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מכון שלזינגר לחקר הרפואה על פי ההלכה

Breast pumps

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31 באוגוסט 2012

הרב המשיב: אחר

שאלה:

Hi,

I am a second-year medical student and have also completed my Semicha, and am currently looking into the topic of using electric breast pumps on shabbos (this was also a practical question for me since my wife had to pump for our daughter earlier this year). I have two general questions about the issue that I was hoping you could help me with:

1) Some Rabbis I have spoken to think there should be no problem because using the electric pump should not really constitute doing a maaseh melacha. However, most Rabbis I spoke to seem to think the consensus of the poskim is that just using the pump (and holding the pumps in place on the breast) is the same as operating any other machine, even if you're not the one who turns on the pump (i.e. say you had a non-Jew turn it on for you, or you used a timer). I was wondering if you could clarify this for me, and if you might be able to provide an actual source that just holding a machine in place while it does its work would be considered a full maaseh melacha.

2) Many poskim, including Rav Ovadya, the Nishmas Avraham and Rav Shlomo Zalman (Shemiras Shabbos vol. 1 chapter 36) write that for babies that are either premature or cannot properly nurse for whatever reason can use electric pumps on shabbos (with the qualification of hakal hakal techilah) primarily because it would be considered sakana to the baby to have to have formula instead of breast milk. I was just wondering about the scope of this heter. I understand it applies certainly to premature babies or babies who really don't have the ability to suck properly, because that in itself might be considered a choleh sheyesh bo sakana. I have also heard that it is the minhag in Israel that women use breast pumps on shabbos when their babies cannot nurse properly. However, say for example you have a baby who is completely healthy otherwise, only they are not gaining weight at a healthy rate, and it is suspected that the lack of weight gain is due to some nursing problem. Pumping allows this baby to get nutrition through a bottle rather than from the breast, and that way it can be ensured that the baby is getting enough nutrition. A baby in this situation would have the ability to drink formula from a bottle though and gain weight that way as well. In this situation, where I think the baby would not be considered a choleh sheyesh bo sakana, would the poskim still permit using electric breast pumps on shabbos due to the notion that "stam tinok mesukan etzel chalav" or because of the potential dangers of giving formula to a baby whose main source of nutrition is breast milk?

And if this last case would still be permitted considering the potential danger of giving formula to a baby that is used to breast milk, what would the halacha be in a case of a baby who has already had small amounts of formula in the past? I saw in the Torat HaYoledet chapter 41 footnote 10 that he feels cases of "mixed feeding" should be evaluated on a case by case basis in terms of whether there would be sakana to give exclusively formula for one day per week rather than pumping milk on shabbos for them.
If you could help me clarify some of these issues that would be great. Thank you for the excellent service you provide.

Sincerely,

תשובה:

As you have already spoken with numerous rabbanim, and also researched the topic, I can only try to add to what you already mentioned in your question. 

1. Drawing milk out of the breast is a violation of "mefarek/dash;" affixing the pump in order to draw the milk is the act of melacha. Although the actual "work" is done through a machine, this is no different than any other tool, such as applying an electric saw to a piece of lumber in order to cut it. A source for this can be found in Gemara (B.K 60a) regarding winnowing. Although the work is done through the medium of wind, it is considered a melacha because "meleches machsheves asra Torah," and this is the means of doing this melacha. [It should be noted, though, that Rashi indicates that this aspect of "meleches machsheves" applies to any melacha when his intention is completed. The Rosh (B.K. 6:11), however, limits the idea to winnowing, where the melacha is primarily performed in this manner.] Similarly, the Chazon Ish (O.C. 36:2), citing the Ramban, writes that plowing by leading or directing an animal or tractor is a melacha, even though the plow itself is pulled by the animal or tractor.

This Chazon Ish would seemingly indicate that even holding the pump in place would constitute and act of melacha, since "the machine is a tool in the person's hand." On the other hand, if it were possible to maintain the pump in place without having to direct it after beoing activated by a timer or non-Jew, perhaps it would be comparable to remaining in the doorway of a house in which a deer was already trapped. (O.C. 316:6. See also Shemiras Shabbos K'hichasa 32:43 about reamaing in a phone booth.) If so, the women's initial action would only be grama. (One can distinguish, though, between the case of the deer, where that animal was already trapped, and this case, will the melacha will occur later.)

2. In regards to insufficient weight gain, unless the discrepancy is drastic, I would agree that this should not be considered sakana, if the attending doctors concur. Nonetheless,if the baby is unable to nurse, and is fed exclusively by pumping, this would seem included in Rav S.Z. Aurbach zt"l's lenient ruling that one is not required to use milk substitutes. (Shemirat Shabbat K'hilchasa 36:21) However, in the case of insufficient milk gain, milk can usually be expressed before Shabbos and refrigerated/ frozen, eliminating the need to draw milk on Shabbos. Furthermore, if the baby can nurse, albeit not to the degree to achieve the desired weight gain, it is difficult to apply here the rule of "stam tinuk mesukan eitzel chalav."

Rabbi Meir Orlian

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