For Muslims, the month of Ramadan commemorates the revelation of the Holy Book, The Quran, to the Prophet Muhammed. In observance of Ramadan, during the ninth month of the Islamic calendar, all healthy adult Muslims are expected to fast from the hours of sunrise to sunset. No food or water is consumed during daylight hours.
Since the Islamic year follows a lunar calendar, the month of Ramadan moves through the seasons. When Ramadan happens during the colder months, the time of fasting may only extend from 7 a.m. to 4 p.m. When it happens during the summer, the daylight hours of fasting can run from 5 a.m. to 9 p.m., depending on where you live. In 2018 the month of Ramadan lasts from May 15 to June 14, which in many latitudes will require fasting to last for more than 12 hours.
Traditionally, pregnant women and breastfeeding mothers, as well as anyone with a health problem, has been considered exempt from this religious observance. Women who choose not to fast have the option to make up the fast at a later date, for example, after they wean their children. It is also traditional to make up for a missed fast with acts of charity. However, a woman may still want to fast during Ramadan, even when pregnant or breastfeeding.
A few studies observed women who chose to fast during their pregnancy and found no negative outcomes for either the mother or her baby. In these studies, daytime fasting among healthy pregnant women did not lead to any significant difference in birth time weight, height and head circumference of their babies or present any health problems during the pregnancy.
That does not mean fasting during pregnancy is completely safe.
Pregnant women need to consume about 1,800 calories every day during the first trimester and about 2,200 calories during the second trimester. Those calories should ideally come from plenty of fruits and vegetables and food rich in folic acid and calcium. While it is possible to get that many calories—and adequate nutrition—during Suhoor, the Ramadan pre-dawn breakfast meal, and Iftar, the Ramadan sunset meal breaking the fast—abstaining from food and water for many hours can lead to low blood sugar and dehydration.
During pregnancy, dehydration can lead to low amniotic fluid levels, Braxton Hicks contractions, preterm labor, a decrease in the baby’s activities, and possible birth defects. Not drinking enough fluids may pose a bigger danger when Ramadan falls during the summer months, especially in warmer locations. Longer hours and higher temperatures make it easier to become dehydrated.
Ramadan fasting has also been shown to change the composition of breast milk. While studies found that fasting does not necessarily reduce the supply, it does alter the balance of the micronutrients normally in breast milk. Breastfeeding mothers need to increase the amount of fluids they drink and to avoid strenuous activity if they decide to fast during daylight hours.
If you decide that you want to fast while pregnant or breastfeeding, here are some suggestions that can help minimize any health risks.
- Talk to your doctor or midwife before starting your fast. To best care for your pregnancy and child, your health care providers need to know your plans, especially if you have ongoing health problems. The decision of whether or not to fast is up to you, but it’s always wise to make an informed decision.
- While fasting, contact your doctor immediately if you experience weight loss, lethargy, dizziness, headaches or labor-like pains.
- Breastfeeding mothers need to drink extra fluids. Make sure you are sufficiently hydrated, especially during the warmer months. Avoid caffeinated beverages because of their diuretic effect.
- Look out for warning signs of dehydration, such as fatigue, dry skin, dry mouth, dizziness, thirst and dark urine. Contact your doctor if you experience these warning signs.
- When you do break your fast, make sure the food you eat is nutritious and that you are getting the recommended daily amount of calories.
Every pregnancy is different. Limiting your food intake during Ramadan may not necessarily present a problem, but it’s always smart to be aware of possible health risks. Be sure to discuss these risks with your doctor or midwife before making a decision, and if you do notice any warning signs, contact your doctor immediately.