Breastfeeding During Ramadan Fasting: FAQs & Tips:

Ramadan Fasting for Breastfeeding Mums

Breastfeeding is a part and parcel of early motherhood. As the primary source of nourishment for infants, this natural process plays a vital role in maintaining their healthy growth and physical development. Babies are usually breastfed up until they reach about 2 years old once they begin to take interest in consuming solid foods. 

In Malaysia, it is not a surprise to see lactating mums fasting during Ramadan. Despite nursing being an intimate experience to establishing the mother-child bond, maintaining lactation (production of breast milk) while fasting can be really tough on breastfeeding mums and may pose health risks if not careful. 

FAQs on breastfeeding during Ramadan

Can I fast while breastfeeding?

Islam states that as long as you have no serious health concerns over your and your baby’s well-being, Ramadan fasting is permissible while breastfeeding—though not compulsory. 

However, health experts advise if the following considerations apply to you, it is better to forgo fasting.  

1. Baby’s age: Baby falls under the age of 6 months.
2. Breastfeeding dependency: Baby is exclusively breastfed (consumes only breast milk).
3. Mother’s health issues: If you suffer from glucose metabolism conditions such as high blood pressure and diabetes. 
4. Lactation complications: If you experience a lack of milk supply or leaking breast milk. 

Otherwise, the choice is up to you whether to fast or skip. 

It is also important to highlight that fasting immediately after childbirth is a huge no-no; the postnatal period requires you to take ample rest for the sake of recovering from the loss of energy and nutrition. During recovery, observing a proper diet is crucial for the new mother as she learns to establish lactation for the first time. For this reason, both you and your newborn baby should be fed regularly around the clock to boost the production of breast milk in order for your baby to survive healthily. Therefore, abstaining from eating or drinking, in this case, will only act as a downside. 

Will it harm me as a breastfeeding mum if I fast?

As Ramadan is a form of intermittent fasting (refraining from eating and drinking only for a certain period of time), breaking fast and nighttime meals will help to restore the loss of calories and fluids, thus relieving any ailments you may suffer at daytime. Hence, Ramadan fasting is less likely to cause you major harm but it can slightly affect you to a certain degree.

The most common experience of a breastfeeding mum when fasting, especially if you are exclusively nursing, is the increased feeling of thirst and fatigue. If fasting as an ordinary person already makes you feel parched and lethargic, imagine the double effect it has when you are supplying for a baby. 

Various reasons contribute to such conditions:

• Breastfeeding activates the release of oxytocin hormone whose main function is to contract the muscles around your breasts in order to let out milk from the nipples. The more oxytocin is released, the more milk is being discharged from your body. This decrease in fluids will trigger your sensation of thirst as an alert that you should drink up enough water, not only to keep yourself hydrated but also to continuously produce breast milk. 
• Juggling between providing baby care and tending to your own maternal needs can be extremely taxing. Such a drop in energy levels may bring down your overall mood and intensify your thirst as well as hunger. 
• Living in regions with hot climates and long fasting hours can worsen the risk of dehydration and low blood sugar.  

Unless you neglect the breastfeeding diet requirements, it is generally safe to fast. Severe dehydration, however, is high-risk and entails immediate medical assistance. 

Will it harm my baby if I fast?

Fasting will have no adverse effects on your baby, given that you maintain proper nutrition and sufficient hydration during non-fasting hours. As babies depend on the mother’s milk to satisfy hunger, ensuring that you have a continuous flow of breast milk is important for them to be well-fed adequately throughout the day. 

Will it cause a low milk supply?

Short-term fasting like Ramadan does NOT lead to a significant decrease in milk supply. Our body has a wonderful ability to quickly adapt to changes in bodily functions; if the calories from your last meal have been used up to provide energy, your body will resort to other ways and still be able to produce breast milk as usual. 

However, a low milk supply can happen when fasting—only if you are severely dehydrated and reach a calorie level below the breastfeeding requirement. 

Will it affect the nutritional value of breast milk?

Breast milk alone is considered a complete diet for babies below 6 months who are exclusively breastfed, without the need to add up supplements. Almost all mothers are able to supply nutritious breast milk for their infants that contain two types of nutrients; macronutrients and micronutrients. 

