Exemption from Major Fasts

Fasting creates an opportunity to transcend our physicality and focus on teshuva (see more here). Even so, it is not obligatory for everyone. In our discussion of exemption from minor fasts, we defined three groups of women who may have special halachic status with respect to fasts:

• Me’uberet a pregnant woman
• Yoledet a woman in childbirth and up to 30 days postpartum (or following a pregnancy loss that occurred after forty days from conception)
• Meineket a nursing woman (this includes women who exclusively pump; for the minor fast days, it might include any woman within 24 months of giving birth)

We also raised some of the medical questions fasting presents for these women, though the scientific literature is scanty and largely inconclusive. Next, we learned that women in these categories are generally exempt from fasting on minor fast days.

On Yom Kippur and Tish’a Be-Av, however, an otherwise healthy me’uberet or meineket is expected to fast:¹

Pregnancy and nursing do not in themselves exempt women from the major fast days. Nevertheless, a person who is ill (choleh) may be exempt from fasting on Tish’a Be-Av and even on Yom Kippur, depending on the nature and severity of the illness. In some situations, a me’uberet, yoledet, or meineket is herself considered ill or endangered, or the fetus or nursing baby might be, with implications for the halachot of fasting.

To understand how this principle is applied, we need first to clarify how the main categories of illness recognized by Halacha relate to the obligation to fast.

I. Choleh she-yesh bo sakana or safek sakana A choleh she-yesh bo sakana is a person who is so ill, weak, or injured that their life is clearly in danger. A case of safek sakana refers to a situation in which we are uncertain whether the person’s life is in danger or not.

Preservation of human life, piku’ach nefesh, is a major halachic principle, according to which we are nearly always prohibited from allowing halachic observance to endanger life.²

The Talmud not only prohibits a person from fasting, even on Yom Kippur, when it presents a mortal danger, but also when it only presents the possibility of mortal danger:

Shulchan Aruch codifies this law with respect to fasting in the case of a physician who is familiar with someone’s illness and not sure whether fasting will endanger them:

Furthermore, even when fasting may only lead to a medical condition that is dangerous, that, too, provides grounds for exemption from fasting on Yom Kippur:

II. Choleh she-ein bo sakana Often just called a “choleh“, this is a person who cannot function because of illness, or for whom fasting will lead to inability to function. For example, someone suffering from a severe, debilitating migraine or for whom migraines are triggered by fasting, would fit into this category.

Ramban teaches that a choleh of this sort is exempt from all rabbinic-level fasts, including Tish’a Be-Av.

Halachic consensus follows Ramban.³

III. Meichush Be-alma This is a minor illness, where a person doesn’t feel well, but on the whole can manage to function. Someone with an ordinary headache or fatigue, whether going into the fast or on account of it, would typically fit into this category, even if they need to lie down for a while. A person who has a meichush be-alma is usually fully obligated to fast.

Aruch Ha-shulchan summarizes:

In short, a choleh she-yesh bo sakana never fasts, even if the sakana is uncertain or indirect. A choleh she-ein bo sakana fasts only on Yom Kippur, when fasting is a Torah-level obligation, but not on Tish’a Be-Av or minor fast days. Someone who doesn’t feel well but is able to function overall (with a meichush be’alma) typically fasts.

Behavior

Sometimes, a person’s behavior can determine which, if any, of these categories they fit into. For example, someone who goes into a fast well-hydrated, and arranges to spend the fast in a cool and comfortable place, may be able to avoid becoming dangerously ill. Moreover, a person whose ability to fast depends on staying home should remain at home rather than attend tefillot.

Similarly, a person who can fast only if spending the day resting, and who is normally responsible for young children, should arrange for someone else to care for the children on the fast day. If necessary, it is better for a spouse to tend to the children rather than attend tefillot, when that will enable the other spouse to rest and fast. Rav Moshe Sternbuch emphasizes this in the case of a pregnant woman with young children:

The Decision

In the above cases, assessment (umad) of a person’s physical state is typically entrusted to a team: the person at risk together with their physician, under the guidance of a halachic authority. In this way, decision-making integrates halachic and medical expertise with the experience of the choleh.

Based on a Talmudic discussion of umad on Yom Kippur, Halacha generally calls for such decisions to err on the side of caution for health:

Shulchan Aruch rules accordingly.⁴

In complex cases, it is preferable to seek the opinion of a religiously observant physician, whose words are granted more halachic credence.⁵ In other more pressing situations, people may need to make their own decisions on the spot.

