Fasting, not fasting, and how to eat when you cannot fast

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This coming Sunday, September 24th at sunset, we will begin the observance Yom Kippur, a day of fasting and atonement.
There are five prohibitions during Yom Kippur (1) Eating or drinking, (2) washing our body, (3) anointing our body, (4) having marital relations, and (5) wearing leather shoes. All these restrictions apply from September 24 before sunset until Monday, September 25th after nightfall.
 In some cases, we do not fast
For example:
MINORS: a boy or a girl younger than nine should not make any fast, even for a few hours. When children reach nine years old, they should fast for a couple of hours if they are healthy. The following year, the parents should encourage them to fast for a little longer so they will slowly get used to an entire day of fasting. When the son or daughter reaches eleven, they should try to fast for the whole day if they are in good health. A healthy girl, twelve years old and a healthy boy, thirteen years old, are obligated to fast.
MOTHERS: A mother should not fast after childbirth during the first three days, a mother should not fast. The same rule applies for 72 hours after a miscarriage. After the first 72 hours from the day of childbirth until the 7th day of delivery, if the mother says that she needs to eat, she should eat. After the 7th day, she has to fast like everyone else unless otherwise indicated by her doctor. A woman in labor should not fast.
SICKNESS: A person with a chronic illness like diabetes, etc. or an older person who is weak because of his or her advanced age, or someone who is taking a necessary medication or is undergoing an essential medical treatment should get the advice of a reliable physician to see if they can stop the medication, or needs to take medication, or if the patient can take his medicine without water. After discussing the options with a physician, a Rabbi should also be consulted to establish, based on the doctor’s advice, how to eat his food or how to take the medication.
In case of a life-threatening situation or even when that potentially might be the case (safeq sakana), the fast should be discontinued even if no physician was consulted.  See below how to eat when you need to break the fast.
The following information is intended as a general guideline for normal and healthy pregnancies. You should not rely on this information as a substitute for professional medical advice. A pregnant woman should observe the fast as everyone else, provided she and the baby are in good health and the pregnancy has no complications. Nevertheless, if the mother feels sick during Yom Kippur, particularly if she is vomiting or having any other symptoms of dehydration, she should break the fast and eat or drink immediately (See below: “How to break the fast”). However, mild dizziness and nausea that can be coped with by lying down on a couch or a bed are considered normal on a fast day and should be endured. If the dizziness or nausea persists or worsens, then the fast should be interrupted.

PREGNANCY 


The following information is a general guideline for normal and healthy pregnancies. You should not rely on this information as a substitute for professional medical advice.

A pregnant woman should observe the fast normally, provided she and the baby are in good health and the pregnancy has no complications. Nevertheless, if during Yom Kippur the mother feels sick, and particularly if she is vomiting or having any other symptoms of dehydration, she should break the fast and eat or drink immediately (See below: “How to break the fast”). However, mild dizziness and nausea that can be coped with by lying down on a couch or a bed are considered normal in a fast day and should be endured. If the dizziness or nausea persists or worsens, the fast should be interrupted.

Dr. Jessica Jacob, an expert OBGYN from Long Island, NY, explains that according to research done on healthy pregnant women, there is no evidence that fasting would cause complications to the mother or her baby. A few years ago, Dr. Jacob gave a very detailed lecture in UMJCA on ‘Pregnancy and Yom Kippur’. It is highly recommended for every pregnant woman to listen to this lecture, where Dr. Jacob explains the medical research on this subject. Dr. Jacob also explains why a doctor would advise a pregnant woman against fasting, how to cope with discomfort, the circumstances in which pregnant women should break the fast, etc.
Click here to download the transcript of Dr. Jacob’s class.

RECOMMENDATION TO REDUCE THE RISK OF DEHYDRATION DURING YOM KIPPUR

To reduce the risk of dehydration, you should hydrate your body with enough fluids. But you have to do it the right way. Drinking much water right before the fast is of little benefit. Most of that water leaves the body right away, and usually, by the night of Yom Kippur, that water is gone. Instead of drinking a lot of water at once, you should drink small amounts of water over the 48 hours before the fast. The recommended amount is to drink approximately 6 to 8 ounces every hour for the two days before the fast so that the cells themselves become hydrated. This recommendation is also given to athletes before running a marathon. Always consult with your physician.

HOW SHOULD YOU EAT AND DRINK WHEN YOU NEED TO BREAK THE FAST?

When you were instructed by your doctor and/or your rabbi to eat on Yom Kippur, proceed as follows
1. Eat a portion of food up to 1 oz. (or 30 grams). After you finish the first portion, wait ten minutes and then eat the second portion of up to 1 oz. You could do this (eat 1 oz., wait ten minutes, eat 1 oz.) as needed until you recover.
2. When you need to drink. Drink 1 oz. of water or any liquid, then wait 5 minutes and drink 1 oz. again and so forth.
3. Once you feel better and don’t need to eat or drink anymore, you should continue fasting.
4. When you eat or drink on Yom Kippur for medical reasons, you do not need to fast another day to compensate for the fast.
5. To measure “1 ounce,” it is recommended to use the plastic 1 oz. Liquor shot cups (kiddush little plastic cups) as shown above.
6. In case of an emergency or a possible life-threatening situation (hypoglycemia, passing out, dehydration, etc.) when these small portions are not enough, one should drink or eat whatever is necessary.