1. Macronutrients 

• Required in bigger (macro) amounts.
• The main function is to provide energy and support bodily functions. 
• Consists of major nutrient groups such as carbohydrates, protein, and fats.

1. Micronutrients 

• Required in smaller (micro) amounts.
• The main function is to boost immunity, tissue growth, and cell repair.  
• Consist of essential vitamins like vitamin A, B, C, D, E and K. 
• Consist of essential minerals mainly but not limited to iron, potassium, magnesium, zinc, iodine, fluoride, copper, sodium, and selenium.

Whereas macronutrients remain unaffected by fasting, research suggests that the mothers’ breast milk displayed a decline in micronutrient content during Ramadan—with the most deficient being zinc, magnesium, and potassium. However, the cause of decline is reported not due to fasting per se but as a result of the mothers’ lack of nutrient intake in their diet. 

Tips for fasting while breastfeeding

If you choose to fast despite breastfeeding, the following tips can serve as your guide to practise it the safe way. 

• Hydration is key.

About 80% of breast milk is water and nursing mums tend to lose around 700ml of milk every day for breastfeeding. As fasting restricts you from drinking more frequently than usual, the risk of dehydration is much higher when you have to supply milk at the same time. 

The basic recommendation of fluid intake for a breastfeeding mum is 12 to 13 cups daily, which is equivalent to 3 litres—although it may vary according to the mother’s body weight. In order to ensure your overall well-being and to sustain a consistent supply of maternal milk, your fluids ought to include beverages, water-rich foods, as well as broths. Staying in sheltered and cool places is also helpful.  

Despite the priority of maintaining hydration, try to drink moderately as excessive drinking can intensify your urge to urinate more, thus losing more fluids. 

• Follow the breastfeeding dietary guideline. 

Sharing nutrition with another human being demands you to double up your food intake, especially while fasting; nursing mums need to consume an additional 500 calories on top of the 2,000 from usual daily requirements. Essentially, you should attain 2,500 kilocalories (kcal) each day when breastfeeding. Getting fewer calories than that can lead to a low milk supply. 

You can check out The Dietary Reference Intake (DRI) Calculator to find out your estimated calories based on different factors like age, body mass index (BMI), and lactation status. 

An optimal breastfeeding diet is simply balanced and nutrient-dense. Having various kinds of healthy foods will be beneficial for your infant, later on, to be more open to exploring different solid foods. Here are some examples to prioritise:

1. Starchy foods: rice, wholemeal bread, potatoes
2. Protein-rich foods: eggs, seafood, meat, nuts and seeds
3. Sources of fibre: oats, beans, whole fruits and green leafy vegetables
4. Dairy products: whole milk, full-fat yoghurt, cheese
5. Healthy fats: avocado, olive oil, nuts, fish

As the choices of healthy foods for breastfeeding are endless, you can focus on what to limit or avoid instead such as high-mercury seafood, processed foods, caffeine, and alcohol. 

A relevant reminder that you should continue practising a proper diet, even after your baby is no longer exclusively dependent on breast milk and has started to eat solid foods. 

• Take essential vitamins or supplements.

Practising a perfectly balanced diet sounds doable, right? Truthfully, not all individuals are able to commit strictly to such a diet every single day—unless they have been trained since young. 

When consulting with health experts, they usually recommend you to include daily vitamins and supplements to make up for the lack of certain nutrients. Here are a list of essential nutrients that you should pay attention to:

1. Calcium and Vitamin D
2. Folic acid
3. Vitamin B group (B1, B2, B3, B5, B6, B7, B9, and B12)
4. Iron
5. Omega-3 fatty acids
6. Iodine

Consider taking these supplements with your Sahur to boost milk supply during daylight. Regardless, supplements are not for everyone. Hence, do seek medical advice first on which ones are suitable and necessary for your prior to consumption. 

• Do not miss Sahur.

