The Pediatrician and Kashrus – A Halachic Analysis


(By Rabbi Yair Hoffman for

There are times when babies fail to thrive because of various medical reasons.  When this happens, there will be occasions when a pediatrician or an allergy specialist will recommend a special baby formula that will help the baby, but contains a questionable ingredient.  One such formula is Alimentum made by Similac.  The doctor will state that it is halachically permitted since the baby’s life may be at stake – and will invite the parents to check with their Rav or Posek.

Convinced that they may be faced with feeding their child treif, in a number of situations, the parent will pursue some alternative course.  At a Rav’s or friend’s suggestion, some will use a formula that still has a hechsher – and negate the doctor’s instructions.  On this account, some of these parents will switch doctors or stop going to that allergist.


What can and does happen is that the baby, who may not be receiving and digesting essential proteins, will be placed at grave risk – and no one will notice.


There is some essential information, however, that the parties involved here may be lacking.

The parent and the Rav may be uninformed about:

  • The fact that the essential protein or other nutrient is not being absorbed into the baby’s body. The protein or nutrient is just passing through the body directly into the diaper.
  • Missing vital proteins and nutrients can, rachmana litzlan, affect various system in the body.
    • The missing protein or nutrient can permanently affect the child’s heart
    • The missing protein or nutrient can affect the child’s brain
    • The missing protein or nutrient can affect the child’s muscles
    • The missing protein or nutrient can create a blood disorder
    • The missing protein or nutrient can create a problem with the kidneys.
    • The missing protein or nutrient can create a permanent skin condition.


What is added to these special formulas is a minute amount of Pig Pancreas enzyme.  The formula manufacturers do not tell the end consumer what they add, but the four commercially available types of this enzyme are Creon, Nutrizym, Pancrease HL, and Pancrex.

At this time, the enzyme is only available from pigs.  Many people, instinctively think that the formula is not kosher.  This is not true, however.  It is just that the formula cannot be given a hechsher.  Most Styrofoam cups also have animal product in it, but we still use Styrofoam cups.  This baby formula is actually more kosher than Styrofoam cups, believe it or not.


People, however, may be unaware that there are four categories of foods.

  • Category A – Foods that are kosher that generally don’t need a hechsher
  • Category B – Foods that are kosher that do need a hechsher
  • Category C – Foods that are halachically kosher because of various Torah concepts such as bitul but cannot be given a hechsher.
  • Category D- Foods that are not kosher that may only be eaten because of Pikuach Nefesh.

The general rule of kosher/non-kosher food combinations found in Shulchan Aruch (Yoreh Deah Siman 98) is that if there is 60 times the amount of Kosher food to non-Kosher – the mixture is still kosher.


Gedolei Torah have written, however, that when an item contains nullified prohibited food – it is still kosher, but one may not give it a hechsher.  This is on account of a concept called, “Ain mevatlin issur lechatchilah” (Shulchan Aruch YD 99:5) one may not negate a prohibition at the outset.


The explanation of the “Ain mevatlin Issur Lechatchilah” concept is as follows:  It is forbidden for a Jew or for a gentile doing it on behalf of a Jew to take a prohibited food and add sixty times the amount of kosher food to it in a mixture.   Having a hechsher placed on a food that has a purposefully negated non-kosher food in it is tantamount to a gentile “doing it for a Jew” according to most Poskim.  Rav Moshe Feinstein zt”l writes this explicitly in Igros Moshe (YD #II Siman 41).  This is also the position of Rav Moshe Sternbuch (Teshuvos V’hanhagos (Vol: I:440), and Rav Menashe Klein z”l Mishneh Halachos (Vol. VII: 113:2).


This is not to say that all Poskim agree that all Category C food is permitted.  Some Poskim have placed limitations on when we apply the laws of Bitul.  The Teshuvas HaRashba (Vol. III #214; cited by the Beis Yosef in Yore Deah Siman 134 toward the end “Chometz”)  writes that the notion of something being batel b’shishim is only applicable when it happens by accident.  However, when it is the normal mode of production, even of that of a gentile’s production – the laws of Bitul do not apply.  In other words, we do not always say bitul.

The Nodah BiYehudah (Mahadura Tanina #52) disagrees and rules that we do not limit when the laws of Bitul apply – even if it is the normal mode of a gentile’s production.  This is also the view of the Pischei Teshuva (end of YD 134:8) and the Gilyon Maharsha.

What is normative halacha?


Rabbi Dovid Tzvi Hoffman, author of the Melamed L’ho’il writes (Vol. II YD #29) that we can be lenient and rely upon the Noda BiYehuda when we first settle in a country.  However, after an infrastructure has developed, we should be stringent in accordance with the ruling of the Rashba.  When there is no formula available this should certainly be considered like there is no infrastructure.


But there is another factor of which we can be lenient here as well.  The Machtzis Hashekel ( at the end of Orach Chaim 427:45) writes that the Poskim who are stringent only rule that way when the nullified treif has been specifically added for either taste purposes or for Maamid purposes – in order to physically sustain the product.  The enzymes in these formula are added to break down proteins and not for Maamid purposes or for taste, nor for color.  According to this Machtzis HaShekel – all would agree that it is permitted – even the Rashba.


The Maharsham (Vol. III #234 “V’nishar) cites both the Rashba and the Raavad that when dealing with an item with no taste – wherein there is no possibility of adding further tastes (nosain taam) – it is permitted to nullify it at the outset.  In other words we do not say, “ain mevatlin lechatchila” regarding these products.  This would certainly apply to such an enzyme.


Yet an additional factor is the fact that in the production process wherein the enzyme was extracted and powderized, the original meat was rendered inedible.  Halachically, this is considered that the meat was rendered to be like “dust of the ground” – afra d’ara and the issur, prohibition, was removed.  Even though it is added back in to the food, there are many authorities who permit it based upon the chemical processing and the powderization.  These authorities include Rav Chaim Ozer Grodzinsky in Achievezer, the Tzemach Tzedek in the Piskei Dinim to Siman 103, and the Darchei Teshuvah 103:3.


It is clear that all the factors and leniencies above make the formula in question a Category C food and it is certainly permitted.  This is especially true if there is any health issue of which a doctor is concerned.  The fact is that even a Category D food is permitted when the child’s health is at risk.  As an additional aside, Rav Tzvi Pesach Frank even writes that there is no problem of non-Cholov Yisroel in these formulas because they are all in powdered form.

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Source: Yeshiva World

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