In a traditional bris, performed by a skilled moyel, the actual procedure of circumcision is much more brief than the usual hospital circumcision. The majority of britot that Hazzan Glantz performs, are done with the following pain management methods in this order.
Upon Arrival: With the parents' permission Hazzan Glantz will apply a numbing cream LMX 4. Plain triple antibiotic with lidocaine may be substituted if the family prefers a less aggressive ointment.
During the ceremony: Sweet kosher grape wine or sweet kosher grape juice is put to baby's lips with a gauze pad by the sandek on which he gladly sucks. Research has shown (see report here) that the sugar content is a significant distraction for infants (another report here)who haven't the ability to focus on more than one thing at a time. A development in recent years borrows from our Jewish tradition making use of a sweet glucose product (Sweet-Ease made by Philips) to baby's lips during hospital circumcisions and other minor invasive procedures.
After the procedure: Oftentimes, babies nod right off to sleep right after nursing or having a bottle. The energy an infant uses to eat is significant. Families are urged to time feedings on the day of the bris so that 1 hour before the bris ceremony is to begin, baby has stopped nursing or having bottles. Being a little hungry will both increase his interest in the sweet wine or grape juice, and increase his motivation to nurse or take a bottle immediately after the procedure is complete and we continue with the naming ceremony.
You are strongly urged to consult your doctor and consider additional options in pain management prior to the day of the bris. If you are giving Tylenol or Motrin, please obtain the exact product, dosage and time relative to the bris from your physician/prescriber.
If you are interested in any other form of anesthetic including a doral penile block and/or your own earlier application of topical anesthetic, please call Hazzan to discuss. It is important that Hazzan Glantz have this information prior because these procedures swell the tissue.