All you need to know about breastfeeding and fasting during Ramadan
Is breastfeeding and fasting possible during Ramadan? Does fasting have an effect on your milk quality? Find out in this useful article now.
Ramadan, the Islamic month of fasting and prayer for Muslims worldwide, has now started. During this month, Muslims around the world abstain from food, drink and other physical needs during the daylight hours.
But what about Muslim mums who are breastfeeding their little ones? Can they still continue to nurse?
According to Kelly Bonyata, an International Board Certified Lactation Consultant (ICBLC) who writes about breastfeeding on Kelly Mom, “Muslim women who are pregnant or breastfeeding may be exempt from fasting if they feel that their health or the baby’s health would be negatively affected by the fasting.”
However, the mother may be expected to compensate for the missed fasting at a later time or once breastfeeding has stopped. Bonyata advises mums to consult a scholar or a book of Fiqh to determine the appropriate guidelines.
If you are a Muslim mum considering breastfeeding and fasting this Ramadan, you may have some questions of your own.
Fasting will not harm your baby if you are breastfeeding. However, it may affect you in one way or another if you don’t plan ahead in terms of your diet, nutrition and pumping schedules.
Jophia Bok, a lactation nurse based in Singapore, explains that some mums who breastfeed while fasting may experience signs and symptoms of low blood sugar, low blood pressure, dehydration or gastritis. They may also experience a reduction in milk supply.
A study conducted by Ertem et al found that “22% of breastfeeding mothers perceived a decrease in their breast milk production and 23% reported increasing the amount of infant supplements during Ramadan fasting.”
Jophia provides the following comprehensive guide for nursing Muslim mums who decide to fast, depending on their baby’s age range.
1. For mums who exclusively breastfeed their newborn to six-month-old babies
Your milk supply may drop and you may feel thirstier and hungrier as your baby’s demand for breastmilk at this age is high. However, the quality of breastmilk will not be affected even if you are fasting. But due to your reduced intake of fluid and food, your milk supply may dip and your baby may cry for more frequent feeding.
Medical experts encourage women with babies in this age range to consider not fasting. This is because your body needs consistent fluid and calories from food to keep your production of breastmilk going for your baby’s high feeding demand.
Some of the potential health risks mums of high-demand babies may face if they decide to fast are low blood sugar and possibly low blood pressure due to dehydration. You might even experience gastritis as your metabolism is naturally higher due to breastfeeding.
2. For mums who breastfeed their six to 15-month-old babies
Younger babies in this age group are starting to eat solids and older babies should already have well-established solids routines. With this in mind, mums should naturally be dropping one breastfeeding session as their babies start eating more in quantity and frequency.
Because of this, breastfeeding mums of babies in this age group will find fasting much easier as the demand for producing breastmilk is not as great. However, some mums breastfeeding their older babies might feel unwell as their bodies continue to need slightly more calories than usual.
3. For mums who breastfeed their 15 to 24 month-old toddlers
For this group of mums, fasting should not be a problem as their babies should be relying more on natural food for growth and development rather than on breastmilk alone.
These mums could even give their toddlers an extra snack or increase the portion-size of their meals to reduce or even cut out one breastfeeding session. However, some fasting mums with breastfeeding toddlers may still feel unwell as their bodies are used to having food and fluids to help in the production of breastmilk.
4. For mums who breastfeed their 24 months and above toddlers
Fasting should not be a problem for this group of mums. Their babies should be eating full table food and relying mainly on natural food for growth and development rather than breastmilk.
Rakicioğlu et. al. (2006) studied mums with babies aged two to five months old, who fasted during Ramadan. They found that while the macronutrient content of breastmilk was not affected, levels of several nutrients in breastmilk (zinc, magnesium and potassium) decreased and the nutritional status of the breastfeeding mothers was affected.
Another study that looked at Gambian breastfeeding mothers who fasted for Ramadan found that milk composition did change to some extent. However, volume was not affected.
The researchers of this study noticed that the mothers appeared to superhydrate themselves overnight when fluids were allowed, and this lessened daytime dehydration. This practice would also enable mums to keep milk production consistent.
