🙋‍♂️ Nursing Women Fasting on Yom Kippur

Question:
I have heard it claimed that nursing women should not fast like everyone else on Yom Kippur and may even initially begin the fast drinking less than a Shiur at set intervals. Is this the accepted halachic ruling?

 

Answer:
No.

The accepted halachic ruling is that a nursing woman is obligated to fast on Yom Kippur just like any other healthy adult. There is no blanket heter for nursing women to eat or drink, even less than a Shiur, simply because they are nursing. This applies even in contemporary times.

The entire discussion of drinking Shiurim revolves around cases of actual or possible danger (safek sakana) to the mother or child. Absent such concerns, a nursing woman is obligated to complete the fast.

This conclusion comes to negate the contemporary practice advocated by some authorities who recommend that all nursing women begin Yom Kippur drinking Shiurim out of concern that fasting may negatively affect milk production. While such opinions exist, the majority of Poskim do not accept this approach as a blanket ruling. Rather, each case must be judged individually based on the circumstances of the mother and child.

 

The Medical Background

The medical literature available on the subject of fasting while nursing does not support the claim that fasting generally causes dangerous harm to nursing infants.

The medical research findings include:

• Most nursing women do not experience a significant decrease in milk production during Yom Kippur itself.
• Some decrease in milk supply may occur on the day after the fast, but it is generally temporary and reversible.
• Researchers have not documented cases in which a one-day fast permanently terminated nursing in women who were previously nursing successfully.
• Nursing mothers frequently experience weakness while fasting, but ordinarily do not reach dangerous dehydration.
• Anxiety and fear regarding fasting can itself negatively impact milk production.

Accordingly, the assumption is that a normal healthy nursing woman can fast unless there are specific reasons to believe that fasting may create danger to herself or her infant.

 

Cases in Which Leniencies May Apply

Despite the above general rule, there are a number of situations in which drinking Shiurim, or in some situations not fasting altogether, may be warranted.

• Premature Infant or Ill Infant Dependent on Mother’s Milk: If the infant is premature, ill, medically fragile, or otherwise dependent upon the mother’s milk, and there is concern that fasting will significantly impair the infant’s nutrition, then the mother may drink Shiurim as necessary. If there is a genuine danger to the child and the child refuses other forms of nutrition, the mother should not fast.
• Mother Experiences Significant Reduction in Milk During the Fast: If a mother begins fasting and actually observes a significant reduction in milk production while nursing an infant who depends on that milk, she may begin drinking Shiurim. The recommendation is generally to start the fast normally and only begin drinking if the concern materializes.
• Mother Develops Unusual Symptoms: If the mother experiences unusual weakness, dizziness, or symptoms beyond ordinary fasting discomfort, she should begin drinking Shiurim and, if necessary, drink normally until the danger passes.
• Infant Undergoing Exclusive Breastfeeding: A more complex situation involves an infant who is being exclusively breastfed and does not normally receive formula or other sources of nutrition. Some Poskim are more lenient in such a case and rule that there is no obligation to begin introducing formula merely so that the mother can fast. Accordingly, if a mother knows from prior experience or other reliable indicators that fasting will significantly diminish her milk supply, or if during the fast she observes that her milk has substantially decreased, she may drink Shiurim as necessary to maintain adequate nursing for the child. Nevertheless, the more recommended approach is to do everything reasonably possible before Yom Kippur to avoid reaching that situation. This includes increasing fluid intake in the days leading up to the fast, drinking generously on Erev Yom Kippur, obtaining adequate rest, arranging assistance with childcare, and where practical, pumping and storing breast milk before the fast. Furthermore, if there is sufficient time before Yom Kippur and the parents are open to doing so, it may be worthwhile to determine whether the child can successfully tolerate formula or other alternatives, thereby reducing the likelihood that the mother will need to drink during the fast. Accordingly, while some Poskim permit a nursing mother in this situation to drink Shiurim when there is concern for the infant’s nutritional needs, the preferred course is to prepare properly and exhaust all reasonable measures that may enable her to complete the fast without eating or drinking.
• Infant Who Refuses Formula or Alternatives: If the infant will not accept formula, bottled milk, or other substitutes and is dependent on nursing, the concern becomes more serious. Such cases require individual rabbinic consultation and may justify drinking Shiurim.

Preparation Before the Fast

The Poskim repeatedly stress that nursing women should prepare extensively for Yom Kippur by:

• Increasing fluid intake in the days before the fast.
• Drinking heavily on Erev Yom Kippur.
• Pumping and storing milk before Yom Kippur when helpful.
• Remaining in bed or resting if necessary rather than expending energy caring for children or attending lengthy services.

