Here are some further details. According to one authority, "[t]he method to be adopted is laid down thus: 'One excises the foreskin, (that is) the entire skin covering the glans, so that the corona is laid bare. Afterwards, one tears with the finger-nail the soft membrane underneath the skin, turning it to the sides until the flesh of the glans appears. Thereafter, one sucks the membrane until the blood is extracted from the (more) remote places, so that no danger (to the infant) may ensue; and any circumciser who does not carry out the sucking procedure is to be removed (from his office).”
Why is the penis sucked? Some physicians contend that it serves to stop bleeding. Not only is there little evidence for this theory, but it was also a largely ineffective method. Furthermore, even in antiquity, surgeons had better methods to stop bleeding, such as pressure, instruments, and medication.
After centuries in which the metzitah b’peh was standard practice, a reform of the rite, involving the application of the lips of the mohel to a glass straw rather than directly to the penis, was first recommended in the Haskalah era (late eighteenth and early nineteenth centuries), by Moses Schreiber, but it was implemented only by a segment of the modern Orthodox movement. Yet many Judaic authorities both medical and rabbinic, continue to uphold the traditional practice of performing fellatio on the infant male. As Henry C Romberg asserts: "[t]he traditional practice of metzitzah b'peh, which has its roots in the earliest history of the Jewish people and has survived unchanged to the present time, should be viewed with great respect. It is spoken of very positively in the Jewish literature on circumcision both as an essential part of the ritual and as a health measure which prevents infection and promotes healing."
In fact, dozens of ultra-Orthodox rabbis signed a full-page Hebrew advertisement that ran in the February 25, 2005 issue of Yated Ne'eman, defending the practice. Rabbi Gerald Chirnomas from Boonton, N.J., a prominent mohel in the Greater New York region, asserted that the practice of orally suctioning blood was the norm for centuries .... Rabbi Avi Shafran, director of public affairs for Agudath Israel ... said that ... it is a religious tradition of many generations ... Another rabbinic organization, the Central Rabbinical Council, and at least two Orthodox newspapers, Yated Ne'eman (in a statement issued by Rabbi Pinchos Lipschutz in the February 18, 2005 edition) also defends metzitzah b'peh.
After the New York Times story transpired, some Jewish organizations hastened with assurances that the practice is rare and not typical of Jewish circumcision rituals. Many of the mohels, it seems, now extract the blood with a tube. However, on March 1, 2005 the Rabbinical Council of America stated: “Bris Milah (ritual circumcision of Jewish males, performed on the 8th day after birth unless there are health contraindications) is a fundamental cornerstone of Jewish life and Biblical law. An important element of every Bris Milah is Metzitzah be'Peh, the extracting of blood from the wound and/or surrounding tissue using the mouth as the source of suction. This practice has been prevalent in all Jewish communities worldwide for thousands of years.”
Yet the Council then goes on to assert: “ Based upon a careful study of the available Halachic and scientific literature, as well as a review of sanctioned practice by numerous reliable Torah authorities past and present, it is the position of the RCA that the requirement of Metzitzah is fulfilled completely and unambiguously by the use of oral suctioning through a tube, as practiced by many Mohalim in our communities. Therefore, according to this viewpoint, the use of such a tube is not only permissible, but is preferred (instead of direct oral contact) to eliminate any unintentional communication of infectious diseases. This protects both the Mohel and the newly circumcised child.” This view is simply a concession to modern, secular views, and not in accordance with traditional Jewish practice.
Since time immemorial oral suction has been the norm. The Mishnah in Masechet Shabbat (133a) records the practice of metzitzah as an essential aspect of the circumcision process, and states that metzitzah must be performed at the end of the circumcision. “They [the mohalim] may perform on the Sabbath all things needful for circumcision: excision, tearing, sucking [the wound] and putting thereon a bandage and cummin.” (H. Dabney trans., p. 116).
In addition, the Gemara explains (ibid, 133b) that refraining from performing metzitzah endangers the baby. The commentators elaborate that metzitzah is performed in order to hasten the healing of the wound.
Modern commentators claim that that metzitzah functions as a medical procedure and not a religious one. Of course is not a medical procedure, but one that endangers the health of the infant, as we have seen.
There are also legal considerations. In an era when there is great concern about sexual molestation of children, many may wonder how an adult can legally put his mouth on a child's genitals. However, the courts often allow exemptions to general laws for religious practices--especially when they are espoused by Orthodox Jewry.