For more than 35 years, I have had the privilege of serving as a mohel. I have stood with thousands of families at one of the most moving and ancient moments in Jewish life: the entry of a baby boy into the covenant of Avraham, our forefather.
A brit milah is not merely a ceremony; it is an act of identity, continuity, faith, and belonging. It links a Jewish child to his people, his history, and his destiny.
Precisely because I believe so deeply in brit milah, I have spent at least 25 of those years campaigning against the practice of metzitzah b’peh, direct oral suction by the mohel after circumcision.
I have done so not because I am opposed to tradition, but because I am committed to it. I have done so not because I want brit milah weakened, but because I want it protected.
And I have done so because, for a quarter of a century, I have feared that if we fail to distinguish between the essential mitzvah of milah and a dangerous later practice attached to it, we will one day give the enemies of brit milah the very weapon they need.
That day may now have arrived in Belgium.
Reports that Belgian prosecutors are pursuing charges against mohalim have understandably caused alarm across the Jewish world. Many have described the move as antisemitic. They may well be right.
Brit milah a fundamental part of Jewish life
In Europe today, where Jewish life is already under pressure from many directions, any attempt to criminalize Jewish religious practice must be viewed with the utmost seriousness. The right of Jews to perform brit milah is not negotiable; it is a fundamental element of Jewish life.
But we must also be honest. If the case is bound up with allegations of metzitzah b’peh, then our response cannot simply be to cry antisemitism and leave it there. We have to ask whether we have, by our own refusal to confront this practice responsibly, placed brit milah itself in danger.
The mitzvah of brit milah consists of the removal of the foreskin, milah, and the peeling back of the mucous membrane to reveal the glans, periah. That is the core halachic act. That is the covenantal procedure. That is what makes the child circumcised according to Jewish law.
Metzitzah is different. It was introduced by the rabbis as part of the post-circumcision management of the wound. In the language of the Talmud, it is associated with concern for the baby’s safety. In other words, its purpose was therapeutic. It was done because it was believed to assist healing or reduce danger at the time.
That distinction matters enormously.
If something is part of the essential mitzvah, then we defend it as such. If something is a health measure, then it must be judged by whether it protects health. And if, in modern medical conditions, there is no evidence that direct oral suction improves healing, while there is very real evidence that it may place a newborn baby at risk, then continuing it cannot be justified by invoking the sanctity of brit milah.
No one serious is suggesting that metzitzah in some form must be abolished. Many mohalim today use a sterile pipette or tube. This preserves the traditional practice of suction, maintains continuity with tradition, and avoids direct orogenital contact between the mohel and the baby.
That is precisely the sort of halachic and practical solution Judaism has always been capable of producing: faithful to tradition, serious about safety, and rooted in common sense.
What cannot be defended is the insistence that the mohel must place his mouth directly on the circumcision wound of a newborn baby.
The medical concern is not theoretical. Public-health authorities have repeatedly warned of the risk of herpes transmission through direct oral suction. Neonatal herpes can be devastating. It can cause serious neurological injury and, in some cases, death. The fact that such events are rare does not make them irrelevant. We are dealing with newborn babies. We are dealing with a practice that is not necessary to fulfil the mitzvah. And we are dealing with an avoidable risk.
Halachically, that should be the end of the matter.
Judaism is not indifferent to danger; quite the opposite. The preservation of life and health is among the highest values in halacha. If metzitzah was instituted for the baby’s welfare, it is a distortion of halacha to continue a form of it that may endanger the baby when safe alternatives exist.
For more than 25 years, I have said the same thing: sooner or later, metzitzah b’peh will be used as a reason to attack brit milah itself. I have said this to rabbinic colleagues, to mohalim, to communal leaders, and to anyone willing to listen.
I have warned that governments and courts will not always make the careful distinction between milah and metzitzah b’peh. They will see a practice they regard as dangerous, and they may respond not by banning the dangerous addition, but by restricting or criminalizing the whole institution.
Sadly, Belgium suggests that this fear was not misplaced.
In England, the Initiation Society – the organization of mohalim – has long made clear in its own rules that metzitzah should not be performed by direct oral contact. Yet we all know that the practice continues in some circles. That is not only medically concerning, but it is also communally reckless.
Every time metzitzah b’peh is performed, it risks more than the health of one child, grave though that is. It also risks the reputation of mohalim. It risks public confidence in brit milah. It risks handing ammunition to those who have never accepted Jewish circumcision in the first place.
And it risks making the defense of brit milah immeasurably harder for those of us who are trying to explain, patiently and responsibly, that Jewish circumcision is safe, ancient, meaningful, and lawful.
This is why the argument must not be framed as “tradition versus modernity.” That is false. The real question is: which tradition are we defending? Are we defending the eternal covenant of Avraham our forefather, or are we defending a particular method of suction that is not essential to the mitzvah and can be safely replaced?
Nor should this be framed as “religion vs medicine.” Judaism has never believed that piety requires ignoring medical reality. The rabbis who mandated metzitzah did so because they believed it protected the child. Were they alive today and presented with the modern evidence, would they insist on preserving a risk rather than protecting a baby? I cannot believe that.
Those who care about brit milah must now speak with clarity. We must defend milah without hesitation. We must oppose antisemitic attempts to criminalize Jewish life.
But we must also stop defending the indefensible. There is no halachic necessity for direct oral suction. There is no medical benefit. There is a clear potential danger. And there is growing evidence that continued insistence on the practice may threaten the future legality of brit milah itself.
The Jewish community should not wait for prosecutors, governments, or hostile campaigners to force the issue. We should lead. Rabbinic authorities, mohalim, and communal organizations should state clearly and publicly that metzitzah b’peh should not be performed. Where metzitzah is maintained, it should be done only with a sterile pipette or equivalent device, with no direct oral contact.
That is not a surrender to secular pressure. It is a defense of halacha. It is a defense of babies. And it is a defense of brit milah.
For 35 years, I have seen the beauty of this mitzvah up close. I have seen grandparents weep, parents tremble, and families feel the weight of Jewish history in a single moment. Brit milah has survived empires, persecutions, expulsions, and modern hostility. It must not now be endangered by our unwillingness to abandon a practice that Jewish law does not require and child safety does not permit.
If we want to protect the covenant, we must have the courage to say so.
The writer is a rabbi and physician. He writes and teaches on Jewish ethics, leadership, and resilience. His work appears on rabbidrjonathanlieberman.substack.com and youtube.com/@rabbidrjonathanlieberman.