Bilirubin and Bris Milah
In Parshas Lech Lecha, Avraham Avinu is commanded to perform the mitzvah of Bris Milah. Beginning with Yitzchak, all Jewish males are circumcised 8 days after they are born. However, as is the case with all mitzvos (aside from the 3 cardinal sins), when the mitzvah performance poses a risk to the child’s survival, we do not perform the bris.
(One famous example is the Halacha, which states that if two older brothers die following their bris, we do not give a bris to subsequent brothers.) The Gemara in Shabbos (137A) teaches that when a baby is sick, we must postpone the bris until the baby is completely better.
However, there are two categories of sickness: a sickness that affects the entire body, and a sickness that only affects a localized area. For a localized issue, we can perform the bris immediately once the baby is healthy. But, for a diffuse sickness (such as fever) the Gemara rules that we must wait 7 days before performing the bris. Furthermore, the Gemara rules not to do a bris on babies with red or yellow skin tones, as these tones are caused by abnormalities in blood levels. The question follows, how yellow/jaundiced must an infant be considered halachically jaundiced to delay the bris?
The consensus is that 12mg/dL is the bilirubin level that Halacha considers problematic. While medical data does not consider this cause for concern, Halacha rules that this is high enough to delay the bris.
A further question that arises when a baby is jaundiced is how long one must wait once the levels return to normal. The Aruch Hashulchan and seemingly R’ Shlomo Zalman both ruled that the bris may be done once labs indicate normal bilirubin levels. This is because Chazal (and medicine) don’t necessarily view jaundice as a sickness (that would require one to wait an additional seven days) but as a potential complication that, once resolved, no longer requires our attention.
Adapted from medicalhalcha.org