I was asked about מציצה בפה which has been an animated debate for a long time.  This was my response:

Metzitzah is an old part of the brit milah process discussed in the Mishnah and Gemara. Historically, it was understood primarily as a health-related procedure meant to draw blood from the wound. The major halachic debate is not whether metzitzah exists, but whether it specifically must be done through direct oral suction (“metzitzah b’peh”), or whether alternative methods are acceptable.

There are very strong halachic sources on both sides of the discussion. Many major rabbis over the generations maintained the traditional practice of direct oral suction, while many other highly respected authorities held that alternative methods — such as using a sterile tube or sponge — are fully acceptable and may even be preferable when there is a health concern.

The attached overview gives a very thorough and balanced history of the debate and brings extensive sources from both perspectives. One important point emphasized there is that many poskim understood metzitzah primarily as a medical/safety procedure rather than an intrinsic part of the mitzvah itself. Therefore, they argued that health-related decisions should follow the best current medical knowledge and available data.

The article also documents that authorities such as the Chatam Sofer approved alternative methods when they were considered medically effective, and many later rabbanim supported use of a sterile tube instead of direct contact.

At the same time, other major rabbinic authorities strongly defended maintaining the traditional practice and rejected changes, especially in response to broader anti-religious or reform movements of the time.

Personally, I think this topic often becomes unnecessarily politicized. If there were a clear and established medical danger, halacha would obviously require taking that seriously. At the same time, many communities believe the risks are overstated and therefore continue the traditional practice. Others use alternative methods while fully observing brit milah according to halacha.

In any case, this is definitely not a simple “everyone agrees” issue. There are legitimate halachic positions across the spectrum, and it is important to discuss the topic respectfully and carefully rather than emotionally or politically.

Having said all that, I have not seen the data showing the dangers of מציצה בפה and I have not seen the data showing the dangers of skipping מציצה completely.  There are certainly more than enough sources to rely on to do מציצה through alternative methods.  I strongly recommend those alternative methods. But as long as there is no solid evidence or data showing a health risk, we should respect the other side of this argument as they do have some very strong sources.