New York City, USA - A controversial Jewish circumcision practice in which the blood of a baby's cut penis is sucked by a religious leader has been condemned after the deaths of two infants.
The 'metzitzah b'peh' performed by ultra Orthodox Jews sees the eight-day old baby have a traditional circumcision but the 'mohel' then places his mouth around the wound and sucks up the blood.
But the practice - intended to prevent infection - has sparked controversy in recent years after the death of two infants and the cntraction of herpes in at least 11 others between November 2000 and December 2011.
Heath chiefs in New York are now pushing through regulation forcing anybody wishing to have the procedure carried out on their babies to sign a consent waiver.
But some Orthodox Jews have complained about the measures claiming that they infringe on their 'religious freedom'.
Rabbi Moshe Tendler, professor of Talmudic Law and Bioethics at Yeshiva University, told KTLA that the practice was 'primitive nonsense'.
'The ritual has nothing to do with religion. It's only their customs. But they've managed to convince the city that it's a violation of their religious freedoms,' he added.
Circumcision rituals originate from Scriptures, in which God tells Abraham that all men must be circumcised eight days after they are born.
Jews believed that blood was the 'life-giving element' and sucking it from the baby's penis was initially thought to prevent infection.
But medical advances over the last hundred years have made clear that it can actually spread diseases. It is practiced widely in Israel and among Hasidic Jews.
Numbers of cases in New York alone emerged after the city's health department launched an investigation following the deaths. The most recent of the deaths was in Brooklyn last September and a criminal investigation is still ongoing.
The earlier death was in November 2004, when a twin caught herpes after undergoing the procedure. The other survived.
Almost 20,500 baby boys had the procedure carried out in New York in June this year.
According to the findings of the investigation, infants who were circumcise with suction between April 2006 and December 2012 had a risk of catching neonatal herpes (HSV-1) infection of 24.4 per 100,000 cases.
New York City Health Commissioner Dr. Thomas Farley said in a statement: 'There is no safe way to perform oral suction on any open wound in a newborn.
'Parents considering ritual circumcision need to know that circumcision should only be performed under sterile conditions, like any other procedures that create open cuts, whether by mohelim or medical professionals.'
Jeffrey Mazlin, a certified mohel and physician in New York who regularly practices circumcision procedures, said Orthodox Jews look view the religion as 'more important than individuals'.
'Because blood is the life-giving element, they believe that it's supposed to be part of the whole procedure,' he said, adding that there were 'no known medical benefits'.
An alternative to the practitioner removing the blood with their mouth is to use a sterilised glass tube or pipette to create the suction, which some Jews have started incorporating into the ritual.
Infectious diseases specialist Dr. Daniel S. Berman defended the practice in a paper published in the Jewish journal Dialogue. He claimed there is no evidence that the 'metzitzah b'peh' procedures caused the infant deaths.
Dr Berman also accused New York government chiefs of 'racial bias'.