Ikey left his doctor’s office confused and upset and immediately called me. “Rabbi, I have fever and the doctor told me not to fast and I must continue my medication. But I’m feeling strong! Is the doctor being overly cautious or must I listen to his advice?” Sara and Rochelle also called because they were concerned the fast may affect their pregnancy and nursing.
While it is universally accepted that anybody ill should not fast on the 17th of Tamuz, there is a difference of opinion regarding the status of pregnant and nursing women. This article will focus exclusively on the rulings of our Sephardic Hachamim regarding the fast of the 17th of Tamuz and not the stricter Tisha Be’av and Yom Kippur fasts.
Fasting Exemptions When Pregnant or Nursing
Sara was concerned because she is pregnant but otherwise healthy. Similar to men, healthy women should, indeed, fast. However, the Shulchan Aruch (O.C. 554:5) is clear that pregnant women are exempt from fasting even if they feel well. This exemption extends into the postpartum period for the first 30 days after birth, and even if the woman is not nursing (ibid. 554:6). And even after 30 days, if such a woman feels weak, she should also not fast (Kaf haChaim 554:28). This exemption applies equally after a miscarriage (that occurred at least 40 days after conception, Biur Halacha 617:4 quoted in Hazon Ovadya Ta’aniyot p. 288).
Rochelle called because she is nursing and was concerned that the fast would negatively affect her milk production. I explained to her that all nursing women are exempt from fasting on the 17th of Tamuz (S.A. ibid), even if they nurse just once a day (Ohr leTzion 3:25:7). Some poskim extend this leniency for a full two years after birth even if a woman is no longer nursing, although Hacham Ovadia, zt”l, rules that such a woman should begin the fast but may rely on this lenient opinion and break the fast if feeling weak, even if not actually ill (Hazon Ovadia, ibid p. 62).
Fasting Exemptions for Physical or Emotional Conditions
Back to Ikey’s question. The Hachamim did not institute fasting for the ill (even if the illness is not life-threatening). In this context, illness refers to someone with fever, an infection, or feeling extremely weak, and clearly to somebody more severely incapacitated, such as suffering from the flu or a migraine. This includes a person who has recovered from an illness or recuperated from surgery but still feels weak (Or l’Tzion 3:29:5). Someone with minor aches, pains, or discomfort is still obligated to start the fast so long as they can generally function normally, but they should break the fast if symptoms become more serious.
Similarly, individuals with certain chronic conditions are exempt from fasting – if fasting may compromise their health. People with diabetes, heart disease, kidney disease, or weakened immune systems must not fast. Likewise, individuals with eating disorders should not fast as it can exacerbate their condition. This similarly applies to those for whom fasting may aggravate existing symptoms of depression, anxiety, or other mood disorders.
Hacham Ben Zion Abba Shaul, zt”l, rules that any fragile person over the age of 80 should not fast (Ohr le’Tzion 3:29:5) as fasting at this age can often have negative effects on their health. That said, age is not a factor per se, and if at any age a person’s doctor feels that fasting will compromise their health, they should not fast (Kaf haChaim 550:6).
Is Ikey’s concern about taking medication a halachic issue? No – one who takes medications for fever, any acute illness, or daily prescribed medicine, must continue to do so, but should try to swallow them without water. Hacham Ovadia (ibid p.30) permits swallowing pills with a little water only if absolutely necessary.
In conclusion, only healthy adults over the age of bar/bat Mitzvah need to fast. Pregnant women through thirty days postpartum and all nursing women are exempt from fasting. Anyone ill or whose health would be compromised by fasting should similarly not fast, and they should continue taking medication as usual.
Importantly, fast days are intended as days of introspection, and even if not fasting, a person should use the day as an opportunity for growth and self-improvement by focusing on spiritual goals and aspirations.
Rabbi Yehuda Finchas is a worldwide expert, lecturer, and writer on medical halacha, and is the head of the Torat Habayit Medical Halacha Institute. His latest book is entitled “Brain Death in Halacha and the Tower of Babel Syndrome.” To contact Rabbi Finchas, or for a comprehensive Hebrew source sheet regarding those exempt from fasting, email rabbi@torathabayit.com.