The Poskim emphasize that a husband should assist with childcare and household responsibilities if necessary and not attend Shul so that the mother can successfully complete the fast.

 

What should she drink if she has been instructed to drink Shiurim?

If a nursing woman has received a ruling permitting her to drink Shiurim in order to maintain her milk supply or protect the wellbeing of her infant, it is preferable that she drink nourishing beverages rather than plain water. Since the goal is to maximize hydration and nutritional value while minimizing the amount consumed, many Rabbanim recommend using drinks that contain calories and electrolytes.

Recommended Drinks

• Pedialyte or similar oral rehydration solutions.
• Hydralyte oral rehydration drinks.
• Gatorade or Powerade.
• Fruit juices, such as grape juice, apple juice, or orange juice.
• Milk.
• Chocolate milk.
• Nutritional drinks such as Ensure or Boost.
• Homemade electrolyte solutions approved by a physician.

These drinks provide hydration together with nutrients and may therefore be more effective than plain water for maintaining nursing function. This is especially relevant when the mother’s drinking is being limited to Shiurim. Nevertheless, this entire discussion is relevant only after a Rav has determined that drinking Shiurim is warranted, as the basic halachic presumption remains that a healthy nursing woman is obligated to fast just like any other person.

 

Less Preferred Drinks

• Plain water.
• Black coffee.
• Tea with little nutritional value.
• Diet beverages without significant calories or electrolytes.

 

Conclusion:
A nursing woman is presumed obligated to fast on Yom Kippur like everyone else. The accepted halachic approach is not to permit all nursing women to begin drinking Shiurim from the outset. Rather, only when specific circumstances raise a concern of danger or possible danger to the infant or mother, such as a premature baby, a medically dependent infant, actual loss of milk supply, inability to tolerate substitutes, or unusual maternal weakness, do the discussions of Shiurim become relevant. In the ordinary case, a nursing woman should prepare properly for the fast and is expected to complete it in full.

 

Sources:
Shulchan Aruch O.C. 617:1; Admur 617:1; Pesachim 54b; Yerushalmi Taanis 1:5; Beir Heiytiv 618:7 in name of Dvar Shmuel 107; Machaneh Chaim 3:47; Kitzur SHU”A 133:12; Shaareiy Teshuvah 554:6; Chasam Sofer 6 Likkutim 23; Kaf Hachaim 617:2; Mishnah Berurah and Biur Halachah 617:1 “Ubros Umanikos”; Chazon Ish O.C. 59:4; Mikraeiy Kodesh Yom Kippur 9:57; Siach Nachum 56; Shmiras Shabbos Kehilchasah 39:18; Axz Nidbaru 9:9; Halichos Shlomo Yom Kippur 1:82; Shoel Umeishiv; Nitei Gavriel 38:21; Piskeiy Teshuvos 617:2; Machon Puah Sefer Puah 3:73; Shut Puach 4:181

 

Situation	Recommended Approach
Infant is exclusively breastfed and healthy	The mother should initially plan to fast like everyone else and should not automatically begin drinking Shiurim.
Before Yom Kippur	She should do everything reasonably possible to maximize her ability to fast, including increasing fluid intake in the days before Yom Kippur, drinking generously on Erev Yom Kippur, resting, arranging childcare assistance, and pumping and storing milk beforehand.
Trying formula before Yom Kippur	The preferred approach is to determine beforehand whether the child can tolerate formula or other alternatives, rather than waiting until Yom Kippur itself. This may avoid the need to drink during the fast.
Some Poskim’s lenient opinion	Some Poskim rule that where the infant is exclusively breastfed there is no obligation to begin introducing formula merely to facilitate the mother’s fast. Accordingly, if the mother knows from experience that fasting will significantly diminish her milk supply, she may have grounds to drink Shiurim.
Milk supply noticeably decreases during the fast	If during the fast she observes that her milk supply has significantly diminished and the infant depends on that milk for nutrition, she may begin drinking Shiurim as necessary.
Mother knows before Yom Kippur that she will be unable to maintain nursing if she fasts	According to some authorities, she may begin drinking Shiurim from the outset. Nevertheless, this should be determined through competent rabbinic guidance and not assumed automatically.
Preferred overall approach	Even where leniencies exist, the preferred approach is to prepare thoroughly beforehand and avoid needing to drink during the fast unless an actual concern develops.