נשים בדיון הלכתי, משך תקופת ההנקה בהלכהJewish Legal Writings by Women, Duration of Breastfeeding in Jewish Law

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1Deena Rachel Zimmerman

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2Human milk is recognized as the ideal form of infant nutrition both by medical research and Halakha. To quote the most recent policy statement of the American Academy of Pediatrics (AAP):¹American Academy of Pediatrics, “Breastfeeding and the Use of Human Milk,” Pediatrics 100 (1997): 1035–39.

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3Human milk is uniquely superior for infant feeding and is species-specific; all substitute feeding options differ markedly from it…Epidemiologic research shows that human milk and breastfeeding of infants provide advantages with regard to general health, growth and development, while significantly decreasing risk for a large number of acute and chronic conditions. Research in the United States and Canada, Europe and other developed countries, among predominately middle class populations provide strong evidence that human milk feeding decreases the incidence and/or severity of diarrhea, lower respiratory infection…

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4Chazal, from practical experience noted:

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5“Stam tinok mesukan etzel chalav.”

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6“The average infant is at danger from [lack of] milk.” (Yevamot 114a)

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7According to modern science and Jewish law, how long (i.e., how many months/years) is breastfeeding an ideal?

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8The same AAP statement cited above also states:

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9Exclusive breastfeeding is ideal nutrition and sufficient to support optimal growth and development for approximately the first 6 months after birth…Gradual introduction of iron enriched solid foods in the second half of the first year should complement the breast milk diet. It is recommended that breastfeeding continue for at least 12 months, and thereafter for as long as mutually desired.

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10The World Health Organization encourages breastfeeding until two years and beyond.²M. Sugarman and Kendall-Tackett. “Weaning ages in a sample of American women who practice extended breastfeeding,” Clin Pediatr 12 (1995): 642–49. How do these recommendations fit with a halakhic approach? Are there halakhic implications to the duration of nursing?

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11The Obligation

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12Breastfeeding is the method of infant feeding that is assumed by Halakha and considered a marital obligation of a wife to her husband.³Ketubbot 59b. If the mother did not want or could not nurse her own infant the option was to hire another woman, a wetnurse. Circumstances existed that the husband would have to pay for this service such as if it were not her family custom to nurse. At other times, if the mother had sufficient funds, she could pay for it herself. However, for a woman who did not have the funds, the Shulchan Arukh⁴EH 82:1. based on the Talmud⁵Ketubbot 59b. ruled that if a woman has vowed not to breastfeed her infant, she could be compelled to do so until the child was 24 months of age. Today, however, a large number of women unfortunately do not nurse. According to 1996 statistics, only 59.7% of American women initiated breastfeeding and only 21.6% continued until 6 months of age.⁶Ross Laboratories, Mother’s Infant Feeding Survey, 1996 (In other countries the number are generally higher.) The Nishmat Avraham questions whether at present a woman can be halakhically compelled to nurse her infant since many women do not. He feels though that a number of months are perhaps indicated in light of the known medical benefits.⁷EH 81:1.

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13The evidence of the medical benefits does have halakhic implications. Caring for one’s health is a halakhic imperative.⁸F. Levin, Halacha, Medical Science and Technology (Brooklyn: Maznaim, 1987) 3–38. See bibliography and sources there. With the known health benefits for the infant and mother it would thus seem that breastfeeding would have halakhic import as well. However, since many poskim have not emphatically forbidden or condemned some practices today with clear medical evidence of harm, such as smoking,⁹F. Rosner, “Cigarette Smoking and Jewish Law,” Halacha and Contemporary Society, ed. A.S. Cohen (NY: Ktav, 1984). See also Smoking and Damage to Health in the Halachah by R. Menachem Slae (Jerusalem: Acharai Publications, 1990). it is certainly unlikely that they would forbid the use of substitute methods of infant feeding.

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14The Minimum

ט״ו

15So great was the fear of harming the child from not nursing that the Rabbis decreed that a woman who is nursing at the time of her husband’s death was not allowed to remarry during the nursing period (Yevamot 36b). Furthermore, she should not remarry during pregnancy as most pregnant women will become nursing women (Yevamot 42b), and it was thought that after three months of pregnancy there would no longer be sufficient milk for the older child.¹⁰This is not necessarily true today as many pregnant women can continue to nurse and in fact it is possible to “tandem nurse” to children of different ages. However, at the time of the Talmud, women in general had a poorer nutritional status than today, proving difficult at times to provide the additional calories needed for both nursing and pregnancy.