Once assessed as a choleh who must break the fast, a person may not be “stringent” and fast, since this is being lenient on the Torah’s mitzva of “piku’ach nefesh.” People who nevertheless fast are considered personally responsible for risking their lives, and their fasting is not considered a mitzva.⁶

On the whole, anyone with medical concerns about fasting should take the following steps:

1. Consult with a physician (and a pediatrician if relevant for a nursing baby), discuss any concerns well in advance of the fast, and clarify what signs to watch out for.
2. Discuss the physician’s response with a halachic authority, including whether it is medically permissible to fast, the conditions under which the fast should be broken, and whether drinking or eating in shi’urim (see below) will be safe and sufficient.
3. Drink more (and for women who pump, perhaps pump in advance to have extra supply) over the days before the fast.
4. Make plans to enable a full day of rest in a comfortable space on the fast day itself, and leave time to recuperate as necessary the next day as well. Nursing mothers in particular should plan to spend the day after the fast resting and breastfeeding frequently to rebuild their milk supply.
5. Prepare a nourishing liquid in advance of the fast and “measure” in advance how much to eat or drink at each interval, if instructed to drink or eat in shi’urim, .

Let’s look at how the question of who is exempt from fasting on Yom Kippur or Tish’a Be-Av due to illness comes to bear on women, specifically the me’uberet, yoledet, and meineket.

Yom Kippur and Tish’a Be-Av

Danger to a fetus in utero is equivalent to the situation of choleh she-yesh bo sakana:

Ramban compares breaking the fast to save a fetus to performing prohibited labor on Shabbat for it. He adds that this halacha applies even at the embryonic stage.

In pregnancy, Rashi notes, a woman’s health and her fetus’s are intertwined.

High-Risk Pregnancy

A woman in a high-risk pregnancy is thus often treated as a chola she-yesh bah sakana, regardless of whether she requests food or displays signs of distress. For example, a me’uberet who has been bleeding, has abdominal pains or contractions, or has a history of miscarriages or preterm labor should not fast.⁷ Similarly, a woman undergoing fertility treatments should not fast during the first weeks of pregnancy, until a heartbeat has been detected.⁸ Women at other stages of fertility treatments, particularly when undergoing ovarian stimulation, may also be instructed not to fast.⁹

Pregnancy Without Complications

Although a healthy pregnant woman with no known pregnancy complications is expected to fast, the Mishna recognizes that her fasting may be dangerous in some cases. It thus introduces the discussion of piku’ach nefesh on Yom Kippur with the example of a pregnant woman who experiences a strong urge to eat when she smells food.

Indeed, Shulchan Aruch rules that a me’uberet who enters the fast in good health but insists upon eating is given food until she becomes calm.¹⁰

Halachic authorities have discussed contemporary applications of a pregnant woman making an assessment for herself about fasting during Yom Kippur. Rav Moshe Harari reports that Rav Avigdor Nebenzahl rules that a me’uberet should drink in shi’urim (again, see below) without delay or need for consultation if she experiences dizziness or nausea from the fast. However, he also reports that Rav Mordechai Eliyahu disagrees:

In a controversial ruling, Rav Yisrael Ya’akov Fischer maintains that even a woman with a typical pregnancy with no known complications may not fast on Yom Kippur, because a significant number of women miscarry following the fast, and because piku’ach nefesh is concerned even with minor possibilities:

This ruling was echoed by Rav Nahum Rabinovitch, who exempted pregnant women between five and nine months from fasting.¹¹

Many rabbis, prominently Rav Eliezer Waldenberg, vociferously disagree with this type of approach, for several reasons: Torah law is at stake; our sages have ruled to the contrary;¹² and thousands of pregnant women fast seemingly unharmed. To prevent danger, women who feel weak may— and should— pursue individual halachic rulings.

In the past, some halachic authorities ruled that a woman nearing term should nearly always fast, since delivery at that stage would not be significantly premature and thus present less of a risk to her and her baby. Those rulings have faded in light of increased understanding that dehydration presents a danger to a woman during labor.¹³

Further Leniency on Tish’a Be-Av

As we learned above, if a me’uberet feels sick on the level of a choleh she-ein bo sakana, then she is exempt from fasting on Tish’a Be-Av. Aruch Hashulchan takes this ruling a step further. He maintains that a me’uberet or meineket is exempt from the fast even if she is not yet sick, but merely feels weak and liable to become sick:

According to Rav Moshe Sternbuch, common practice on Tish’a Be-Av is also to exempt a me’uberet who usually has difficulty fasting (i.e., when she is not pregnant), as a chola she-ein bah sakana.