Jophia explains that even if you do not have a consistent well-balanced diet, your body is still able to produce quality milk by adjusting the nutrients in it to suit the growth and needs of your baby.
Ask yourself the following questions before you start fasting, advises Jophia. How long are you going to fast for? Will you have regrets if the fasting affects your milk supply? Are you open to alternative methods of feeding baby if your breastmilk supply dwindles due to fasting? Are you open to even stop fasting if you feel unwell?
Once you have thought through these questions, you can move in the direction that you want without guilt.
Here are some more tips to consider:
- Plan one month before you fast and start stocking up on your supply of expressed breastmilk. This stock can be your backup during the month of fasting in case you find it hard to latch directly.
- Your Suhoor or pre-dawn meal needs to be wholesome enough to give you enough energy to last the whole day. Include plenty of fruits and vegetables (e.g. green smoothies, fruit salad), high fibre carbohydrate foods like brown rice and multigrain bread, foods that contain protein (chicken, fish, beef, eggs) and dairy products for calcium.
- When it’s time for you to break your fast (Iftar), avoid suddenly gorging yourself with food. Start with three or four dates. They are considered to have almost complete minerals and are high in simple sugars that are easily absorbed into the body, thereby helping to bring your blood sugar levels back to normal, slowly.
- Other than dates, bananas are also good to break fast with. Then slowly move on to having some warm water or warm fluid. Slowly progress to soft soupy foods (e.g. lentil soup) with less oil and salt.
- Drink plenty of warm water through the night in order to re-hydrate your body.
- Express during the night at least once or twice in order to maintain your milk supply and also to stock up in case you need it.
- If you are considering breastfeeding and fasting, medical professionals suggest that that you start increasing your fluid intake as early as two days before you start fasting. This will put you on a good start.
- Lactation experts recommend that you avoid heat exposure and wind down your activities as much as possible.
Two Muslim mums who breastfed and engaged in fasting for Ramadan in the past share some of the things they ate during both Suhoor and Iftar that helped them keep their energy and nutrition levels up through the day.
This coming Ramadhan will be my second time fasting. Last year, I had managed to fast the whole of Ramadhan and nursed my then three month old son fully when I was home. I also had three pump sessions daily at work.
Before dawn, I had seven pieces of dates before starting my meal. I had rice every morning and drank Milo, followed by three glasses of water.
When breaking fast, I drank Milo and had three pieces of dates before my meal. I also ate rice with veggies and meat as sides. During the night, I drank water frequently. – Mariah Dasuki
Hassy Rizzy, another breastfeeding mum who decided to fast last Ramadan, found that eating two slices of Gardenia brand Oats and Honey bread with cheese and drinking two cups of Meiji chocolate milk for her pre-dawn meal enabled her to express much more milk than usual.
Here are some more great Suhoor foods for breastfeeding mums as recommended on the breastfeeding website Suckled Sunnah:
- Boiled eggs: A great source of protein and omega 3 fatty acids
- Oatmeal: A really good breastmilk booster and a good source of proteins, vitamins and minerals
- Hummus: Chickpeas are considered to be a good milk booster and contain proteins, while tahini (sesame seed butter) has calcium
- Baked yams: Prepare the previous night and eat warm or cold with a little butter and brown sugar
- Nuts: Try macadamia nuts and cashews to boost your milk supply
Jophia recommends you seek medical attention if you have the following signs and symptoms while breastfeeding and fasting:
- Blurring of vision: a possible indication of low blood pressure
- Giddiness: a possible indication of low blood pressure
- Fainting spell: could indicate low blood sugar levels
- Nausea and vomiting: a possible indication of dehydration
- Vomiting with presence of blood stains: could indicate stomach ulcers in severe gastritis cases
- Pain in the epigastric region (which is one palm size above your belly button): possible indication of gastritis
- Reduced urine production and presence of blood stains in the urine: could indicate severe dehydration
Mums, we hope you found this article useful. If you would like to contact Jophia regarding any breastfeeding-related matter, her phone number is 9159 6557.