Hatafat Dam Brit

Samuel A. Kunin M.D. http://www.SamKuninMD.com

Board Certified Urologist and Mohel Sam@SamKuninMD.com (818) 881-4548

H


istorically, circumcision predates Genesis 17
where Brit milah (ritual circumcision) is
established as a sign of the Covenant. Therefore,
Who today requires a hatafat dam brit?
Most would agree with the following list:
theoretically, from that time on, a mechanism was
required for a circumcised male to be able to enter  • A Jew circumcised prior to eight days of age,
into the Covenant. The origins of hatafat dam brit (the  • A male requesting to convert to Judaism
drawing of a drop of blood from the remnant of the  who previously had been circumcised,
foreskin) are uncertain.  • A Jew routinely circumcised after eight days
 The practice of hatafat dam brit exists  of age, or for medical reasons, without 
today, and with it, a great deal of anxiety and  appropriate blessings (e.g.., a child too ill to be
misinformation. Some call it a "second circumcision"  circumcised after birth or who needed 
or a "ceremonial circumcision." Any suggestion of the  corrective surgery such as hypospadius),
word 'circumcision' sends a false message and will
 • Anyone born nolad mahul
create fear. It is merely the drawing of a drop of blood  (born "circumcised"),
from the foreskin directly under the glans penis (the
head of the penis). It is quick and relatively painless.  • Theoretically, any circumcision performed
When speaking to prospective candidates for this  where the status of the circumcision was in
 question. An example is if the Brit milah was
procedure, I suggest that it feels like plucking a single
 performed at night.
hair and that it is much less uncomfortable than any
blood draw they have had in the past.
 It is not unusual for a Jewish man whose wife is converting or whose child is having a bar/bat
mitzvah to undergo hatafat dam brit if his circumcision or brit milah was in question.
 Hatafat dam brit is not required when doing so would create physical harm, as in the case of a
hemophiliac. Some argue that it may be waived in situations where there might be great psychological harm
or extreme trauma to the candidate. If a child has had a Brit milah I'shem gerut (for the sake of conversion)
performed by a mohel and witnessed by two acceptable Jewish witnesses, hatafat dam brit is not required.
  Differences of opinion occur within the various denominations. The Orthodox usually will not
accept the authority of a Conservative beit din (rabbinic court) and often require a second hatafat dam brit.
Some Reform rabbis do not require hatafat dam brit. Regarding hatafat dam brit, Reconstructionist rabbis
often follow Conservative practices.
 The Conservative model as cited in the Summary Index The Committee on Jewish Law and
Standards published by the Rabbinical Assembly is the basis for much of what is presented in this
monograph.

Hatafat Dam Brit

Samuel A. Kunin M.D.

1 http://www.SamKuninMD.com
 When is hatafat dam brit performed?
Hatafat dam brit is performed prior to mikvah (ritual immersion). On occasion, I do it anywhere
from days to weeks before mikvah. However, the majority of those I perform are done at the
mikvah just prior to immersion. When done properly, there is no contraindication to doing it at
this time.
Brit milah is to be done during daylight hours only and not on Shabbat or any Chag (holy) day
unless it falls on the eighth day. Hatafat dam brit follows the same guidelines and is not to be
performed on Shabbat or holy days.

Who may perform hatafat dam brit?

The purpose of this paper is to instruct rabbis who may choose to perform this procedure
themselves. It may also serve as a guide to any Jewish physician they may engage to perform it.
There is one rabbi I know of who encourages adult men to perform it themselves. Precedent for
this exists from Genesis XVII when Avram circumcises himself. Whoever draws the blood must
be a Jew, ideally knowledgeable enough to recite the Hebrew blessings. If not, a rabbi may recite
them.

How to perform hatafat dam brit:

A) Equipment: Theoretically all one needs are everyday household items including a sewing
needle, matches to sterilize the tip of the needle, alcohol and cotton balls. However, the items I
use include:
  • a gauze pad
  • an alcohol swab
  • a sterile 27 gauge, 1/2 inch needle. A "Unistick" or similar lancet devices used for
  finger sticks may work just as well. However, such a device may hide the chosen
  puncture site and provide less control of the depth of the stick.

