Traditional Circumcision Raises Risk of Infection, Study Shows

Study finds that brit conducted by a mohel leads in many cases to infections of urinary tract.

Circumcision as performed by mohels, men whose profession is performing the Jewish ritual of brit milah, leads to a high rate of urinary tract infections among babies, according to a report released recently by physicians at Schneider Children's Medical Center in Petah Tikva.

The vast majority of Israeli Jews have their children circumcised by mohels. The religious obligation aside, many parents consider the ceremony of removing the foreskin to be hygienic and healthy. However, the study by the Schneider physicians, published in the pediatric journal the Archives of Disease in Childhood and headed by Prof. Yaakov Amir, found that circumcision conducted by a mohel leads in many cases to infections of the urinary tract that can significantly endanger the baby.

The researchers believe the infection is caused by the bandage left on the penis after circumcision. "For several years, we have noticed a wave of urinary tract infections among very young children - usually from the age of eight days on," Amir said. "We decided to investigate the phenomenon, and obtained figures from several hospitals."

Researchers identified 162 cases of babies under two months old undergoing hospitalization for urinary tract infections. Of these, 108 were boys and 54 girls. "We saw the same phenomenon in each hospital - a wave of urinary tract infections around the ninth day after pregnancy," he said.

"By contrast, among girls there was no such wave, but a gradual rise in cases over the first year of life. So it was clear to us that this issue is related to circumcision."

In addition, they found urinary tract infections to be far more common among babies who had undergone circumcision by a mohel rather than a physician. "There are children in Israel who undergo circumcision by a doctor. We saw that there is less infection among them than among those who had the procedure performed by a mohel," Amir said. "Without appropriate and intensive treatment, the bacteria could reach the blood, possibly even causing death."

"When the mohel finishes cutting, he takes a piece of dressing and wraps it around the member. That's the root of the problem - the bandage doesn't allow the baby to urinate completely. The baby sometimes stays for 15 or 20 hours with this bandage, and if the circumcision is performed before Shabbat, it is sometimes two days before the mohel removes the bandage," Amir added.

Menachem Fleischman, a mohel who supervises new members of the profession in the central region of the country, said they must be aware of the effect the bandage could have. "It is preferable that the bandage does not press too hard. One must pay attention, and a mohel who is adequately trained will make sure to surround the area with special cotton wool right after cutting."