NYC health commissioner condemns metzitzah b’peh

The New York City Health Commissioner has issued a strongly worded statement calling for an end to a controversial circumcision-related rite.

Dr. Thomas Farley said that direct oral-genital suction, known as metzitzah b’peh, should not be performed during Jewish ritual circumcision, and announced that several hospitals, including those serving the haredi Orthodox Jewish community, have agreed to distribute a brochure that describes the risk of contracting the herpes virus from the practice.

The controversy over metzitzah b’peh was reignited in March after it came to light that an unidentified infant died Sept. 28 at Brooklyn’s Maimonides Medical Center from “disseminated herpes simplex virus Type 1, complicating ritual circumcision with oral suction,” according to the death certificate,

Health Department investigations of newborns with herpes virus between 2000 –2011 have shown that 11 infants contracted the herpes virus when mohelim, or ritual circumcisers, placed their mouths directly on the child’s circumcision wound to draw blood away from the circumcision cut, according to a statement from the Health Department. Ten of these infants were hospitalized, at least two developed brain damage, and two babies died.

The brochure “Before the Bris” describes the risk to infants of contracting herpes through direct oral-genital suction and advises parents to ask the mohel before the bris if he practices metzitzah b’peh.

“There is no safe way to perform oral suction on any open wound in a newborn,” Farley said. “Parents considering ritual Jewish circumcision need to know that circumcision should only be performed under sterile conditions, like any other procedures that create open cuts, whether by mohelim or medical professionals.”

Haredi leaders have resisted calls to replace direct oral suction with alternative approaches used by some mohelim, such as the use of a sterile tube or gauze to take the blood from the circumcision wound.