Eating On Yom Kippur For A Choleh

1) A pregnant woman must fast on Yom Kippur. (S.A. 517:1) Someone whose life may be in danger by fasting on Yom Kippur is obligated to eat. Not all cholim who are obligated to eat on Yom Kippur have the same halachic dispensation. There are cholim (who may be in danger) whose illness only warrants minimal eating or drinking. Minimal consumption is termed pachos mi’keshiur, or “shiurim”. Eating in shiurim means eating not more than a prescribed amount within a prescribed period of time.
2) At times a doctor will forbid a pregnant woman from fasting if she suffers from high blood pressure, diabetes, or if she has experienced miscarriages in the past. A pregnant woman must therefore consult with her doctor and her rabbi before Yom Kippur to see if she can fast. Even if the doctor and rabbi advise her to eat she must ascertain whether eating and drinking pachos m’kishiur would suffice. We will therefore discuss the laws of eating on Yom Kippur for a choleh, however, every woman must discuss her particular situation with her rabbi, because everyone’s circumstances and specific needs are unique.
3) In the event that one must eat or drink on Yom Kippur, one should first say the following prayer:
הנני מוכן ומזומן לקיים מצות אכילה ושתיה כמו שכתבת בתורתך, ושמרתם את חוקתי ואת משפטי אשר יעשה אותה האדם וחי בהם, ובזכות קיום מצוה זו, תחתום אותי ואת כל חולי עמך ישראל לרפואה שלימה, ואזכה ביום הכפורים הבא לקיים שוב ועניתם את נפשותיכם. כן יהי רצון, אמן.
“I am about to fulfill the mitzvah of eating and drinking, as You wrote in Your Torah, ‘And you shall keep My statutes and My laws that one must do and live through them.’ In the merit of fulfilling this mitzvah, please seal my decree, and that of all those who are ill among Your nation Yisrael, for a complete recovery. Next Yom Kippur, may I merit to fulfill once again the mitzvah of ‘you shall afflict your souls [through fasting].’ May this be Your will, Amen.” (See Netai Gavriel Yom Kippur Page 295)
4) Eating- On Yom Kippur the pachos mi’keshiur requirement for food is the volume of food that is less than a koseves hagasa, a type of large date. Harav Moshe Heinemenn shlit”a explains that the volumetric measurement of a koseves hagasa is more than 1.5 fl. oz. (44 ml). Therefore, one who is ill (as above) may eat 1.5 fl. oz. (which is less than a koseves hagasah) of food. Harav Ovadia Yosef zt”l writes, “The common custom is to give one who is ill pieces of bread with a condiment the size of 30 grams (1.05 oz.).”
5) One should preferably measure out the food before Yom Kippur. However, if one did not do so one may measure the food on Yom Kippur. (Chazon Ovadia Yomim Noraim page 297)
6) In between eating sessions one must wait kdei achilas pras, the amount of time it takes to eat a pras of bread. The poskim debate how many minutes it takes to eat a pras of bread:
A) According to the Chasam Sofer (6:15)- 9 minutes.  This is also the view of the Mishnah Berurah (618:22).
B) The Baal Hatania is cited as ruling that it is 8 minutes. (See Shiurei Torah by Rav Chaim Naeh page 204)
C) According to the Aruch Lner (Bikurei Yaakov 639:13)- 7.5 minutes. This is also the view of Harav Dovid Tzvi Hoffman zt”l. (Melamed L’Hoeil 113:5)
D) There are conflicting reports of the view of the Tzemech Tzedek. One report from the Tzemach Tzedek is 7 minutes. While another report from the Tzemach Tzedek is 6 minutes. (See Shulchan Menachem page 43 and Katzos Hashulchan 2:36:5) Harav Ovadia Yosef zt”l (Yabia Omer 9:108:96) writes that, “The proper amount of time (kdei achilas pras) in accordance with most authorities is between 6 and 7.5 minutes.”
E) Harav Yitzchak Elchonon Spekter zt”l is cited as ruling that one should wait 5 minutes. (See Chazon Ovadia Yamim Noraim page 298)
F) Harav Moshe Feinstein zt”l (Igros Moshe Orach Chaim 4:41) writes that while one should wait on Yom Kippur 9 minutes, if this is difficult one may wait half that amount (4.5 minutes).
G) It should be noted that Harav Ahron Felder zt”l writes that Harav Moshe told him that a choleh should wait 4 minutes between eating sessions on Yom Kippur. (Rishumei Ahron vol. 2 page 47)
H) The Shemiras Shabbos K’Hilchoso (Chapter 39:18) cites the Chasam Sofer that at the very least one should wait 2 minutes between eating sessions.
7) For practical halacha, one should wait 9 minutes between eating sessions. If this does not suffice and the person must eat more frequently they should wait as long as she can, depending on her state of health. At all events, one should wait for a period of at least 2 minutes. (Shemiras Shabbos K’Hilchoso ibid.)
8) Drinking- The minimal volume for beverages that qualifies for shiurim is less than a m’lo lugmav, a cheekful of liquid. Unlike food, the shiur of liquids differs with each individual’s capacity to hold liquid in his or her mouth. The larger the mouth, the larger the m’lo lugmav. Conversely, the smaller the mouth, the smaller the m’lo lugmav. (S.A. 612:9) Harav Moshe Heinemann shlit”a explains that for purposes of drinking on Yom Kippur we say an average adult has a m’lo lugmav that is larger than 1.5 fl. oz. (44 ml). A teenager may have a smaller m’lo lugmav.
9) One can ascertain his or her personal m’lo lugmav by filling his mouth completely with water, expelling the water into a measuring cup and dividing the amount in half. This number is the amount held by one cheek – a m’lo lugmav. Pachos mi’keshiur is slightly less than this amount. This “test” should preferably be conducted before Yom Kippur. (M.B. 618:21)
10) How long should one wait between drinking sessions. Ideally, one should wait 9 minutes between drinking, as one would ideally wait between eating sessions. (Chazon Ovadia Yomim Noraim page 297) If this amount of liquid is insufficient for the patient, one may drink this amount of liquid every two minutes. (View of Rav Moshe Feinstein zt”l Rishumei Ahron vol. 2 page 47)
11) If it is determined that this amount is insufficient and one’s life may still be in danger, the patient must drink as much as necessary, even if it is more than the shiur of volume and less than the shiur of time.
12) If staying in bed will help prevent the patient from eating, even one session, in shiurim, she should stay in bed and not go to shul. (Shemiras Shabbos K’Hilchoso 39:28)
13) A patient who has to eat in shiurim must not eat or drink more than he or she needs that day in order to keep him or her out of danger. (Shemiras Shabbos K’Hilchoso 39:26)

14) It must be remembered that eating or drinking in shiurim is permitted only if the doctor and rabbi require it and that a person who is ill but is not in danger must not eat or drink at all, even if confined to bed.
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