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16The standard “nursing period” in the Talmud is 24 months. On the citation on Yevamot 36b, Rashi states simply “A woman whose husband has died and she is pregnant or nursing is forbidden to remarry until the infant is 24 months old because that is how long an infant nurses.” From the words in the Gemara it would appear that this rule does not apply to a nursing divorcee unless the child will not nurse from another woman. However, there are those who would forbid remarriage in these circumstances as well (see Tosafot on Yevamot 36b) This decree of “meneket chavero” is brought as Halakha in the Shulchan Arukh:¹¹EH 13:11.

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17The sages decreed that a man should not marry or even betroth the pregnant [former] wife of his friend or the nursing [former] wife of his friend until the infant is 24 months old excluding the day the infant was born and the day that they are betrothed regardless if she is a widow, divorcee, or prostitute whether she has weaned the child or given it to a wetnurse…

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18This decree is given such import because it involved the fear of harm to the infant and in general, unlike many other rabbinical enactments where the tendency is to be lenient, the trend with this decree is to be stringent.¹²Otzar haPoskim 73a. The Jerusalem Talmud even finds a prooftext in the Tanach.¹³Sota 4:3. “Do not remove the boundaries which the ancestors have placed and in the fields of orphans do not come.”¹⁴Mishle 23. (The play on words here is that fields = “sadei” and breasts = “shadei”). Rav Yosef Caro, the author of the Shulchan Arukh, in the Beit Yosef (his commentary on the Tur), makes it clear how seriously this decree is to be taken:¹⁵Beit Yosef on Tur 13:1.

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19A number of such circumstances have come before me and I have forbidden all of them…and anyone who tries to be lenient in this manner is breaking the fence (poretz geder) of the words of the sages.

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20Others were willing to be lenient in extraordinary circumstances such as Rav Mintz who allowed a nursing prostitute to marry because of the physical and spiritual benefits that would be accrued to her and the child by her being married.¹⁶Mahari Mintz 5. Many attacked him for this action but the Chatam Sofer defended him, as the initial reason for the decree was the benefit of the infant.¹⁷Chatam Sofer 2:422 and 3:30.

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21The Chatam Sofer also states that even at the time of the Talmud many infants nursed for shorter periods.¹⁸EH 30. However, because of the fear of harming the child by not nursing, the decree of remarrying applies until 24 months of age due to concern for the minority of infants who need the full 24 months. Thus saying that today women often nurse for less does not lessen the import of the Rabbinic decree of meneket chavero. Rav Moshe Feinstein did take current trends into consideration as a reason for leniency. In general his feeling was that 21 months is sufficient taking into consideration that since it would take 3 months of pregnancy for the breastmilk to cease, even if the mother became pregnant immediately on remarrying the infant would have the benefit of 24 months of breastmilk. R. Moshe Feinstein also said there was basis for accepting an 18 months minimum as this example is given in the Talmud in a debate between Beit Hillel and Beit Shammai.¹⁹Nishmat Avraham, EH 13:11. He also ruled in times of great need, for example an Israeli war widow whom someone was willing to marry now but not to wait, 12 months would be a sufficient wait prior to remarrying.²⁰Iggerot Moshe, EH 49 and 50.

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22When issues of remarrying are not involved, at least 18,²¹Tzemach Tzedek haChadash 45 as quoted in A. Steinberg, Encyclopedia Hilkhatit Refu’it (Jerusalem, 1994) s.v. “Hanaka.” or 24 months is desirable. The Pitchei Teshuva, commenting on the Shulchan Arukh,²²YD 81:7.16. quotes a responsa of the Adnei Paz who states:²³Siman 17.

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23Those who feel that weaning an infant early is good for the child’s Torah learning are in error…in fact it is forbidden to wean before 24 months unless there is a compelling reason.

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24The Maximum

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25The original source of discussion of a limitation of the duration of breastfeeding is found in the Talmud (Ketubbot 60a):

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26An infant continues to nurse to 24 months [of age]. From this point on it is as if he is nursing from an unkosher insect (sheketz) according to Rabbi Eliezer. Rabbi Yehoshua states even to 4 or five years. If he stopped nursing after 24 months and returned [to breastfeed] it is comparable to nursing from an unkosher insect. From here [4–5 years] on it is comparable to nursing from an unkosher insect.

