Considerations in planning vegan diets: infants
Section snippets
Growth of Vegan Infants
A limited number of studies have examined the birth weights of infants of vegan mothers. A study of close to 400 infants and children, 75% of whose mothers used vegan diets throughout pregnancy, found birth weights and incidence of low-birth-weight infants to be similar to those of well-educated US white women (3). The reported birth weights of 19 term infants born to vegan women were slightly lower than infants with non-vegetarian mothers (4). Lower birth weights of infants of Dutch women
Breast Milk of Vegan Women
Nutrients in breast milk most sensitive to maternal diet are most of the B vitamins and vitamins A, C, and D (9). Mineral content, total fat, and cholesterol content are not significantly affected by maternal diet. Although total fat content of breast milk of vegan women is similar to that of omnivores, fat composition may vary depending on maternal intake. Sanders (10) found that milk of British vegan women was lower in saturated fat and eicosapentaenoic acid and higher in linoleic acid and
Docosahexaenoic Acid in Diets of Breastfed Vegan Infants
Docosahexaenoic acid (DHA) is a long chain n-3 fatty acid present in all cells of the body and found in especially high concentrations in the brain and retina. Since DHA is found primarily in fish and eggs, vegans do not consume it but depend on endogenous synthesis from the n-3 fatty acid linolenic acid. A low ratio of linoleic acid/linolenic acid in the diet maximizes conversion (27), (28). Some studies show decreased plasma DHA levels in vegans compared to omnivores (10), (29).
Infants who
Milk for Vegan Infants
Human milk is the optimal food for all infants. The advantages of breastfeeding are numerous (43). The American Academy of Pediatrics recommends human milk as the exclusive nutrient source for full-term infants for the first 6 months after birth (44). They also recommend that breastfeeding be continued for at least the first 12 months along with appropriate supplementary foods (44). Many vegan women choose to breastfeed longer than this (45) and this practice should be supported.
Commercial
Supplements for Vegan Infants
With the exception of vitamin B-12 and possibly zinc, guidelines for supplementation of vegan infants are the same as for omnivore infants. Because maternal vitamin B-12 stores may not be available to the infant, and because infants require a sustained intake of vitamin B-12 to support rapid growth, it is important that all breastfed vegan infants receive a regular supplement of vitamin B-12 (0.4 μg/day for the first 6 months, 0.5 μg/day beginning at age 6 months) unless the mother’s diet is
Solid Foods for Vegan Infants
Guidelines for introducing solid foods for vegan infants are the same as those for non-vegetarian infants (1). Either breast milk or commercial infant formula provides adequate nutrition for infants until somewhere in the middle of the first year. The infant’s individual growth and development pattern provides the best guideline for when to introduce solid food, rather than the infant’s age (2). However, solid foods should be introduced by age 6 months (2). Table 2 provides a suggested schedule
Home Preparation of Infant Foods
Many vegan parents will choose to use commercially prepared baby foods since there are products available for vegan infants. Commercial products contain limited selections for the older vegan infant so parents may opt to prepare their own baby foods. This practice should be encouraged since foods that are important in the diets of vegan children such as legumes, tofu, and leafy green vegetables are seldom available in commercial form and should be introduced early to increase later
Allergies
Although many foods can cause allergic reactions in infants, vegan infants may be at somewhat reduced risk for food allergies since they do not consume cow’s milk, the leading source of food allergy in young children. Foods most likely to cause allergic reactions in vegan infants include nut butters, peas, citrus fruits, corn products, soy products (including infant soy-based formula) and wheat. As for any infant, solid foods should be introduced as single ingredient foods, one at a time, at
Macrobiotic Diets for Infants
Macrobiotic diets often differ from more usual vegan diets in important ways and, because a basic principle of macrobiotics is to eat in harmony with one’s local environment, macrobiotic practices also differ throughout the world. The diets typically do not include meat (although seafood is often included) or dairy foods and they restrict intake of fruit and certain vegetables. With careful planning, macrobiotic diets can meet the needs of infants. However, a number of studies have found
Conclusion
Appropriately planned vegan diets can meet the nutrition needs of infants and can support normal growth. Vegan infants under one year should ideally receive breast milk for all milk feedings. A commercial infant soy-based formula is another option. Supplemental food should not be introduced before 4 to 6 months. Infants should be given supplements as prescribed by the health care provider. These will include iron and possibly vitamins D and B-12 and zinc for the breastfed vegan infant.
