I.
When is it permissible for a pregnant or breastfeeding woman not to fast?
There is a proven concession in Islamic teachings allowing pregnant and breastfeeding women not to fast if they fear for themselves or their children as a result of fasting.
Abu Dawud (2408), at-Tirmidhi (715), an-Nasa’i (2315) and Ibn Majah (1667) narrated that the Prophet (blessings and peace of Allah be upon him) said: “Allah, may He be Glorified and Exalted, has waived half of the prayer, and fasting, for the traveller and for pregnant and breastfeeding women.” Classed as authentic (sahih) by al-Albani in Sahih Abi Dawud.
The concession does not include every pregnant or breastfeeding woman, as some may understand from the words. This is not what is meant according to scholarly consensus; rather what is meant is those who would be harmed or who fear harm from fasting. This is what Ibn `Abbas (may Allah be pleased with him) said when he explained this concession, that what is meant is if she fears harm for herself or her child.
Abu Dawud (2318) narrated that Ibn `Abbas said, regarding the verse {And from those who are able [to fast, but with hardship] - a ransom [as substitute] of feeding a poor person [each day]} [al-Baqarah 2:184]. Ibn `Abbas said: The concession was granted to old men and old women who are able to fast but find it hard, allowing them not to fast and, for each day they do not fast, they should feed one poor person. This also applies to pregnant and breastfeeding women, if they are concerned. Abu Dawud said: That is, if they are concerned for their children, they may not fast and should feed [the poor instead].
An-Nawawi said: Its isnad is sound (hasan).
Al-Mawardi (may Allah have mercy on him) said:
There are two scenarios regarding pregnant and breastfeeding women if they do not fast:
They are either not fasting because of fear and need, or not.
When there is no fear for the woman or the child, and there is no urgent need not to fast, then the ruling is the same as the ruling on one who breaks the fast deliberately, meaning that this action is sin and disobedience, and the fast must be made up. As for whether expiation is required, there is a difference of scholarly opinion concerning that.
If they do not fast because of fear, then fear is of two types:
- The fear is of physical harm to themselves, in which case there is no doubt that it is permissible for them not to fast, and they must make up the fast later on, but no expiation is required, as in the case of one who does not fast because he is sick.
- The fear is of harm to the child or foetus, not the women themselves. There is no difference of scholarly opinion concerning the fact that it is permissible for them not to fast…
End quote from Al-Hawi by al-Mawardi, 3/436.
What is meant by fear is not fear of death for the child or the mother; rather it is fear of harm to either of them, or that fasting will exhaust the mother and cause her extra hardship, more than is usual when doing this act of worship.
Al-Khatib said in Al-Iqna`: If they fear harm from fasting for their children only, meaning that the pregnant woman fears that she may miscarry, or the breastfeeding woman fears that her milk supply will decrease and the child could be at risk.
Al-Bujayrimi said: At risk does not necessarily mean at risk of dying; rather it may refer to the risk of harm to the child as a result of the mother fasting. (2/399).
For more information, please see the answers to questions no. 66438 and 49794.
II.
The guideline on fear of the pregnant or breastfeeding woman that makes it permissible to not fast
The jurists stated that what is meant by fear that makes it permissible to not fast in this case is: thinking it most likely that the harm referred to above will occur.
They stated that this thinking it most likely is to be based on experience or signs which indicate that such harm is already occurring, or if a Muslim doctor tells her that.
As for just thinking, or deciding not to fast on the basis of mere rumours or the words of someone whose opinion is not reliable, that does not make it permissible to not fast.
Al-`Allamah Ibn Nujaym (may Allah have mercy on him) said:
The guideline on fear or concern is what is thought to be most likely to happen on the basis of experience, or if a skilled Muslim doctor tells you, as is mentioned in Al-Fatawa az-Zahiriyyah, as we have noted above, because if she is not afraid or concerned, there is no concession allowing her not to fast…
End quote from Al-Bahr ar-Ra’iq, 2/307.
Al-Hasakfi said in Ad-Durr al-Mukhtar:
Or in the case of a pregnant or breastfeeding woman, whether she is the mother or a wet-nurse…
or in the case of a sick person who fears that his sickness will be made worse, or a healthy person who fears becoming sick, or a servant woman who fears becoming exhausted, on the basis of what is thought most likely to happen due to some indications or experience, or because a skilled Muslim doctor of good character has told them [that harm is likely].
It says in An-Nahru taba`an lil-Bahr that it is permissible to follow the medical advice of a non-Muslim doctor, provided that his advice does not involve giving advice not to do an act of worship.
Ibn `Abidin said in his commentary Radd al-Muhtar:
What is meant by a healthy person who fears becoming sick is that he thinks it most likely that that will happen, as we shall see below. What is mentioned in Sharh al-Majma`, that he should not break his fast, is to be understood as referring to fear that is based on mere conjecture…
What is meant by experience means even if someone else tells that person about his experience, when they both have the same illness.
What is meant by skilled is the doctor should be well-versed in medicine. Therefore, it is not permissible to follow the opinion of one who has minimal knowledge of medicine.
What is meant by saying that the doctor should be a Muslim is that the opinion of a disbeliever cannot be relied on, because of the possibility that his aim is to spoil the act of worship.
What is meant by being of good character is that this is a stipulated condition, and az-Zayla`i emphasised the importance of that.