The pre-dawn meal is meant to provide the necessary nutrients and energy for daytime fasting in Ramadan. Skipping Sahur is never a good idea, particularly when you have a baby to nourish for. Utilise this meal to prepare your body for the fasting day ahead by taking in a wholesome diet that focuses on prolonging fullness and retaining hydration. Delaying Sahur time can also work to delay hunger.  

• Avoid skipping the feeding routine. 

Breast milk supply depends highly on demands; the more frequent you breastfeed, the more supply is readily available. If you skip several feeds or pump at irregular times, your body clock will receive that as a signal of low demand—causing it to decrease the production of milk.

Thus, breastfeeding mothers need to stick to a regular feeding schedule in order to ensure consistent lactation. In the case where you are not physically around to breastfeed your baby or that he or she refuses it, try pumping your breast milk according to the same feeding timings and keep them in storage bags for later use. As long as the breast milk is discharged routinely, your milk supply will less likely to be depleted. 

• Get enough rest. 

Successful lactation depends not only on your physical health but also on your psychological condition. Aside from fulfilling nutritional requirements, you need to try getting a minimum of 8 hours of nighttime sleep to recharge. If sleep is disturbed by your baby’s behaviour which is usually the case, make sure to compensate during the day if possible. Resting at least 2 hours before breastfeeding is also advised, so that relaxing your body can make the baby comfortable, thus easing the flow of breast milk. 

Steer clear of strenuous activities such as intense exercises and heavy lifting to avoid wasting energy unnecessarily, when you should be storing as many calories as you can to supply maternal milk.

• Take care of your mental health. 

Looking after a baby in their nursing stage while fasting can take a huge toll on your mental health as much as it can physically. Whilst you may think that fatigue is common as a breastfeeding mum, that does not mean you should ignore any warning symptoms of burnout. Stress combined with postpartum hormones may temper your emotions in a negative way, particularly for new mothers.  

Take one step at a time and do not feel ashamed to ask for help. The breastfeeding experience should be a pleasing one, hence try not to beat yourself too hard over matters that you cannot control. If dark feelings or thoughts start to linger in your mind, find outlets to express them—perhaps through creative means like journaling, confiding in a trusted companion, or seeking professional assistance. 

• Consider partial fasting.  

Instead of dedicating to a full-month fasting, you may want to take it easy while breastfeeding. Plan to fast on alternate days or specifically during weekends, instead of pushing your body to go all out. As your baby naturally detaches from breast milk over time, fasting for the whole of Ramadan will be more feasible then. 

• Monitor yourself and your baby closely.

Taking care of yourself means taking care of your baby. Fasting can cause unpredictable bodily responses, even after observing all the useful tips as mentioned. This is where spotting signs or symptoms of potential breastfeeding risks such as dehydration and lack of breast milk supply deem crucial. 

If you sense the following symptoms of dehydration, it is time to call it a day and break your fast immediately.

1. Severe headaches and feeling light-headed
2. A lesser amount of urine
3. Urine displays a darker yellow colour and a strong smell

In addition, these are major signs to know if your baby is not getting enough milk which calls for a medical visit:

1. Losing weight or not putting on weight
2. Fewer wet diapers than usual
3. The baby shows feelings of discomfort and is constantly crying after feeding 

If you are unsure or in doubt, it is always better to consult a doctor before it is too late. 

Prioritising you and your baby’s health this Ramadan

Islam recognises the physical and emotional impact of fasting on pregnant and breastfeeding mothers, hence why Ramadan fasting is not imposed on them. In fact, religion opposes any practice that brings harm to the health as a person’s well-being matters more. 

Do not feel guilty if you are unable to fast; you can always replace the missed fasting days much later when your body is fit to do so. Another common alternative is to pay ‘fidyah’, which is to bear a certain price to provide basic food (commonly rice in Malaysia) for the less fortunate. 

Ramadan extends beyond mere fasting; this blessed month serves as a window to reassess not just our lifestyle habits, but our emotional and spiritual state as well. You can still make the most out of the holy month by observing other aspects that are within your capability such as doing charity, practising patience, investing more time with God through worship acts, limiting your indulgence in worldly affairs, and gaining extra knowledge. With that, the Homage team wishes you happy fasting and hopes that this year’s will be more fruitful than the previous ones!

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