#Article (Archive)

Fasting during pregnancy

Jul 16, 2013, 11:04 AM

Is fasting during pregnancy harmful for unborn baby? Here are some guidelines for those who are in two minds whether to fast in pregnancy or not

In sacred religion of Islam, it is an obligation for all adult and healthy Muslims to be on fasting during the Holy month of Ramadan. Each year, about 400 million out of 1 billion Muslims do this duty. Such tasks like eating, drinking, and smoking are forbidden from sunrise until sunset.

Fasting during pregnancy has been always considered as a debatable condition. There are Muslim women who do not fast during pregnancy for the sake of their children’s health, however, they feel guilty because of their religious beliefs.

On the other hand, some pregnant mothers prefer to cherish their religious principles despite their hesitation on children’s health and they fast during pregnancy. It should be taken into consideration that either low birth weight (LBW) neonates or lower inside the womb growth may be at higher risk of mortality, neonatal side effects, and severity of increased neonatal diseases.

Well, Dr Hassan Azadeh, a senior lecturer at the University of The Gambia and senior consultant in Obstetrics and Gynaecology will today focus on advising pregnant women and people will serious ill on the effects of fasting during the hot season in The Gambia.

Fasting and baby’s health

Islam excuses women from fasting, if they are in an advance stage of pregnancy, where fasting could be harmful for a mother and a baby. Islam also excludes those women from fasting who are breastfeeding and those who are menstruating.

When a baby is growing inside the womb, she is totally dependent on its mother for necessary proteins, nutrition and vitamins. It is suggested that women should not fast during their first and third trimester. They could fast during their second trimester if their obstetricians grant permission.

Doctor’s opinion does matter

Talk to your doctor, to your Nurse and get an overview of your health condition, if you are feeling obliged to fast. Let your health care provider give you a clean chit. Your obstetrician or gynaecologist is the person who knows your medical history and health conditions very well.

There is no harm to observe fasts during Ramadan or for that matter any other religious event, if your health care provider allows you. Most of the health care providers do not agree on fasting for a longer period if you are pregnant. Though short term fasting can be practiced.

Effects of fasting during pregnancy

There can be several short term or long term effects of fasting during pregnancy. Many women choose to fast even if they are pregnant. Fasting during pregnancy could increase a woman’s risk for premature birth. Mothers who experience extreme nausea and vomiting during first trimester should not consider fasting. Practicing waterless fast can have adverse effects on your baby.

Your baby

Pregnant women or nursing mothers need constant supply of essential nutrition, vitamins, proteins, folic acid, and minerals. They need to keep track of their nutrition intake for the wellbeing of themselves and their babies. Fasting may affect the development of the foetus. Fasting in pregnancy carries certain risks for the unborn baby such as abnormal breathing movements, low birth weight, and reduced gestational period.

Pregnancy and fasting tips

A life growing inside the mother’s womb is dependent on her. If a mother starves, then the baby will starve too. If a mother consumes healthy food, a baby will be healthy too. If you are fasting during your pregnancy, keep following tips in mind to prevent any health hazards.

• Drink plenty of water before starting and finishing your fast, if it is a waterless fast.

• Break your fast with a healthy meal which includes food items from every food group.

• Instead of leaving food entirely you can eat food that is allowed to eat during fasts such as fruits, milk, peanuts, etc.

• If you are feeling extremely weak during your fast, then do not hesitate to break it.

• Try to eat healthy foods before starting your fast.

• Avoid activities which will leave you physically exhausted while fasting

Your baby is your responsibility. One wrong decision can be the cause of harm to your baby. Your baby is developing day by day inside your womb. Though you cannot see it, you can feel it. Sometimes it is better to listen to experts than following your faith.

In the light of these sayings, many believe that any Muslim who is sick, or whose sickness would adversely affect his well-being during the fasting period, should either not fast or at least break his fast accordingly. An additional argument often used is that if the fasting by a sick Muslim would jeopardise his health further, then this ultimately will neither benefit himself nor his role in society and he should be discouraged from observing the fast.