I say: if he follows the advice of a doctor who does not meet these conditions and breaks his fast, then what appears to be the case is that he must offer expiation, just as if he broke the fast without there being any indicative signs or experience on which to base that action, because in that case, he is not acting on the basis of what he thinks most likely to happen, and people are heedless about that!
End quote from Hashiyat Ibn `Abidin: Radd al-Muhtar, 2/422-423.
Al-`Allamah ash-Shirwani said in Hawashi at-Tuhfah, 3/441.
Regarding the words “If fasting causes these problems…”, the fear or concern referred to must be based on the opinion of a Muslim doctor of good character. End quote.
III.
Medical studies on the impact of fasting on the breastfeeding woman and the child
After referring to a number of specialised medical studies by specialist doctors, we may sum up the following:
- The components of milk: some studies have proven that fasting has no impact worth mentioning on the components of milk. (See Study no. 1).
- Some studies have discussed the impact and said that there is no impact on the main components of milk, such as proteins, glucose and so on. Therefore there is no significant impact on the nutritional effects of milk. However, there is some impact on minor components, such as zinc, magnesium and potassium. (See Study no. 2).
- Regarding the amount of milk, most studies indicate that the amount of milk is not affected in general, because most mothers replace fluids after breaking the fast.
- However, there are some studies which prove that the amount of milk is in fact affected in cases of fasting whilst breastfeeding, and the mother needs to give the child some formula to make up for the shortfall. (See Study no. 3).
- Nutrition and growth of the child: most studies indicate that the child is not affected in terms of growth, because the components of milk in general are not affected by fasting. (See Studies no. 2 and 4).
- The mother’s general state of health:
- Some studies have proven that the general nutritional state of the mother is affected when breastfeeding, hence the studies recommend not fasting at all when breastfeeding, because of the impact on the mother’s health. (See Study no. 2).
- But there are other studies which contradict that, and say that the general nutritional state of the mother is not affected. (See Study no. 4).
To sum up the medical studies, after having examined them:
The medical perspective focuses on the physiological or pathological impact in the case which is the subject of this study. From that perspective it may truly be said that fasting has no impact on the child’s health or on his growth, but the amount of milk may be affected according to the general state of hydration in the breastfeeding woman’s body. If she can drink a sufficient amount of liquids during the night, there will be no great impact on the amount of milk.
As for the mother’s health, it will undoubtedly be affected – generally speaking – because breastfeeding is dependent on the mother’s nutritional intake, therefore the mother needs to pay special attention to nutrition during the breastfeeding period, and also increase her liquid intake. Even though breastfeeding when fasting has no obvious impact on her health, it may cause exhaustion to the mother, especially if she is physically weak or has other health problems.
References:
- Fasting during the holy month of Ramadan does not change the composition of breast milk, A.Benera, S.Galadarib, et al., Nutrition Research, Volume 21, Issue 6, June 2001, p: 859-864.
- The effect of Ramadan on maternal nutrition and composition of breast milk, Neslişah Rakicioğlu, Gülhan Samur, Ali Topçu, and Aylin Ayaz Topçu, Pediatr Int., 2006 Jun; 48(3): p. 278-83.
- Attitudes and practices of breastfeeding mothers regarding fasting in Ramadan, I O Ertem, G Kaynak, et al., Child Care Health Dev., 2001 Nov; 27(6): p. 545-54.
- Knowledge, attitude and practice of Saudi women in Najran area towards breastfeeding during Ramadan. Awad Mohammed Al-Qahtani, Hatem Mohamed, and Awad Mohamed Ahmed, Sudan J Paediatr., 2020; 20(1): p. 42–48
The medical information mentioned here, and its sources, were provided to us by Dr. Muhammad Farahat, a doctor who also specialises in medical jurisprudence; he has a Master’s degree and a Doctorate in Jurisprudence and its Fundamentals.
IV.
If the worry about breastfeeding the infant whilst fasting is, in general, concern about the amount of milk that the child gets during the day, and whether it is sufficient for his nutrition, or there is any shortcoming that will have a negative impact, this is something that is not the same in every case; rather it varies according to how long or short the day is and how much milk the mother produces, whether the amount is small or great. If the mother can drink more liquids at night and reduce physical activity, exposure to the sun and so on, then in that case she will be able to fast.
But if there are clear signs that the milk she can produce is too little to meet the infant’s needs, then in this case the view that says that there is a concession allowing her not to fast is stronger.
A paediatric specialist doctor told us that the signs and indications mentioned in the question, which describe the condition of the child, confirm his need for milk and make it more appropriate that the mother should not fast, especially in the case of one who experiences extreme hardship in breastfeeding when she is fasting, if this is what the questioner meant by saying that she feels exhausted.
The option of accepting the concession and not fasting is further supported, according to what we have been told, if the child is under the age of 6 months, because he needs to rely on his mother’s milk completely. After the age of 6 months, the matter is easier, because she could make up for the shortage of milk from other sources.
Summary:
The concession allowing pregnant and breastfeeding women not to fast is confirmed if they fear for themselves or their child.
But the concession is not general in application; rather it is limited to cases of hardship or harm, or when it is thought most likely that harm will occur.
This thinking it most likely that harm will or occur, or fear of that happening, which makes it permissible to not fast can be recognised from the clear signs in a specific case, especially when there is obvious hardship or exhaustion for the mother.
If there are no clear signs, or the matter is not clear, then you must consult a trustworthy doctor.
And Allah knows best.
