Fasting in pregnancy

Is fasting safe for me and my baby?

There's no clear answer to this. Although there is good research to suggest that fasting doesn’t affect the birth weight of a baby (Glazier et al 2018), it’s not yet clear how fasting may affect your health or the health of your baby during pregnancy (Glazier et al 2018). It’s for this reason that experts recommend not fasting during pregnancy.

We do know that fasting isn’t considered to be safe if you have diabetes or have developed diabetes during pregnancy (gestational diabetes) (Afandi 2017). This is because fasting can affect your blood sugar levels (Diabetes UK 2015). While you’re fasting during the day, your blood sugar levels can fall and you could become dehydrated (Diabetes UK 2015). When you’re breaking your fast at night, your blood sugar levels can become too high if you’re eating a lot at Suhoor (pre-dawn meal) and Iftar (meal taken at dusk) (Diabetes UK 2015).

It’s important to remember that if you're pregnant, Islamic law doesn't require you to fast. You can make up missed fasts later. Or you could do fidyah, which is a way of compensating for your missed fasts by giving food to someone in need (BNF 2015). For example, you could make a donation to a food bank.

If you don't feel well enough to fast, or you’re worried about your health or your baby's wellbeing, talk to your GP or midwife and get a general health check before deciding.

Deciding whether to fast or not is a very personal choice. You’ll need to decide based on how you’re feeling, what stage of your pregnancy you’re at and how your pregnancy is going. One important factor to consider is when the fast takes place. If Ramadan falls during the summer, this means hot weather and long days, which puts you at greater risk of dehydration (BNF 2015).

What do studies into fasting in pregnancy show?

The most recent research into fasting during pregnancy shows little or no effect on newborn babies whose mums fasted in pregnancy. However, some women may experience dehydration or lack of energy, because of fasting. Here’s what the research has told us so far:

• Fasting does not make your baby more likely to be born early (premature) (Safari et al 2019).
• Fasting during pregnancy does not mean that your baby is more likely to have a lower birth weight (Glazier et al 2018).
• You may have less energy if you fast, because you’re not taking in as much food and water as you need (Savitri et al 2017).
• Fasting during the second trimester of pregnancy may reduce your risk of developing gestational diabetes and prevent you from putting on a lot of extra weight (Safari et al 2019).

How will I cope with fasting during pregnancy?

If you’re a healthy weight and have a generally healthy lifestyle, you’re likely to cope better with fasting. Your baby needs nutrients that come from you, and if your body has enough energy stores, fasting is likely to have less of an impact.

How your body deals with fasting will also depend on:

• your general health before you became pregnant.
• what stage of pregnancy you’re at.
• how long you fast for during the day – this can be anywhere between 11 and 18 hours depending on the time of year (BNF 2015).

Fasting in the summer months is likely to be harder work for you than it would be in the winter due to the longer days and higher temperatures (BNF 2015).

What do other pregnant women do during Ramadan?

It’s thought that at least seven out of 10 pregnant Muslim women in the UK choose to fast for Ramadan, for at least some part of the month (Savitri et al 2017).

Not everyone fasts for the whole month though. You can make up any missed days of fasting after Ramadan has finished and once your pregnancy is over (Muslim Aid 2014).

Most Islamic leaders say that you should fast if you are healthy enough to do so. But they also say that if you are unwell, or pregnant, you are exempt from fasting (MCB 2019). You shouldn't ignore this special permission if you feel unwell, or if you fear that fasting could harm you or your baby.

Only you can judge how healthy you feel, and what the right decision is for you. Talk to your family, midwife or doctor and Imam, to help you consider your options.

How should I prepare for fasting?

