Halachic Guidelines for Shiva Asar b’Tammuz for the Ill, Elderly, Pregnant or Nursing Women, and Medical Professionals

Five things befell our ancestors on the 17^th of Tamuz… the Luchos were broken, the [daily offering of the] Korban Tamid ceased, the [walls of Jerusalem were]breached, Apostomus burned the Torah, and he set up an idol in the Heichal (Mishnayos Ta’anis 4:6).

Chaza”l enacted a fast day in recognition of these events, and its observance is mandatory. Nevertheless, they were lenient in certain situations, as below.

1. The fast begins at Alos haShachar and lasts until Tzies haKochavim (Shulchan Aruch, 550:2, 562:1).
2. Washing, moisturizing or applying creams (“Sicha”), wearing leather shoes, and marital relations are all permissible (Shulchan Aruch, 550:2).
3. According to Ashkenazic custom, a Ba’al Nefesh (one who is scrupulous in Shmiras haMitzvos) should be stricter than the letter of the law and refrain from washing himself with hot water. However, he may wash his entire body with cold water, and his face, hands, and feet with hot water (Mishna Berura 6; Sha’ar ha’Tziyun 8-9). He should also refrain from marital relations unless it is Leil Tevila. R’ Shlomo Zalman Auerbach zt”l held that one should only be stringent and refrain from bathing and marital relations on Shiva Asar b’Tamuz and Tisha b’Av (Halichos Shlomo 13).^[1] Sefardim are lenient (Or l’Tzion^[2] Vol. 3 Chap. 25, footnote 1, p.234).
4. A person may bathe for medical reasons.
5. Ashkenazim do not rinse their mouths, even in the morning. If a person is in significant discomfort, he may rinse out his mouth but should not swallow (Shulchan Aruch, 567:3, Mishna Berura, ibid. 10-11). The same would apply if a person needs to wash his mouth for medical reasons, such as after oral surgery. Using a medical mouthwash that is not Ra’ui l’Shtiya (fit for consumption) is permissible. One may swallow saliva (ibid. 13).
6. If a person mistakenly ate, he should nevertheless complete the fast, even if he ate a Kezayis (Mishna Berura 549:3). He does not need to fast another day instead. However, he may do so if he wishes to atone for his mistake (ibid. 568:8). If he has a weak constitution and doesn’t fast well, he should redeem the fast by giving Tzedaka (Kaf haChaim 549:7).
7. Children do not fast. Although the Mishna Berura (550:5) rules that if a child understands the fast, he should only be given bread and water, this is not common practice, and children may eat normally (Halichos Shlomo 13, footnote 10).
8. A Choleh sheEin Bo Sakana is exempt from fasting except on Tisha b’Av and Yom Kippur, as the Chachamim did not make enactments that would adversely impact those who are sick (Shulchan Aruch 554:6). Cholim may not be stringent and fast (Mishna Berura 550:4).
9. Who is considered a Choleh she’Ein Bo Sakana?
10. A person whose entire body is in pain or who needs to lie down due to illness (Shulchan Aruch O.C. 328:10).
11. A temperature of more than 37.5⁰C exempts a person from fasting (Or l’Tzion 3, p260). A higher temperature may render a person a Choleh sheYesh Bo Sakanah.
12. A headache that causes perspiration due to the pain (Or l’Tzion ibid.)
13. A person with a headache that causes him to perspire in pain (Or l’Tzion ibid.)
14. A person with an internal infection, such as a throat or kidney infection, or septic arthritis.
15. A person with gastroenteritis causing diarrhea or intestinal distress.
16. A cardiac patient who will be harmed by fasting.
17. Patients with malignant diseases.
18. Patients with diabetes or hypertension should consult their physician and Rav or Posek.

