Circumcision and Congenital Heart Disease

Background

 

Circumcision is one of the most widely practiced rituals in Judaism.  At 8 days of age, Jewish boys are ritually circumcised by a Rabbi known as a mohel.  The mohel has been formally trained in circumcision and the ritual is the first commandment given to Avraham who was instructed to circumcise himself at the age of 99.  Circumcision is the entry into the covenant between Jewish boys and g-d.  As it states in parsha Lech Lecha “You shall circumcise the flesh of your foreskin, and it shall be as the sign of a covenant between Me and between you. And at the age of eight days, every male shall be circumcised to you throughout your generations…”

 

Circumcision and Neonatal Illness

 

While the American Academy of Pediatrics (AAP) does not endorse routine circumcision, the AAP policy statement states “the benefits of circumcision are sufficient to justify access to this procedure for families choosing it and to warrant third-party payment for circumcision of male newborns.”  Dr. Darren Klugman, a pediatric cardiologist and pediatric intensive care specialist often gets questions about how to proceed with the mitzvah of circumcision for baby boys born with heart disease or other illnesses which require hospitalization or medical treatment at birth.  Dr. Klugman emphasizes that both according to Jewish law and best medical practice, circumcision should be delayed until the infant is medically stable and strong enough to tolerate the procedure.  While the procedure is very low risk, the priority is on performing life-saving treatment for the baby in the most extreme circumstances and on ensuring the baby’s health in general.  Should circumcision need to be delayed, Dr. Darren Klugman recommends consulting with a rabbi and the medical team caring for the baby to find the mohel most specialized in handling such circumcision.