than that of the circumcision. Also, in my experience, the baby has always cried after having been given a penile block. And, as above, while toxicity and/or the possibility that it may be absorbed is remote, if it is, it could cause methemoglobinemia, seizures or cardiac arrest.
Sugar water can be given to the baby to reduce his discomfort. The baby may suck on a gauze pad soaked in concentrated sugar water prior to, and during the circumcision. In my experience it is the safest and best way to reduce the baby’s discomfort. Also, a study was recently published comparing sugar water to a topical anesthetic and the results were the same!
If you wish to use what Jewish families use, kosher sweet wine or grape juice can be given to the baby before the circumcision or following it. (It’s the sugar content, not the alcohol content that helps the baby.) In combination with the sugar water, the baby’s discomfort is significantly reduced and the recovery time increases significantly.
I will humorously suggest to the parents that the best anesthetic for the baby is as follows: Before the circumcision, take two glasses and fill them with wine. The mother drinks one glass of wine and the father drinks the other—the baby will be fine. Finally, my observations are anecdotal and experiential, not scientific. I have performed more than twenty thousand circumcisions during my career as a Mohel.
Does jaundice prevent a circumcision from taking place?
Normal physiological jaundice is just that--normal. It does not prevent a circumcision from taking place. The bilirubin count can be as high as eighteen and as long as the doctor agrees that it is normal physiological jaundice, the circumcision may proceed. Pathological jaundice will most likely prevent a circumcision from taking place and your pediatrician will advise you. In any event, if the doctor determines that the baby may not be circumcised for any reason, the mohel may not proceed until the doctor has declared the baby fit and healthy.
What if the baby is born prematurely?
The doctor will determine if the baby can be circumcised. While there may be other health concerns, most parents want to know how much the baby should weigh before he can be circumcised. Most doctors will recommend that the baby weigh at least five pounds.
Do you perform any kind of ceremony for non-Jewish families?
Yes, if they request it. Many families will read verses from Scripture or some poetry, write a letter to the baby and so on. One may have music playing in the background and lighting candles are also done.
How do I explain to my three-year-old what a circumcision is?
I don't think very young children need to have the surgical aspects of a circumcision explained. In general, I also recommend that children under the age of ten or twelve not be permitted to watch the circumcision.
What if you are not available when I call you to do my child's circumcision?
Since the event is not time bound, there should be no problem scheduling a mutually convenient time.
Does insurance cover the circumcision?
Many insurance plans do not cover the cost of the circumcision that is performed by a non-medical mohel. A receipt can be provided for you to send in, but be prepared for rejection.
What do I do now?
Once the baby is born, email me at email@example.com. Best wishes for an easy delivery and a beautiful, healthy baby.