Doha, Qatar: Most parents are keen to train their children to observe the obligation of fasting during the holy month of Ramadan and to accustom them to this practice. However, they sometimes overlook the medical considerations related to ensuring safe fasting, particularly in later childhood.
Consultant Pediatrician at Sidra Medicine, Dr. Mohammed Sinan Al Hajjaji, cautioned that, from a medical perspective, full fasting is not recommended for children under the age of seven.
At this age, children have limited glycogen stores and are more susceptible to rapid drops in blood sugar. Moreover, they require continuous energy intake to support brain development.
He noted that gradual fasting (training), such as fasting for half a day, until noon, or until the afternoon prayer, may be appropriate, provided the child is in good health, has a normal weight, does not suffer from chronic illnesses that would require medical consultation before fasting.
He also discussed the potential positive health effects of fasting in children, which may be more evident in older age groups. These include improved dietary discipline, such as reducing random snacking, regulating mealtimes, and limiting excessive sugar intake if the fast is broken healthily, and theoretically improved insulin sensitivity. While intermittent fasting has demonstrated such benefits in adult studies, fasting in healthy children may help reduce insulin resistance, particularly among those who are overweight. However, he emphasised that there are insufficient long-term studies on children to conclusively confirm these effects.
Additional potential benefits include enhanced fat utilisation as an energy source, as the body begins to rely on fat after 8 to 12 hours of fasting. This may assist in weight management among children with obesity. Fasting may also help develop tolerance to hunger, serving as a physiological training mechanism that regulates hunger and satiety signals and reduces dependence on quick sugars.
Dr. Al Hajjaji also outlined possible negative effects of fasting in children, which may vary depending on age and health status. One of the most significant risks is hypoglycemia, particularly in children under 10 years old, due to lower glycogen reserves and higher metabolic rates. Symptoms of low blood sugar may include dizziness, sweating, headache, lethargy, or fainting.
Other potential risks include dehydration, especially among children in hot climates or those who are physically active, as they are more vulnerable. Signs of dehydration may include headache, reduced concentration, constipation, and low blood pressure. Academic performance may also be affected, particularly during the first days of fasting, when children may experience fatigue, distraction, and headaches,though this often improves after several days.
Additionally, changes in sleep patterns are common, as many children alter their daily routines, stay up late, and experience fragmented sleep. This disrupts the biological clock and may affect hormones, mood, and school performance.
He further identified cases in which children should not fast or should seek prior medical advice. These include children with diabetes (especially type 1), underweight children (malnutrition), severe anemia, heart or kidney disease, chronic conditions requiring regular daytime medication, young athletes undergoing intensive daytime training, and children who suffer from recurrent headaches or fainting.
Dr. Al Hajjaji offered several health recommendations to ensure safe fasting for children, including consuming a protein-rich suhoor (such as eggs, yogurt, or beans) along with complex carbohydrates, avoiding simple sugars at suhoor, drinking adequate amounts of water at night, avoiding sun exposure during fasting hours, reducing physical activity, and breaking the fast gradually (water and dates followed by a balanced meal).
Finally, the pediatric consultant stressed that fasting should be stopped immediately if the child exhibits warning signs such as dizziness or fainting, severe headache, marked lethargy, pallor, cold sweating, reduced urination, or vomiting.