10. A patient who underwent a minor surgery, such as an uncomplicated fracture repair under general anesthesia, is exempt from fasting for three days following the surgery. If he doesn’t feel well, he is exempt for seven days. After a more significant surgery, he is exempt for 30 days. The same applies after birth. Each case should be examined individually. If he feels weak, he is exempt even after 30 days (Or l’Tzion ibid. 6).
11. Those who feel extremely weak, have eye pain, or suffer from a severe headache, are exempt from fasting and should consult a doctor (Poskim, O.C. 550).
12. A person over the age of 80 should not fast (Or l’Tzion 3:29). Below that age, if a doctor maintains that fasting will cause him harm, he is considered a Choleh sheEin Bo Sakana and is exempt from fasting. If he is healthy and strong, he should fast (Kaf haChaim 550:6). Some elderly people fast more easily than younger people. One who harms himself by fasting loses more than he gains.
13. Convalescing patients who still feel weak from residual effects of illness are exempt from fasting. For example, one who had a fever higher than 38⁰C for three days, or fever accompanied by infections and diarrhea, is exempt from fasting for three days after the symptoms have resolved. If he had a high fever (i.e., greater than 39⁰C), he is considered to have been a Choleh sheYesh Bo Sakana and is exempt from fasting for seven days (Or l’Tzion ibid.)
14. A patient who needs to eat is not required to fast at all and may eat from the beginning of the day (Avnei Nezer^[3] O.C. 540). However, he should not indulge in meat and wine. He should eat only what is necessary for his health (Mishna Berura, 550:5). He does not recite Aneinu in davening.
15. One may take medications that have no taste or flavor. If swallowing them without water is difficult, one may drink a small amount.
16. Pregnant women do not observe this fast (Shulchan Aruch O.C. 554:5). Sefardic practice is that pregnant women fast only on Tisha b’Av and Yom Kippur (Or l’Tzion 25:7). However, the Rema (O.C. 550:1) holds that they customarily do fast, unless it would cause significant distress. The Mishna Berura (ibid. 3) clarifies that they should not fast if they are weak in any way.
17.  It is commonly held today that since people generally have weaker constitutions, and pregnant women are likely to be distressed by fasting, they should not fast (Halichos Shlomo 16:1 & Chut Shani, Shabbos 4, p261). [Some cite R’ Shmuel Wosner zt”l as ruling that they should begin fasting, but if they feel weak, they should eat and/or drink immediately.]
18. Pregnant women are exempt from conception until birth (Mishna Berura 3, and Or l’Tzion ibid.)
19. According to the Shulchan Aruch (ibid.), nursing women should not fast. This is the Sefardic custom. However, the Rema’s view is that nursing women should fast, unless it will cause them great distress. Contemporary Poskim rule that they should not fast due to the concern that their milk supply will be affected (Chut Shani, Shabbos 4, p260). The Chut Shani^[4] and Or l’Tzion (ibid.) rule that she is exempt from fasting, even if she only nurses a little bit or just once a day.
20. A Yoledes is exempt from fasting for 30 days (Shulchan Aruch O.C. 554:6) as she is considered a Cholah she’Ein Ba Sakana (see below). After 30 days, she does not need to fast if she feels weak (Kaf haChaim 554:28). Some hold that she is exempt for 24 months. They reason that a Meinekes is not exempt from fasting because she is nursing, but because she is considered to be recovering from the birth, which Chaza”l describe as having “jarred her limbs”, for a full 24 months. The Halacha does not follow this position, but each case should be examined independently. If she feels weak during those 24 months and wishes to be lenient, there are Poskim to rely upon (Chazon Ovadia, Ta’aniyos p62).
21. If a woman experienced a miscarriage more than 40 days post-conception, she has the same status as a Yoledes (Biur Halacha 617:4; Shemiras Shabbos Kehilchasa 36:5).
22. One may take supplements such as “Kalei Tzom” before the fast.
23. Medical professionals who believe fasting will impede their ability to work are exempt from fasting. There is greater room for leniency if they are likely to be involved in matters of Pikuach Nefesh.
24. However, those who work in less demanding conditions, such as in an outpatient clinic, and the fast will not impede their ability to work or make decisions, are obligated to fast.

[1] [Editor’s note: In contrast with the other fast days.]

[2] R’ Ben Zion Abba Shaul zt”l (1924–1998)

[3] R’ Avrohom Bornsztain zt”l (1838–1910)

[4] R’ Nissim Karelitz zt”l (1926-2019)