B) Anatomical considerations:

1) The foreskin is the skin just below the head of the penis. This skin usually has a
different color than the normal shaft skin and one usually sees a line demarcating this
junction. (figure 1)

2) In this area, blood vessels are usually seen coursing along the direction of the shaft.
Often, there is some angulation of these vessels. Fortunately, they are easy to see and
therefore easy to avoid if one looks carefully when performing the procedure.

head of the penis

remnant of foreskin

normal skin

figure 1
Hatafat Dam Brit
Samuel A. Kunin M.D.

2 http://www.SamKuninMD.com
The procedure:

1) Gently grasp the head of the penis between the thumb and forefinger and pull it slightly
taut. The head of the penis is covered with the gauze sponge so that one is not touching the
skin of the penis. Some wear surgical gloves.
2) Have the person help you (if he is old enough) by giving counter-traction. A parent may do
this for an infant or child.This is done by having him gently pull the skin at the base of the
penis towards the body with the index and middle finger. This will create more stretch and
keep him from reaching towards the needle. (figure 2)
3) Select the site to be punctured.
4) Swab this area with the alcohol sponge.
5) Carefully break the skin with the needle.
6) Say the appropriate blessing and have the convert say his blessing. For children, the father
or the officiant may say it.

grasp head of penis

covered with gauze sponge

break skin, avoiding blood vessels

apply counter-traction

figure 2
The requirements of hatafat dam brit are satisfied with the mere discoloration of the skin at
the tip of the needle. Anywhere from one drop to many drops of blood may be expressed. Use
the gauze sponge to display the drop of blood. If there is further bleeding, tie the sponge
around the penis at the place of the needle stick using one knot ONLY and pulling it firm
enough to apply direct pressure for at least ten minutes.

Hematoma (blue discoloration under the skin) is rare and will not occur if the above
mentioned vessels are avoided. If it occurs, it is usually self limiting and of no consequence.
Hatafat Dam Brit
Samuel A. Kunin M.D.

3 http://www.SamKuninMD.com
Ceremony of Hatafat Dam Brit:

Rabbi:  Through the ages, the sign of the covenant of the Jewish people with God was
  brit milah, circumcision. Today we celebrate this moment of commitment by
  symbolically letting drops of blood – our connection with Abraham's ancient
  covenant, and      's bonding to our people and
  our faith.

After blood is let, convert says:

Ba-ruch Atah Adonai Elo-hei-nu Melech ha-olam,

a-sher kid-sha-nu be-mitz-vo-tav ve-tzi-va-nu la-mul
et ha-ge-rim.

Praised are You, Adonai our God, who rules the universe, whose mitzvot add holiness to our
lives and who gave us the mitzvah to circumcise converts.

Alternate Text:

Ba-ruch Atah Adonai Elo-hei-nu Melech ha-olam,

a-sher kid-sha-nu be-mitz-vo-tav ve-tzi-va-nu la-mul
et ha-ge-rim u-l'ha-tif mei-hem dam brit she-il-mah-leh
dam brit loh nit-ka-y'mu sha-mayim va-aretz, she-neh-emar:
im loh vri-ti yo-mahm va-lai-lah chu-kot sha-mayim
va-aretz loh sahm-ti. Ba-ruch Atah Adonai, ko-ret ha-brit.

Praised are You, Adonai our God, who rules the universe, whose mitzvot add holiness to our
lives and who gave us the mitzvah to circumcise converts and, through such an act of
kedushah, deepen our connection with heaven and earth, as it is written (Jeremiah 33:25),
"...Without My covenant, day and night, the laws of heaven and earth, I would not sustain."
Praised are You, Adonai, who establishes the covenant.

Hatafat Dam Brit

Samuel A. Kunin M.D.

4 http://www.SamKuninMD.com