Dr. Aaron Jesin
Mohel & Family Physician
Ritual Orthodox Circumcision
4256 Bathurst St. Suite 203
Downsview, Ont. M3H 5Y8
Telephone: (416) 635-5012

INSTRUCTIONS FOR RITUAL CIRCUMCISION
The following is a list of items which you will need to prepare for the ceremony:

  1. Kosher sweet red wine. (The wine must have acceptable supervision for the dietary laws. Carmel, Kedem, Manischewitz and several other brands are acceptable.) Please check with me if using any others as there is one brand that claims to be kosher, but is not universally accepted.
  2. A kiddush cup or medium sized glass.
  3. Two candles and candle sticks. (e.g. Shabbat candles; but no candles if the ceremony takes place on the Sabbath or other Jewish Holy Day.)
  4. Three taleisim (prayer shawls).

Unless the brit millah is being performed in the hospital, you will also need to prepare the following:

  1. Pillow and pillow case.
  2. A flat tray which can fit inside the pillow case, preferably not heavy.
  3. Two chairs - one of these should be a plain hard chair; e.g. kitchen chair.
  4. A small table next to the chairs (for my instruments).
  5. Prepare an extra diaper on this table; preferably a disposable one.

For after care of the brit millah, you will need:

  1. Vaseline
  2. Gauze. Either squares or a roll is ACCEPTABLE. DO NOT use gauze with a plastic coating, i.e. do not use "Easy Release" or "non-stick" gauze.

GENERAL INSTRUCTIONS:

  1. It is extremely important to try to have a minyan (10 Jewish men over the age of 13 years) present. Even if this is not possible, the bris must still take place.
  2. It is a mitzva to have a kiddush or meal after the ceremony. As this is a ritual occasion, please try to ensure that all the food is kosher. I will be happy to offer any advice in this regard.
  3. Please write down ahead of time the Hebrew names of the baby, father and mother in order to prevent an error being made in the excitement of the moment.

HONOURS:
Please decide on these ahead of time, and inform the people:

  1. Sandek -- The man who holds the baby during the brit millah.
  2. Sandek Sheini (Me'umad or standing) -- The man who holds the baby during the naming ceremony.
  3. Kwater & Kwaterina -- The couple who bring the baby into the room.
  4. Kisei Eliyahu -- A man to put the baby down on the chair of Elijah before the brit.
  5. OPTIONAL: You may also honour as many people as you wish by including them in a line which participates in passing the baby to the brit. Women are also encouraged to be included in this category.
  6. The father will be required to recite the following blessing:


(Barooch atoh adonai elohainu melech ha'olam asher kideshanu bemitzvotav vetzivanu
lehachneeso bivreeto shel Avraham aveenu.)

 
BABY CARE:
Before the Bris:

  1. Try not to feed the baby for 2 hours before the brit. This is important.
  2. Dress the baby in a gown or T-shirt plus receiving blanket.

After the Bris:

  1. I will usually make myself available to change the baby's initial dressing.
  2. For the first few diapers, when the baby urinates, it is normal for the urine to dilute the blood from the dressing through the diaper making it appear bloody on the outside. Inside the diaper, the dressing will appear obviously wet and not bright red. If you suspect active bleeding, i.e. if the inside of the diaper is full of bright red blood or clots, put some pressure on the penis with a piece of gauze and call me immediately.
  3. If the baby does not urinate within 6 hours, please call.
  4. Once the initial dressing falls off, or is removed by myself, place a piece of gauze with a large wad of vaseline over the penis at each diaper change. Continue this for 3 days.
  5. Redness and some swelling may occur for 5 to 7 days.
  6. Use only sponge baths until the 3rd day.
  7. Dry sticky yellow discolouration which cannot be rubbed off is normal and may last 2-4 weeks.
  8. Yellowish or greenish liquid pus usually signifies infection and should be reported. It is easily treated with an appropriate ointment which can be obtained from myself or your doctor.

PIDYON HABEN
It is necessary for a first born male, whose father or mother are not a Cohen or Levi and who was not born by C-Section, to undergo redemption of the first born. I will be happy to answer any questions you might have in this regard.

ANAESTHESIA
This topic has become much discussed in the last few years. It is important to note that all the studies regarding circumcision and pain have been done with non ritual circumcision which is a longer and more painful procedure. However, though babies recover extremely quickly from their bris even if wine is their only anaesthetic, it is possible that they experience some element of pain. The majority of Rabbinical scholars do not allow the use of an injectable anaesthetic for brit milah. However, everyone allows the use of topical cream. The recommended cream would be EMLA. It has to be put on at least 1 hour before the procedure. It should be spread fairly liberally covering the whole penis and top of the scrotum. The penis should then be loosely wrapped with cellophane, and this should be left on till the brit.
You should be aware that the EMLA has not been approved for babies under the age of six months. However in a Toronto study published in the New England Journal of Medicine, it has been found to be safe. I have found it to be inconsistently effective. It also may cause some swelling as well as rendering the area a bit slippery. This has never caused a problem during a brit. I leave the decision of using this cream up to you, the parents. Please feel free to ask me any questions you might have about it.

Please feel free to call me with any questions.

Dr. Aaron Jesin
The Jesin Circumcision Clinic
Family Physician & Mohel
Ritual Orthodox & Non Ritual Circumcision
4256 Bathurst St. Suite 203
Toronto, Ont. M3H 5Y8
Telephone: (416) 635-5012
e-mail: aaron@drjesin.com


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