Some halachic authorities call for additional leniency on Tish’a Be-Av out of concern for the fetus. Rav Shlomo Zalman Auerbach reportedly exempted pregnant women from fasting on Tish’a Be-Av due to the heat of the day, on a case by case basis.¹⁴

Here, too, Rav Yisrael Ya’akov Fischer considers all pregnant women exempt from fasting on Tish’a Be-Av, as a matter of sakana:

Again, Rav Nahum Rabinovitch rules similarly,¹⁵ and again these blanket exemptions have been contentious.

Summary

Women in high-risk pregnancies are often advised not to fast. Healthy pregnant women with no known complications are generally advised to fast. Many halachic authorities instruct me’ubarot to break the fast at any sign of distress or with a particularly strong urge to eat. On Tish’a Be-Av, a me’uberet who feels weak or has a history of difficulty fasting is widely considered exempt. Some halachic authorities have suggested broader exemptions for pregnant women, especially on Tish’a Be-Av.

A me’uberet with any health concern should consult her physician and halachic authority prior to a fast, ideally receiving clear parameters for how to fast safely and when to break the fast. If the decision is reached that she should attempt the fast, then she needs to be very aware of how she is feeling so that she not fast beyond the point of health for her and her fetus.

Yom Kippur and Tish’a Be-Av

From the point at which contractions begin for childbirth¹⁶ and during the first three days postpartum (i.e. for 72 hours from childbirth or pregnancy loss)¹⁷ a yoledet‘s condition is considered critical. Therefore, she has the status of a chola she-yesh bah sakana, so that we violate Shabbat for her and require her to eat on Yom Kippur or Tish’a Be-Av. We can also violate Shabbat to meet her needs at her request for the first week postpartum:

By the same token, a yoledet within seven days (168 hours from childbirth or pregnancy loss) need not fast as long as she or her physician deem sustenance necessary for her health.

In practice, a postpartum woman or woman following pregnancy loss generally does not fast on Yom Kippur or Tish’a Be-Av before a full week has passed. Following a Cesarean section, a woman is not technically considered a yoledet, but she is a chola she-yeish ba sakana. She does not fast for the first eight to ten days, depending on her condition.¹⁸

After the first week postpartum, a woman’s status as a yoledet no longer automatically exempts her from fasting on Yom Kippur. However, she will often be a meineket (discussed below), and may still have the status of a chola. The halacha will depend on her individual circumstances.

Further Leniency on Tish’a Be-Av

Following Ramban, Shulchan Aruch rules that a yoledet within thirty days of childbirth does not fast on Tish’a Be-Av, because it is rabbinic, and our sages did not decree a fast in such cases. Rema agrees that there is room for leniency. He notes, though, that there is a custom for a yoledet (after seven days) to fast on Tish’a Be-Av unless she feels severe discomfort and may be in danger.¹⁹

Aruch Ha-Shulchan, though, states that women of his era are not as strong or healthy as in the time of Rema. Therefore, a yoledet has the status of a chola and is not allowed to fast on Tish’a Be-Av for the first 30 days post-partum.²⁰

When a yoledet within thirty days of childbirth does not fast on Tish’a Be-Av, she still may be encouraged to fast for a brief amount of time, unless it is difficult for her.²¹

Summary

A yoledet doesn’t fast during the first week (168 hours) postpartum, and is exempt from fasting on Tish’a Be-Av for thirty days following childbirth.

Yom Kippur and Tish’a Be-Av

The laws of a choleh can be relevant to a nursing baby, and thus to a breastfeeding woman. The Talmud considers a baby to be in mortal danger when mother’s milk is unavailable:

Therefore, Chatam Sofer rules that a healthy meineket may eat even on Yom Kippur if her child is fully dependent on her milk and would be in danger if she were to fast.

Rav Nahum Rabinovitch (quoted below) even permits a meineket to drink on Yom Kippur whenever she feels weakness if the infant depends on her for food. Halachic consensus follows this ruling,²² though there is some disagreement as to whether it should apply when infant formula is available.²³ Rav Shlomo Zalman Auerbach, for one, views the availability of formula as irrelevant to the discussion.
When the fast actually affects a meineket‘s milk supply, he goes so far as to allow for her to drink in small amounts (shi’urim, discussed below) on Yom Kippur in the first months after childbirth, even when the baby is healthy:²⁴

Still, Rav Auerbach notes that it is best for a meineket to drink extra in advance of the fast, which can head off disruptions to supply to start with. (Pumping in advance to have some extra milk on hand can be helpful as well).

Further Leniency on Tish’a Be-Av

On Tish’a Be-Av, if a meineket herself is sick on the level of a chola she-ein bah sakana, then she should not fast, as is the general rule.²⁵ In our discussion of a me’uberet, we saw Aruch Ha-shulchan’s ruling to exempt a me’uberet or meineket who feels weak or ill from fasting on Tish’a Be-Av.