Those suffering from minor ailments do not really have any problems fasting. Those suffering from acute conditions may need advice about altering their dosing regimen. Drugs that are normally required to be taken frequently, such as antibiotics, can be problematic for fasting patients. However, the increasing availability of alternative drugs with long half-lives as well as the increasing formulation of short-acting drugs as sustained release preparations, have offered much needed assistance to fasting patients.

For example, patients suffering from acute upper respiratory infections, such as a severe sore throat, may still be able to fast. Such a patient might be prescribed antibiotics that have to be taken three or four times a day and would not be able to fast. Alternative routes of drug administration can help fasting patients.

An increasing area where practitioners are likely to advise patients on fasting is in those suffering from diabetes mellitus. Many Muslims, especially of Asian descent, have an increased risk of suffering from some form of diabetes. The International Journal of Ramadan Fasting Research has suggested the following guidelines for health professionals treating Muslim patients with diabetes: “Diabetic patients who are controlled by diet alone can fast and hopefully, with weight reduction, their diabetes may even be improved. Diabetics who are taking oral hypoglycaemic agents along with the dietary control should exercise extreme caution if they decide to fast. These patients should consult their medical doctor for dose adjustment. If they develop low blood sugar symptoms in the daytime, they should end the fast immediately.”

In addition, diabetic patients taking insulin should consult their doctor to see if their dose can be adjusted to allow fasting during Ramadan. In all cases of fasting with diabetes, blood sugar levels should be closely monitored, especially before and after meals.

Balanced diet

Those observing the fast should have at least two meals a day, the pre-dawn meal (Suhoor) and a meal at dusk (Iftar).

 Your food intake should be simple and not differ too much from your normal diet. It should contain foods from all the major food groups:

- fruit and vegetables

- bread, cereals and potatoes

- meat, fish, or alternatives

-  milk and dairy foods

- foods containing fat and sugar

Complex carbohydrates are foods that help release energy slowly during the long hours of fasting. They are found in foods such as barley, wheat, oats, millet, semolina, beans, lentils, wholemeal flour and basmati rice.

Fibre-rich foods are also digested slowly and include bran, cereals, whole wheat, grains and seeds, potatoes with the skin on, vegetables such as green beans, and almost all fruit, including apricots, prunes and figs.

Foods to avoid are the heavily processed, fast-burning foods that contain refined carbohydrates (sugar and white flour), as well as fatty food (for example cakes, biscuits, chocolates and sweets, such as Indian mithai).

It’s also worth avoiding caffeine-based drinks such as tea, coffee and cola. Caffeine is a diuretic and stimulates faster water loss through urination.

Wholesome foods

Suhoor, the pre-dawn meal, should be a wholesome, moderate meal that is filling and provides enough energy for many hours.

“Suhoor should be light and include slow digesting food like pitta bread, salad, cereal (especially oats) or toast so that you have a constant release of energy,” Dr Mahroof says.

“It’s important to have some fluids with vitamins, such as fruit juice or fruit. Some people have isotonic drinks (such as Lucozade) to replace any lost salts.”

It’s customary for Muslims to break the fast (Iftar) with some dates, in accordance with the Prophetic traditions.

Dates will provide a burst of energy. Fruit juices will also have a similar, revitalising effect. Start by drinking plenty of water, which helps rehydration and reduces the chances of overindulgence. Avoid the rich, special dishes that traditionally celebrate the fast.

Foods to avoid

deep-fried foods, for example pakoras, samosas and fried dumplings

high-sugar and high-fat foods, including sweets

high-fat cooked foods, for example, parathas, oily curries and greasy pastries

Healthy alternative

baked samosas and boiled dumplings

chapattis made without oil

baked or grilled meat and chicken

homemade pastry using just a single layer

milk-based sweets and puddings such as rasmalai and barfee

Cooking methods to avoid

deep frying


excessive use of oil

Healthy cooking methods

shallow frying (usually there is little difference in taste)

grilling or baking is healthier and helps retain the taste and original flavour of the food, especially with chicken and fish

For further information send text to Dr Azadeh on 7774469, call on AAFRI radio Health Show every Wednesday from 9 - 9.30 am or email: azadehhassan@yahoo.co.uk