I do not perform metzitzah b’peh and I never have. When I trained as a mohel, my understanding then and now is that the Talmud explains metzitzah as a method to prevent illness by drawing blood away from the wound to remove impurities. The center of this controversy is how metzitzah should be performed.
Performing metzitzah using one’s mouth is primarily a Chasidic custom. Many in the Chasidic community insist that direct oral contact (i.e. b’peh) is the only acceptable way to perform metzitzah. The Chatam Sofer (Rabbi Moshe Sofer) in his responsum to Rabbi Eliezer Horowitz defines the word metzitzah as “squeezing,” and not “suction.” The Chatam Sofer clearly states that if there is any danger whatsoever associated with metzitzah b’peh, it should not be done “b’peh” (with the mouth), but instead should be performed via the use of a gauze pad (s’fog).
Metzitzah can be performed; just the custom of performing it with the mouth (“b’peh”) should be eliminated.
The average Jewish family doesn’t know that most non-Chasidic Orthodox mohels don’t perform metzitzah b’peh. Not only do I not perform metzitzah b’peh, I wear gloves, autoclave my instruments and maintain the highest levels of aseptic technique. Even worse, this story has turned many Jewish families away from even having a bris altogether and given incredible ammunition to the anti-circumcision crowd. The continued public discussion of what is really a non-issue for the majority of observant mohels practicing today is causing incalculable damage to a beautiful mitzvah.