What if the meineket is healthy? As above regarding Yom Kippur, some halachic authorities maintain that if the baby depends on her milk and she feels her supply drop, she may break her fast.

Additionally, if the baby is dependent on mother’s milk and is in distress, regardless of whether the meineket feels a drop in milk supply, then the baby has the halachic status of a choleh she-ein bo sakana, which provides grounds for the meineket not to fast on Tish’a Be-Av.

Controversially, Rav Nahum Rabinovitch extends this argument to exempt all nursing women from fasting on Tish’a Be-Av:

In a more narrow and more widely accepted ruling, Rav Sternbuch argues that a meineket should generally fast on Tish’a Be-Av. But if it’s possible that her milk will dry out and this may endanger the child, then she should not.

At the same time, Rav Sternbuch suggests that a woman whose child will take a milk substitute without endangering its health should fast.

Summary

Ideally, a meineket should fast. When a meineket’s fasting poses a real danger to the infant, she should not fast. Even on Yom Kippur, if the baby depends on its mother’s milk and the milk supply is affected, she may break her fast with shi’urim. On Tish’a Be-Av, it is enough for there to be a strong possibility of her milk drying out and thus affecting the baby for the meineket not to fast. Also, if a meineket feels weak and liable to become sick on Tish’a Be-Av, then she should eat.

In both cases, she should take steps, such as extra pumping and drinking in the days before the fast to have extra milk on hand and further resting on the fast itself, in order to prevent dehydration or supply issues.

Some halachic authorities have suggested broader exemptions for breastfeeding women (though less so than for a me’uberet), especially on Tish’a Be-Av.

Special concerns about breastfeeding – such as a history of supply problems, a baby with a complicated medical situation, an infant under six weeks old, or even anxiety about fasting – are relevant on both Yom Kippur and Tish’a Be-Av. A woman should seek medical and halachic guidance in advance in order to determine the best course of action.

On Yom Kippur

Exemptions from fasting on Yom Kippur often permit eating “less than a shi’ur” at a time. What does that mean? To understand the concept of shi’urim, we first need to revisit the Torah’s injunction to afflict ourselves on Yom Kippur.

Eating or drinking on Yom Kippur violates the mitzva of afflicting ourselves and incurs the grave punishment of karet, spiritual excision from the Jewish people.

This penalty applies to men and to women.²⁸ (For a more detailed discussion, see here.)

The Mishna quantifies the point at which a person incurs the full liability of karet for violating the fast: by eating an amount of food equivalent to the volume of a large date, or by drinking a cheek’s full of drink.

The Talmud explains that consuming this amount of food or drink violates the obligation of affliction because it gives one the opposite experience, a sense of feeling settled:

Our sages stipulate that to violate the obligation of affliction, this amount of food or drink must be consumed within the amount of time that it takes to eat a half a loaf of bread, kedei achilat peras. This is usually understood as nine minutes, but could potentially be as few as two (an opinion relied upon in very pressing situations).²⁹ The Tosefta explains that smaller amounts of food or drink consumed at longer intervals do not combine to the measurement (shi’ur) for which one is liable:

What if someone eats less than a shi’ur? The Talmud asks why the first clause in the mishna above uses the relatively tame term “prohibited” (assur) with respect to eating on Yom Kippur, instead of stating that one is “liable” (chayyav) for karet. It suggests that this language teaches that any eating and drinking is prohibited, even if one does not consume the full measure required to incur the punishment of karet:

Halachic consenus follows Rabbi Yochanan, who typically prevails in disputes with Resh Lakish,³⁰ and considers eating a partial measure on Yom Kippur as a Torah violation. There seems to be an implicit prohibition of eating or drinking even the smallest quantities on Yom Kippur, perhaps because even a small amount detracts from affliction. Rambam and Shulchan Aruch both rule in this vein:

When to Eat or Drink in Shi’urim

Based on these opinions, we would think that consuming any amount of food or drink on Yom Kippur is restricted to cases of danger or possible danger to life, when piku’ach nefesh pushes aside Torah law. The Semag even writes that Reish Lakish, who considers the violation rabbinic, permits eating an amount less than a shi’ur only in cases of mortal danger.³¹

And yet – in cases of real danger, why would measures matter at all? Isn’t the restriction to less than a shi’ur superfluous where a life is at stake, when one should be able to eat as much as necessary? According to some interpretations,³² the following Talmudic passage addresses exactly this point:

