1. When do we have the bris?
A bris is performed on the eighth day of life. The day of birth counts as the first day, as long as the birth occurs before sundown. Thus, if a child is born during daylight on a Monday, his bris would be the following Monday. If he was born after sundown on Monday, the bris is the following Tuesday. A bris must take place before sunset, and it may be postponed only for medical reasons.

2. Can a bris be performed on Shabbat or Yom Tov?
Yes. The Talmud derives that the positive commandment to circumcise on the eighth day of life supercedes the prohibition to perform work on Shabbat or Yom Tov. There are some exceptions to this rule, however. If the bris is postponed for medical reasons, it may no longer be performed on Shabbat or a festival. Also, a baby born through cesarean section may not have his bris on these holy days. It is always best to consult with the mohel or Rabbinic authority before confirming the day of the bris.

3. What should my baby wear?
An outfit that is easily raised over the baby’s waist as the circumcision is being performed , and easily pulled over the baby’s body afterwards. A gown works well.  Otherwise, a 2 piece outfit (i.e. separate pants and shirt) is also easy for me to work around.  However, an outfit that snaps from above the waist all the way down to the feet is cumbersome. 

4. Is a minyan required?
A minyan (group of 10) is preferable but not mandatory.


5. What is your fee?

My fee is based upon my time committment and distance traveled. I have a standard fee for travel within 25 minutes. I charge extra to travel beyond (e.g. Ann Arbor). My fee includes a 20 minute phone conversation with the family several days prior to the bris. In addition, I will arrive at the home or synagogue 30 minutes prior to the start of the bris and I will also observe the baby with the family and teach aftercare for 45minutes afterwards. I will also provide you with a special kippah for the baby as well as a  bris  certificate from the Women's League of Conservative Judaism.- All of this is included in my fee. I'm happy to discuss this further with you by phone.

Can you bill my insurance or may I have a receipt to submit to insurance for reimbursement?

The only way I can bill your insurance is if the actual circumcision/bris is performed in my office. I am happy to accomodate                        families  with this request. However, if the circumcision is performed outside of my office, then I cannot bill insurance or provide you with a receipt. If you need a claim for an HSA account, I am happy to oblige.

6. Do you perform a bris for an interfaith family?

Yes. – With the assumption that the bris is being performed as the first step towards a Jewish life. If an interfaith family is planning to also  baptize the child, then having a bris may not be in the best interest of the child. The bris is the quintessential declaration of being a Jew  and establishes a covenant with G-d. Having a bris means living exclusively Jewish.

Traditional Jewish law holds that the religious status of the baby is  the same as his mother. So for example if the mother of the baby is Jewish, the baby is considered Jewish. But if the mother of the baby is Gentile, then the baby would be considered Gentile under Orthodox law.

The Reform movement issued the patrilineal descent in 1984 which in essence states that the baby is under "the presumption of Jewish descent" as long as either the mother or father is Jewish and as long as the parents demonstrate "timely and public acts of Jewish identification " (e.g. bris, Hebrew school, bar mitzvah etc.). In other words, the reform movement does not require formal conversion of the baby if the mother is Gentile and father is Jewish as long as the parents raise the child as a Jew.


However you may want to discuss this issue with your Rabbi as to whether or not the Rabbi would recommend having the bris performed for purposes of conversion. The issue could arise again in the future if your son were to marry somebody in the Conservative or Orthodox movement, or if your son decided he wanted immediate citizenship in Israel one day.



6. What type of clamp do you use?
 I  have extensive experience using two surgical instruments - the Gomco clamp  and the Mogen clamp. My preference is the Mogen clamp due to it's speed and accuracy.  The total procedure time is 60-70 seconds.
 

7. Does the circumcision hurt?

The short answer is yes. However, much can be done to minimize the baby's discomfort.

No parent wants to see his/her baby in pain. Neither do I.  Through years of experience, I have developed a protocol that minimizes the pain of the procedure.


STEP 1- Giving the baby an oral sucrose solution. Medical studies have proven that sugar raises the baby's natural endorphins ( his natural pain killers). Once the baby is sucking on the sugar solution, the local anesthetic can be injected with minimal discomfort.

STEP 2- Administer a Dorsal Penile Nerve Block (DPNB) while the baby is sucking on sugar. Dr. Singer has developed a proprietary blend of local anesthetic for use at a bris that is unique, safe, and long lasting.

STEP 3- Perform the circumcision in one minute using the Mogen clamp.

Dorsal penile nerve block is the standard form of local anesthesia used for newborn circumcision. This block is performed by injecting lidocaine at the base of the penis and it temporarily numbs the nerves that provide sensation to the penis. The American Academy of Pediatrics has endorsed local anesthesia as the standard of care for all newborn circumcisions.

The use of local anesthesia requires proper medical training and licensing. This means that only a doctor is permitted to give an injection of lidocaine at a bris.  Under no circumstance is a non-physician mohel (i.e. a Cantor or Rabbi) permitted to use any form of local anesthesia (i.e.  Nerve block).

There are two topical anesthetics available, but both are inferior to a DPNB: In addition, topical anesthetics can cause swelling of the penis and distort the anatomy making the circumcision more difficult.

EMLA ( Eutectic Mixture of Local Anesthetics) can produce some pain relief, but it has several significant drawbacks: (1) It is not FDA approved for use in circumcisions in babies less than one month of age. (2) One gram of cream has to be applied under occlusion to the baby’s penis prior to the bris. Parents often have difficulty accomplishing this.(3) The cream can cause swelling of the foreskin which distorts the anatomy of the penis.


8. Is a hospital circumcision the same as a bris?
Absolutely not. A hospital circumcision is surgery performed for medical benefit or social purposes. The procedure is carried out in a "circumcision room" away from the parents, devoid of religious meaning. In contrast, a bris is a mitzvah, a sacred obligation. The circumcision is performed with proper religious intent (Kavanah), as the baby is held by loving arms. It is never done before the eighth day, and it always includes meaningful blessings. The bris is a supreme act of identification with the Jewish people.

9. Can you tell me about your ceremony?
My ceremony is both traditional and enlightening with a nice blend of appropriate humor. It begins with an interesting explanation of the relevant halachah (Jewish law) and minhagim (customs). The principal participants are introduced and blessings are recited both in Hebrew and in English. The circumcision, which takes approximately 60 seconds, is performed towards the end. The baby receives his Hebrew name and we rejoice in song and feast. The entire ceremony lasts approximately 15 to 20 minutes. My goal is for you and your family to gain a deeper appreciation of this awesome mitzvah.

10. Can the circumcision be performed in a separate room than the rest of the ceremony?

Yes it may.

 Some parents would prefer to have the surgery performed privately and separate from the rest of the ceremony.  This is acceptable to do, but recognize that most of the prayers and designated honors will take place before most of your friends and family arrive.  Also, I recommend that if you take this approach, you provide a 45 minute recovery period to allow the baby to feed and settle down before we proceed with the naming ceremony.

 



 

Frequently asked questions

Craig Singer, M.D. Certified Mohel