Yom Kippur – Shiurim & Medication Guidance

A shiur is a small amount of food/drink which should be taken by someone who urgently requires basic nutrients on Yom Kippur in a situation where it is not permitted to break their fast and eat/drink regularly.

You should not decide to take shiurim on Yom Kippur independently but rather in consultation with your rabbi, ideally after an initial conversation with a reliable doctor who is aware of your medical history and the implications of any conditions you may have. This will provide the rabbi with important information and risks that may influence his psak.

Sometimes, however, this is not possible. In cases of genuine, urgent and life-threatening concern where this is not possible and you suspect that shiurim may not be sufficient, one should break the fast and eat/drink as normal.

Some other, less pressing scenarios are described below.

30ml every 9 minutes. If this is not sufficient then you may drink 30ml every 5 minutes.

Any liquid may be used and depending on the circumstances it may be useful to drink something nutritious that will provide you with energy such as grape juice.

A volume of 30cc of food every 9 minutes. If this is not sufficient then you may eat the volume of 30cc every 5 minutes. Note that this is a measurement of volume, not weight.

It is advisable to prepare a 30cc cup in advance of Yom Kippur in order to be prepared to measure the shiurim.

On the contrary, once it is permitted to eat or drink there is a mitzvah of simchas Yom Tov. Therefore you are advised to choose something nutritious and enjoyable.

Yes. The volume of solids and liquids are independent and do not combine (einam mitztarfim), therefore, one may ingest 30ml of liquid and the volume of 30cc of solid at the same time.

Yes.

Unless there is relevant medical history that will affect your ability to fast then you should attempt to fast as normal. If you suspect that there are additional factors which may impact your ability to fast safely, you should consult with your rabbi.

If you feel faint or dizzy you should eat or drink as normal until these symptoms subside.

If you are nursing your baby with your own milk and you baby is not bottle fed and your supply begins to diminish, you make drink shiurim to replenish your supply (but may not eat). Even if you estimate that you will be able to continue the fast until Motzei Yom Kippur, if this will compromise your ability to continue nursing long term and you child is very young, you may drink shiurim.

If you feel faint or dizzy, you should eat or drink as normal until these symptoms subside.

If you begin to feel contractions, downward pressure, bleeding or reduced movement then you should, you should eat and drink as normal until these symptoms subside.

If you are already unwell with a life-threatening condition and know that by fasting your condition will worsen to the point that you will need to break your fast, you may start taking shiurim from the beginning of the fast taking to prevent this.

No.

If pills are required for an important medical purpose they may be taken. If the pill has a sweet coating, it should be wrapped in tissue and may then be swallowed.

Where necessary, one may use a small amount of liquid which has been rendered distasteful to swallow a pill. For example, add some dish detergent or mouthwash to water and use that. Alternatively, prepare a very strong tea (with multiple tea bags) before Yom Kippur and let it sit for a very long time until it starts to go sour. This may then be used to swallow a pill.