Religious fasting and breastfeeding

ABA has the following information for the benefit of people who are part of cultures/religions that fast and for others who are interested in knowing more about this but the Association does not express a view either on whether women should fast or how they should do it.

Ramadan is a time of great community celebration and it is a joyful, inspiring time. Adherence to the Islamic religion requires fasting from sunrise to sunset throughout the month of Ramadan. Therefore, the duration of a fast can vary from 12–16 hours, depending on whether Ramadan falls in the summer or winter months. It is not usually seen as a hardship or hindrance, more a privilege — that one is healthy enough to fast and lucky enough to do so with their community. It is also an obligation for practising Muslims, and missed fasts must be made up for by fasting at a later date, or fidyah. Therefore, most practising Muslim mums prefer to fast.

A woman who has fasted since she was old enough to do so is capable of making the decision whether to fast. If she feels fit on the day, she can decide to fast. And if she decided to fast and she or baby’s health are affected she can pause fasting until they recover and resume as she sees fit. As a form of religious respect, non-Muslims should refrain from dissuading a Muslim mum from fasting.

Breastfeeding and Yom Kippur

Yom Kippur, the Jewish Day of Atonement, requires an almost 25-hour fast. Jewish mothers who are breastfeeding can consult a Rabbi or the Nishmat for more information about fasting for Yom Kippur.

Milk supply

While severe dehydration can decrease milk supply, breastfeeding research tells us that short-term fasting does not decrease milk supply.2,3

Nutrient content of breastmilk

Zimmerman et al (2009)4 studied the breastmilk of 48 healthy mothers who were exclusively breastfeeding a baby aged between 1 and 6 months and who fasted for close to 25 hours during Yom Kippur. This study found that fasting resulted in some short-term changes to breastmilk composition. The author of this study indicated that, ‘The practical significance of these changes should be seen within the context that thousands of babies undergo this exposure yearly without reported clinical effects’. Breastfeeding mothers can help ensure their baby remains well hydrated by continuing to breastfeed as per normal and monitoring their baby's output (poos and wees). If the mother has any concerns about her ability to fast, she should seek medical advice.

Bener et al (2001)5 also studied the breastmilk of 26 healthy mothers between the second and fourth weeks of Ramadan and 2 weeks after the end of Ramadan. This study found no significant differences in the content of major nutrients of breastmilk taken during and after Ramadan.

Effect on baby

Khoshdel et al (2007)6 studied the effect maternal fasting during Ramadan had on the growth of exclusively breastfed babies aged 15 days - 6 months. The mothers of 36 of these babies fasted throughout Ramadan and 80 mothers did not fast. The babies’ growth was evaluated twice during Ramadan, 3 times in the second month and bimonthly in the next 4 months. This study found no significant differences in the growth of the babies in either group. This study concluded that Ramadan fasting by breastfeeding mothers does not adversely affect the growth of exclusively breastfed babies at least in the short-term.

Likewise, Haratipour et al (2012)7 studied the growth of 55 healthy exclusively breastfed babies aged 1–6 months. Of the 55 babies, 20 of their mothers fasted throughout Ramadan and 35 of their mothers did not. The babies’ growth was evaluated twice in Ramadan and four times in the first, second and third months after Ramadan. This study concluded that Ramadan fasting by breastfeeding mothers did not adversely affect the growth of breastfed babies at least in the short term.

If a mother does not drink fluids for a day, her baby would generally breastfeed as usual the day of the fast, but would often breastfeed more often the next day or two.4

Effect on mother

Healthy mothers are likely to cope well with short-term fasting. However, it is always a good idea to seek medical advice prior to fasting.

Zimmerman et al (2009)4 recommend for breastfeeding mothers to ‘increase their fluid intake during the 2 days prior to the fast so they begin the fast as well hydrated as possible’. They also recommend for breastfeeding mothers to ‘decrease their activities and heat exposure as much as possible during the fast’.

References                                           

1. NHS Choices. 2012. Ramadan health FAQs. URL: http://www.nhs.uk/livewell/healthyramadan/pages/faqs.aspx Accessed 30/7/2013

2. Neville, M.C., Sawicki, V.S., Hay, W.W. Jr 1993, Effects of fasting, elevated plasma glucose and plasma insulin concentrations on milk secretion in women. J Endocrinol 139(1),165–173.

3. Tigas, S., Sunehag, A., Haymond, M.W. 2002, Metabolic adaptation to feeding and fasting during lactation in humans. J Clin Endocrinol Metab 87(1),302–307.

4. Zimmerman, D.R, Goldstein, L., Lahat, E., Braunstein, R., Stahi, D., Bar-Haim, A., Berkovitch, M. 2009, Effect of a 24+ hour fast on breast milk composition. J Hum Lact 25(2),194–198.

5. Bener, A., Galadari, S., Gillett, M., Osman, N., Al-Taneiji, H., Al-Kuwaiti, M.H.H., Al-Sabosy, M.M.A. 20001, Fasting during the holy month of Ramadan Does not change the composition of breast milk. Nutrition Research 21,859–864.

6. Khoshdel1, A., Najafi , M., Kheiri, S., Taheri, E., Nasiri5, J., Yousofi, H., Jafari, A. 2007, Impact of Maternal Ramadan Fasting on Growth Parameters in Exclusively Breast-fed Infants. Iran J Pediatr 17(4),345–352.

7. Haratipour, H., Sohrabi, M.B., Ghasemi, E., Karimi, A., Zolfaghari, P., Yahyaei, E. 2012, Impact of Maternal Fasting During Ramadan on Growth Parameters of Exclusively Breastfed Infants in Shahroud. J Fasting Health 1(2), 66–69.

 The information on this website does not replace the advice of your health care provider.

© Australian Breastfeeding Association May 2018

 

 

 

 

 

 

 

 

 

 

 

 

Last reviewed: 
May 2018