The New York City Board of Health now requires parental consent from parents before an infant can participate in an ultra-orthodox form of the Jewish ritual circumcision.

The metzitzah b'peh is performed during bris and requires a practioner, or mohel, uses their mouth to extract blood from the circumcision area. During this process babies run the risk of developing fatal infections such as herpes. 

A panel of doctors and public health officials collectively agree the risk of spreading infectious diseases through oral contact was enough to approve the ordinance.

According to health officials, between 2004 and 2011, nearly 11 infant boys contracted herpes from the ritual.  Of the 11 infants, two died and another two suffered brain damage.

The new ordinance requires a signed consent form from a parent or legal guardian of the infant. This form will state the health department advises parents that direct oral contact can lead to the child contracting herpes, as well as fatal injuries such as brain damage and even death.

Additionally, the city has also required ritual circumcisers to inform parents in writing whether or not the circumcision will include direct oral contact. This revision will go into effect in 30 days.

Those who do not comply with the new requirement may receive a warning letter from the department of health or a fine up to $2,000.

According to Dr. Jay K. Varma, the City's deputy commissioner for disease control, enforcement will only be based on investigations of complaints, not spot checks or raids.

Orthodox Jewish groups such as Agudath Israel of America and the Central Rabbinical Congress, banded together to sue the city in efforts to block the regulation.

Though city health officials believe there is enough supporting evidence, primary care physicians who work with ultra-Orthodox families beg to differ.

Dr. Kenneth I. Glassberg, the director of the division of pediatric urology at Morgan Stanley Children's Hospital at NewYork-Presbyterian told The New York Times, "Medically, I don't approve of it but if you're asking me, 'Does it cause harm?', I haven't seen enough proof that it causes harm."