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27Interestingly, these ages are compatible with the duration an infant will generally nurse if allowed to continue to breastfeed until the child is ready to cease. For example, a study of weaning ages in American women who practice extended nursing and wait for child initiated cessation of breastfeeding shows that the modal age of weaning is 37 months.²⁴M. Sugarman and Kendall-Tackett, ibid. Many traditional cultures today also practice breastfeeding until 2–4 years.²⁵K.A. Dettwyler, “A time to wean: the hominid blueprint for the natural age of weaning in modern human populations,” Breastfeeding Biocultural Perspectives, eds. P.S. Macadam and K.A. Dettwyler (NY, 1995).

כ״ח

28What could possibly be the halakhic problem with breastfeeding as long as the child desired? Why need a maximum at all? In general kosher milk comes from kosher animals. Although human meat is not to be consumed, human milk is kosher. The rabbis however were afraid that if direct nursing from a woman was permitted even for an adult, people may incorrectly determine that milk from an unkosher animal is permitted and thus they proscribed direct nursing for “adults.”²⁶Taz, YD 81:9. The debate in the Gemara is from what age this rabbinic degree applies to children.

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29The opinion of Rabbi Yehoshua that breastfeeding up to age 4–5 years old is permitted is accepted as Halakha. However, another requirement for permitting breastfeeding beyond 24 months is that the child has not stopped nursing for 3 consecutive days. The Yerushalmi adds the additional proviso that this three-day separation has to be by a healthy infant, not one who is sick.²⁷Ketubbot 5:6 [30a].

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30The Halakha as stated in the Shulchan Arukh:²⁸YD 81:7.

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31An infant breastfeeds until 4 years for a healthy child and 5 years for a sickly child if he has not ceased; but if he is weaned for three whole days [= 72 hours] after 24 months he should not be returned to the breast. This is if he ceased while healthy, but if he ceased due to an illness and was unable to nurse, he can be returned. If there is a danger, he can be returned even after a number of days. Within 24 months of age even if he ceased in health for a month or more he can be returned and nurse until the end of 24 months.

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32There are a number of debates on exactly when restarting is permitted. Can a child who was in danger continue once the danger has passed?²⁹Shakh, YD 81:22. See also Responsa Yabia Omer, YD 5:11. Can a child who ceased for a prolonged period while less than 24 months return until 24 months exactly or as long as he/she wishes?³⁰Lechem Mishna on Rambam, Hilkhot Ma’akhalot Asurot 3:5. As in general, Halakha “errs” on the side of leniency and caution when a possible risk to health is involved,³¹Shulchan Arukh, OC 428. why the hesitation to allow resumption of breastfeeding? One reason given is that a child can have the benefits of expressed breastmilk at any age thus there is less reason to permit continued direct breastfeeding.³²See n28 above.

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33An issue not addressed in any printed responsa to date is what if the mother of a child over 24 months leaves the child for three days. One such example would be a mother who is hospitalized due to illness. From the general principle of piku’ach nefesh it would seem that this would be permissible. What if, however, she leaves for non-medical reasons, for example, on a business trip?

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34A possible answer to this question seems to be found in the Haga’ot Maimoniyot.³³Comment 7 on Rambam, ibid. in his commentary on the Rambam. The Rambam states that the three-day separation is a reason not to restart only in a healthy child, not a sickly one. The Hago’at Maimoniyot points out that the source of this is the Yerushalmi and explains “mitoch boryav,” that the child does not need to nurse but stopped of his or her own volition, and is no longer interested in nursing, “katz bo.” It would thus seem that if the interruption was due to maternal reasons, restarting nursing would be permitted.

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35To summarize, it would appear that an “Halakhic Policy Statement” on the duration of breastfeeding would read as follows:

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36Breastfeeding is the ideal form of infant nutrition and thus should be encouraged as part of a total plan of healthy behavior. It is recommended that breastfeeding continue for at least 18–24 months, and may continue thereafter until 4 years for a healthy child and 5 years for a sickly child as long as the child while healthy, has not initiated an interruption of 72 hours (once thee child is over 24 months of age). In cases of interruption of this length, please consult a competent halakhic authority.