Part 2
Dr Lewis has a good understanding of the local community in which she practices and is aware of the activities and practices associated with Ramadan. She knows that during Ramadan, Muslims fast between dawn and dusk and that it is possible to counter any serious effects on the body by properly planning meals eaten before dawn and after dusk.
Dr Lewis asks Nadirah how she feels about fasting. Nadirah explains that she wants to be involved with the rest of the family’s activities to mark the holy period. She tells Dr Lewis that her older brothers and sisters all fast at this time of year and explains that she asked her parents to be allowed to join in. Mrs Anwar explains to Dr Lewis that she and her husband discussed at length whether to allow Nadirah to fast, stressing that she and her family keep a close eye on her for the time that she is fasting.
Dr Lewis explains to Nadirah and Mrs Anwar that fasting in young children can sometimes reduce concentration and can cause several other symptoms, including headaches, tiredness and dizziness. She encourages Nadirah and Mrs Anwar to make sure that she is getting all the main food groups in the meals that she does eat. She also gives them some advice to help reduce the effects on Nadirah while she is fasting, such as to drink plenty of water at mealtimes and avoiding caffeine to keep hydrated. She recommends that Nadirah avoids strenuous activity and situations in which fainting would be particularly dangerous, such as swimming or cycling.
Having talked through the issues and the things the family can do to manage the fasting period Dr Lewis is satisfied that Nadirah’s fasting is not currently compromising her welfare. But she emphasises that Nadirah must go to her GP if her symptoms continue and advises Mrs Anwar to let Nadirah’s school know when she is fasting. Dr Lewis also tells Mrs Anwar that she will pass on all the relevant information about Nadirah’s consultation to her GP practice.
See Protecting children and young people: the responsibilities of all doctors for further guidance on identifying children and young people at risk paragraphs 2-12.