You must choose the following people to honour at the bris:

1. Sandek Rishon – Jewish man to sit at the table to hold the baby’s legs during the bris. Traditionally one of the grandfathers.

2. Sandek Sheini – Jewish man or woman to hold the baby during the naming. Traditionally one of the grandfathers or grandmothers. There is some flexibility here.

3. Kvaterin – Person or people who will carry the baby into the room to begin the ceremony. Traditionally a childless couple but any number of people (1-6) may be chosen. This is flexible.

I do not routinely see the baby before the day of the bris as I rely on the pediatrician to inform you of any health concerns. Please inform me if there is a Family History of Bleeding Disorders or any other health concerns.

Note: The baby must have his Vitamin K shot prior to circumcision

Tempra or Tylenol need not be given before the bris. It may be given after the bris if needed. (See Aftercare 3. Temperament- below)

Feeding the baby before the bris is fine but try to hold off for 1½ -2 hours so that he will find it soothing right afterwards. An easy access outfit is best such as a nighty or gown with an open or drawstring bottom. Sleepers are fine. Snaps and zippers are fine but avoid buttons. An undershirt is not necessary.

The Father’s Bracha is as follows: Baruch Ata Adonoy Elohaynu Melech Ha-olam, Asher Kiddishanu Bimitzvotav Vitzivanu, LEHACHNISO BIVRITO SHEL AVRAHAM AVINU. (I will bring this Bracha on a card for the dad.)

My fee is $700.00 (Within the GTA)

I will arrive ½ hour before the bris begins in order to set up and spend a few minutes going over the final details with you. If the bris is not at your home, you must meet me at the venue ½ hour before the bris begins.

The bris will begin punctually at the appointed time and guests should be warned of this.

Honourees should arrive at the bris 15 minutes early.

The bris ceremony begins with a brief explanation for the guests before the baby is brought into the room by the kvaterin. The baby will be placed on Elijah’s Chair where he will rest for a moment. I will then pick him up and place him on the table in front of the Sandek Rishon. The father will be standing to the left of the Sandek and will give the baby some gauze dipped in wine during the bris. The father will say his Bracha (which he can either read or repeat after me) by which time the bris will be finished. After the baby is dressed, the naming will take place. This ends the ceremony. Total duration is approximately 15 minutes.

Following the ceremony, I will clean up for five minutes and then together with both parents complete the first diaper change. I will thoroughly explain the aftercare and point out a few things regarding the baby‘s penis. In general, the appearance remains the same for approximately three days.

I will phone you the next day to check on the baby‘s progress and to answer any questions you may have.

The first diaper should be changed within 2 hours after the bris. Subsequent diapers can remain on for the usual 3-4 hours.

1. Bleeding – Spotting is normal for the first 24 hours and is no reason for concern. If active bleeding (blood flowing) is noted, firm pressure should be applied to the penis with a piece of gauze for 3-4 minutes and if the bleeding continues, your physician or I should be contacted immediately.

2. Bandage – Gauze and polysporin dressings should be used with each diaper change for three days after the bris. Open a 2 x 2 inch gauze pad once, so that it becomes 4 x 2 inches. Apply a liberal amount of polysporin to one side and spread it around. Place the gauze, polysporin side down to form a “tent or cap” over the penis and close the diaper.

3. Temperament – Your baby may be slightly fussier than normal for the first 24 hours. He should be held, cuddled and fed and can be given 40 mg (½ ml = 0.5 ml) of acetaminophen liquid (Tempra, Tylenol) every 4-6 hours if necessary. Most babies behave no differently after the bris than before the bris.

4. Bathing – Sponge baths are suggested for the first three days after the bris. During this time, the penis can be cleaned if necessary by squeezing warm water over it from a wash cloth. Immersion may take place beginning the fourth day. Drying should be accomplished by gentle patting. Soaps are permitted but should not be applied to the penis itself.

5. Urination – Urine is normally sterile and will not cause any stinging or irritation.

6. Stooling – The scrotum tends to prevent stool from contacting the penis, however, this may occur. If so, squeeze water over the penis from a warm washcloth and then wipe or dab the penis gently with the washcloth until clean. In general, immediate diaper changing is recommended after each stool.

7. Baby Wipes and Barrier Creams (Sudocrem, Zincofax, Vaseline, Penaten) – These are permitted on the buttocks and groins but should not be applied directly to the penis.

8. Sleeping – Baby’s sleeping position is unimportant and placing him on his stomach is permitted after the umbilical cord has fallen off.

9. Healing – Complete healing will take from 10 – 14 days. The wound site at this point is a mucosal surface just like your lips and the inside of your mouth. Therefore, the changes that occur will be present immediately following the bris and the following will be noted:

a) redness – this is normal and may take two weeks to disappear.

b) swelling – primarily on the underside. This will appear as a shiny pink roll (or lip) of tissue between the head and shaft of the penis and might not always be symmetrical. The swelling may not start to diminish for three or four days.

c) scabbing – due to the mucosal nature of this skin, if present at all, the scab will be a whitish or light yellowish crust or film. It will be noticeable mostly on the underside but may be on top or even on the head of the penis as well. This crust will be adherent to the penis and will disappear on its own. It should not be removed.

d) infection – this is rare and occurs in less than 1% of cases. If the swelling is thought to be increasing after the first 36 hours, or if there is increasing redness or a creamy discharge from the wound, infection should be considered and you should contact your physician or me immediately.

After the bris, you can reach me by email or phone with any questions.

As a matter of routine, I will phone you the next day to check on the baby‘s progress and to answer any questions you may have.

The cost for Brit Milah/Ritual Circumcision is $700.00 (Within the GTA)

Payment Methods: Cash, Cheque or Interac Transfer

Every baby has unique anatomy. I use my expertise to examine the baby’s anatomy to achieve the best possible aesthetic result.

Concealed Penis – If the baby has a lot of pubic fat, the head of the penis may slip inside like the head of a turtle. I will show you how to deal with this easily, to prevent problems in the future such as adhesions (see below). This is most prone to occur at 3-6 months of age as the baby accumulates more pubic fat and before his penis has a chance to grow. If at any time when changing the baby you are unable to see the entire head of the penis, press down firmly with two fingers at the base of the penis so that it “pops out”. Continue to do this with every diaper change – you will not hurt him. For more information on this topic, please click here.

Rotated Penis – This occurs in approximately 15% of babies, usually counter clockwise. This is a normal variant which I will point out to you if present.

Late Bleeding – Occasionally there is slight fresh bleeding on day 5-7 post-op. This occurs if the scab shrinks or separates from the skin edge or from the head of the penis and it is similar to the bleeding one might see when the umbilical stump is separating. It is of no major concern but gauze and polysporin should be reapplied for a further 12-24 hours to prevent sticking.

Gauze is stuck! – This can happen if the original gauze stays on for too long, especially the 1st or 2nd post-op diaper. Soak the gauze with warm water for a few minutes and it should peel off easily. Make sure to use extra polysporin on the next diaper.

Colour – The head of the penis (glans) is a very vascular organ. This means there are a lot of small blood vessels under the surface. Depending on ambient temperature and state of arousal, the color may appear pink, red or bluish. This is of no concern.

Adhesions – Occasionally, the skin on the shaft of the penis will seem to creep forward and stick to the corona (base of the glans). If this happens, I can show you how to gently push the skin back to prevent permanent adhesions.