In Utero Ramadan Exposure and Early Childhood Health Capital: Evidence from Ethiopia

Previous studies use Ramadan as a natural experiment to show the adverse effects of fasting during pregnancy on the offspring’s birth weight, educational achievement and health during adult life. Building upon these studies, we investigate the effect of maternal fasting during Ramadan on physical development during early childhood. Using Ethiopian Demographic and Health Survey, we employ a difference-in-differences strategy where children born to non-Muslim mothers serve as the reference group.

We find that Muslim children, who are exposed to Ramadan in utero, on average have 0.12 standard deviation lower height-for-age z-score. The adverse effect of the exposure on children’s height seems to be stronger if Ramadan coincides with the third trimester of pregnancy. Contrary to the previous literature, our results are mainly driven by girls. Muslim children, who were born during Ramadan are more likely to be stunted even though the exposure to Ramadan was only partial. We speculate that the high prevalence of stunting among these children may be due to prematurity at birth; a phenomenon documented for Jewish women during Yom Kippur fasting.

Our results imply that nutritional interventions during early infancy and childhood may be too late and maternal nutrition during pregnancy should be an integral part of policies towards improving child outcomes.