Ramban interprets this passage to mean that even someone in danger who is allowed to eat on Yom Kippur (or to violate other prohibitions of eating) should still take care to break up the eating into partial shi’urim, when possible, so as not to perform an act that would otherwise be considered punishable by karet:

On this reading, piku’ach nefesh doesn’t entirely eliminate the restrictions of Yom Kippur. Therefore, mitigating the theoretical punishment by eating small amounts at a time makes a significant difference. Note that Ramban here equates the situation of a pregnant woman who is certain she must eat with that of a choleh she-yesh bo sakana.³³

Perhaps inspired by this case, Sefer Ha-chinuch writes that is it permissible for even a choleh she-ein bo sakana who is especially weak to eat in this way.³⁴

In Practice

In practice, Shulchan Aruch rules according to Ramban’s opinion that a me’uberet or choleh she-yesh bo sakana should eat and drink quantities less than a shi’ur at intervals longer than kedei achilat peras (known as “shi’urim”), as long as this is sufficient for them . If the doctor, pregnant woman, or choleh say that eating in shi’urim is not enough, or are not sure it will be sufficient and safe, then they may eat without restriction.

We saw above that the shi’ur for eating is the volume of a large date. In practice, the volume of an egg (ke-beitza) is a much more common shi’ur for various halachot of eating, and thus more familiar. Therefore, Shulchan Aruch specifies that one should eat about two-thirds of the volume of an egg at one time. This is safely within the volume of a large date, which is only slightly smaller than an egg. Halachic consensus today is that the shi’ur for eating is 30cc.

The shi’ur for drinking, a cheek’s full, depends on the particular person. Ideally, it is measured before Yom Kippur. A person can fill her mouth with water, and spit out the water into a measuring cup. One cheek’s full is about half that quantity.

Since food and drink do not combine to make a shi’ur, this translates to less than a shi’ur of food and less than a shi’ur of drink every nine minutes—and these can be staggered. The nine-minute measure can also be reduced, as necessary, in accordance with more lenient opinions.³⁵

Rav Eliezer Melamed notes that eating in shi’urim can be problematic in its own right, since eating or drinking a small amount every few minutes in order to consume enough to stay out of danger may preclude the sick person from getting the rest they need. Therefore, he rules that when a sick person also needs their rest, such as a yoledet who is exhausted, they should eat and drink normally so that they can sleep and recover.³⁶

Shi’urim on Tish’a Be-Av

Do shi’urim apply on Tish’a Be-Av?

Many halachic authorities, including Aruch Ha-shulchan, maintain that there is no constraint of shi’urim on Tish’a Be-Av when someone does not fast, regardless of that person’s choleh status.

Aruch Ha-shulchan views the concept of shi’urim as relevant only in Torah-level contexts. Similarly, Rabbi Dr. Avraham S. Avraham, in his compendium of medical Halacha, writes that Shulchan Aruch strongly implies that shi’urim do not apply on Tish’a Be-Av to someone who is sick, for whom our sages made no decree to fast.

At the same time, he notes that Rav Shlomo Zalman Auerbach ruled that someone who is currently healthy, but is not fasting out of concern for becoming sick, or for potential threat to a fetus, should eat measuring out shi’urim:

Rav Shlomo Zalman Auerbach’s ruling could apply to a nursing woman who does not fast on Tisha Be-Av due to concern for the health of her infant.

When the 9th of Av falls on Shabbat, the fast is pushed off, nidcheh, beginning Saturday evening, and ending Sunday night. In this case, a berit mila may be performed in the early afternoon, and the ba’alei berit (the father, mohel, and sandak according to Beit Yosef and Rema) may break their fast afterward.

This halacha seems to indicate that the laws of Tish’a Be-Av nidcheh are less stringent than those of a regular Tish’a Be-Av, on which no one would be allowed to break their fast in honor of a berit mila. Rav Ya’akov Reischer, who it appears would usually require a yoledet from seven to thirty days or a me’uberet to fast on Tish’a Be-Av unless they experience distress, applies this idea to allow for breaking a fast more readily on Tish’a Be-Av nidcheh, at the first sign of discomfort.

Although contemporary custom does not follow the Shulchan Aruch’s ruling concerning a berit, instead scheduling the berit in late afternoon and the celebratory meal after dark, Rav Reischer’s ruling remains influential.³⁷

Rav Ovadya Yosef concurs, and adds that breastfeeding women also need not fast on Tish’a Be-Av nidcheh. Nevertheless, Rav Ovadya deems it proper to fast at least until midday when possible. A person eating in this case must recite havdala and drink from the cup (or give it to a child) just prior to eating.