Plan ahead to make things easier during Ramadan:

• Talk to your midwife, who can check your health. Pregnancy can be a demanding time for your body. You and your baby need plenty of nutrients and fluids. Your doctor or midwife can help you to work out your dietary needs. You may also need to have more frequent check-ups during your fast.
• If you have diabetes and you want to fast, and many women do, talk to your midwife or doctor beforehand and plan your food and drinks carefully.
• If you normally have caffeinated drinks, such as coffee, tea and cola, it’s a good idea to cut back before you fast to prevent withdrawal headaches (BNF 2019). You shouldn't have more than 200mg of caffeine a day when you’re pregnant, which is about two cups of instant coffee (NHS 2017). Remember that chocolate and green tea also contain some caffeine.
• Talk to your employer about managing your work during Ramadan. It may be possible for you to reduce your working hours or have extra breaks. Read more about working and fasting.
• Keep a food diary, so you know what you’re eating and drinking.
• Start preparing early by doing shopping and errands before you fast.

What warning signs should I look out for during fasting?

Contact your doctor or midwife for advice as soon as possible if you’re fasting and:

• You're not putting on enough weight, or you’re losing weight, which could be harmful for your baby (NHS Inform 2019a). You probably won't be weighed during your antenatal appointments, so weigh yourself regularly at home while you’re fasting.
• You become very thirsty, are weeing less frequently, or if your wee becomes dark-coloured. This is a sign of dehydration, and it can make you more prone to urinary tract infections (UTIs) or other complications.
• You feel dizzy, faint, weak, confused or tired, even after you’ve had a good rest. Break your fast immediately with a sugary drink and a salty snack or an oral rehydration solution such as Dioralyte, and contact your doctor or midwife (BNF 2015).

Discover more pregnancy symptoms you should never ignore.

How can I make fasting in pregnancy easier?

• Stay as hydrated as you can (BNF 2015). If the weather is warm, keep to the shade, don’t push yourself to do too much and drink plenty of fluids at Suhoor. You need to drink more than usual when you’re pregnant, so eat foods that contain lots of water such as stews and soups.
• The changes to your eating habits and lack of fluids can make you constipated (Moola et al 2014). Have plenty of high-fibre foods when you break your fast, such as wholegrains, fruit, vegetables and beans (Moola et al 2014).
• Fasting can sometimes bring on indigestion, especially if you’re eating before dawn and then going back to bed (Moola et al 2014). Try eating small meals often during non-fasting hours and if you can, don’t eat high fat or salty foods (Moola et al 2014).
• Take things easy and accept help when it is offered. Even if your family and friends stay up late, you may need to mark this Ramadan with more quiet, restful time.
• Ask family or friends who have fasted while being pregnant for tips and suggestions.
• Try not to walk long distances or carry anything heavy.
• Cut down on housework and anything that tires you out.

What's the best way to break my fast?

• Try to eat slowly at Iftar. Start with light meals such as soups (BNF 2019). Foods that contain natural sugars such as fruit and milky drinks are a good choice too, as they’ll give you some much needed energy (BNF 2019).
• After you’ve broken your fast, opt for meals that give you a healthy balance of starchy foods, fruit and vegetables, dairy and protein such as well-cooked meat, fish, eggs or beans (BNF 2019). This will help your baby to grow well.
• Opt for complex carbohydrates, such as wholegrains and seeds, and high-fibre foods, such as pulses and dried fruits. These will help to keep you going as they release energy slowly. Rather than high-fat, refined foods, choose healthier options such as potatoes or chickpeas.
• Eat little and often if you can and make sure you drink plenty of fluids such as water, low sugar and caffeine-free drinks to help you stay well hydrated.
• Try not to have lots of sugary foods that will raise your blood sugar levels quickly. Your blood sugar may then drop quickly, which may make you feel faint and dizzy.

I'm still not sure if I should fast. What should I do?

Ask your midwife to give you a general health check before you begin. An Imam will probably suggest getting medical advice to help you to make your decision. Consider trying a trial fast for a day or so, see how you feel, and then go back to your midwife or GP for a check-up if you feel you need it.

More advice on fasting in pregnancy:

• How can I cope with working while fasting?