German doctors are urging Muslim parents not to have their children fasting during the Islamic month of Ramadan, which this year starts on Tuesday evening.
The Professional Association of Paediatricians would rather parents explain to their children how "fasting is unhealthy for them".
Ramadan, which shifts according to the movement of the moon, is observed around the world by millions of Muslims. They abstain from food and drink between sunrise and sunset for 30 days.
This year, the month coincides with longer days in early summer, which means people in Europe will be fasting for about 18 hours a day.
- What is Ramadan?
- How to exercise, eat and sleep well during Ramadan
- Why I gave up fasting for Ramadan
How does fasting affect children?
Children of the Muslim faith are expected to begin fasting once they have reached puberty, usually by the age of 14.
Younger children do not need to fast but German paediatricians say that many are encouraged to do
"We always see very pale and unfocused children during Ramadan," doctors said in their statement. Some students came to see them straight from school, they said, after collapsing from "severe headaches or abdominal pain".
Doctors are not the only ones concerned. German teacher associations have also repeatedly warned of the tiredness Muslim children suffer while fasting in Ramadan, local media report.
Is fasting illegal or dangerous?
No national law or rule prevents children or teenagers from fasting.
"Even young Muslims are free to fast in Ramadan," Susanne Eisenmann, state minister for culture, youth and sports, told German media.
But she went on to say she saw it as a parent's duty to consider a child's health, especially those in elementary school.
"They have to make sure that their children can experience the fasting month in a healthy way," she said so that "performance and concentration skills in school do not suffer".
Individual institutions have made efforts to stop children from fasting in the past. In 2015, a primary school in London banned its children from fasting during Ramadan - a "stupidly foolish" action that one Muslim leader said could have spared the community bad press had the school simply spoken to parents.
The UK's National Health Service (NHS) says it is not harmful for children to fast, in an advice page about Ramadan.
It does advise against young children, aged seven or eight, fasting, adding: "It's a good idea to make children aware of what fasting involves and to practice fasting for a few hours at a time."
Do all Muslims have to fast?
Ramadan is seen as a spiritual time for reflection, improvement and increased devotion and worship of Allah, the Arabic word for God.
Fasting during this time is one of the five pillars of Islam, and all adult Muslims are expected to do it, reading and reflecting on the entire Koran, the holy book, and abstaining from smoking and sexMedia
They can either make up for any of the 30 days of fasting at another time in the year or pay fidyah, which is a religious donation of food or money when a fast is broken.
For those who can fast, every day is started with prayer and a pre-dawn meal called suhur, and fasting is broken with a sunset meal called iftar.
At the end of Ramadan, which will be on 14 June, there is a three-day celebration called Eid al-Fitr, which is marked with special foods, new clothes and presents for children.
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