NEW YORK (JTA) — Two more New York infants were diagnosed with herpes after undergoing the controversial Jewish circumcision practice metzitzah b’peh.

Both boys developed symptoms of herpes this month soon after the direct oral suction technique was used, according to an alert issued Tuesday by the New York City Health Department.

The health department in 2012 implemented regulations requiring parents to sign a consent form prior to such circumcisions. Agudath Israel of America and other haredi Orthodox groups have opposed the regulation, contending in a lawsuit that it violates religious freedom. They also have insisted that metzitzah b’peh is not dangerous.

A federal judge upheld the regulation in 2013, but the health department has not been aggressive about enforcement, the Forward reported.

Since 2000, the health department alert said, there have been 16 cases of infants contracting herpes following metzizah b’peh. Two of the infants died and at least two others suffered brain damage.