References (92)
- et al.
The influence of a vegetarian diet on the fatty acid composition of human milk and the essential fatty acid status of the infant
J Pediatr.
(1992) - et al.
Vegetarian childrenappropriate and inappropriate diets
Am J Clin Nutr.
(1988) Effects of maternal dietary intake on human milk composition
J Nutr.
(1986)- et al.
Studies of vegansThe fatty acid composition of plasma choline phosphoglycerides erythrocytes, adipose tissue, and breast milk, and some indicators of susceptibility to ischemic heart disease in vegans and omnivore controls
Am J Clin Nutr.
(1978) Nutritional concerns of lactating women consuming vegetarian diets
Am J Clin Nutr.
(1994)- et al.
Cyclical serum 25 hydroxyvitamin D concentrations paralleling sunshine exposure in exclusively breast-fed infants
J Pediatr.
(1987) - et al.
Increased urinary methylmalonic acid excretion in breast-fed infants of vegetarian mothers and identification of an acceptable dietary source of vitamin B12
Am J Clin Nutr.
(1988) - et al.
Vitamin B12Low milk concentrations are related to low serum concentrations in vegetarian women and to methylmalonic aciduria in their infants
Am J Clin Nutr.
(1990) - et al.
Taurine and other free amino acids in milk of man and other mammals
Early Hum Dev.
(1978) - et al.
Carnitine status of lactoovovegetarians and strict vegetarian adults and children
Am J Clin Nutr.
(1989)
Dietary carnitine effects on carnitine concentrations in urine and milk in lactating women
Am J Clin Nutr.
Exposure of infants to phytoestrogens from soy infant formulas
Lancet.
Regulation of unsaturated fatty acid biosynthesis
Biochim Biophys Acta
Dietary linoleic acid influences desaturation and acylation of deuterium-labeled linoleic and ALAs in young adult males
Biochem Biophys Acta.
Dietary essential fatty acids, long-chain polyunsaturated fatty acids, and visual resolution acuity in healthy fullterm infantsa systematic review
Early Hum Dev.
Effect of dietary linoleic/alpha-linolenic acid ratio on growth and visual function of term infants
J Pediatr.
Effect of docosahexaenoic acid supplementation of lactating women on the fatty acid composition of breast milk lipids and maternal and infant plasma phospholipids
Am J Clin Nutr
Growth and development of British vegan children
Am J Clin Nutr.
Effect of traditional oriental soy products on iron absorption
Am J Clin Nutr.
Absorption of zinc from soy protein meals in humans
J Nutr.
Dietary zinc intake and zinc concentrations of plasma, erythrocytes, and breast milk in antepartum and postpartum lactating and nonlactating womena longitudinal study
Am J Clin Nutr
Studies in human lactationsecretion of zinc, copper, and manganese in human milk
Am J Clin Nutr
Zinc absorption from composite meals I. The significance of wheat extraction rate, zinc, calcium, and protein content in meals based on bread
Am J Clin Nutr
Dietary interventions to prevent zinc deficiency
Am J Clin Nutr
Zinc and micronutrient supplements for children
Am J Clin Nutr
Zinc supplementation during lactation
Am J Clin Nutr
Sunshine exposure and serum-25-hydroxyvitamin D concentrations in exclusively breast-fed infants
J Pediatr.
Influence of dietary fat on the nutrient intake and growth of children from 1 to 5 y of agethe Special Turku Coronary Risk Factor Intervention Project
Am J Clin Nutr.
Development of childhood allergy in infants fed breast, soy, or cow milk
Allergy Clin Immunol.
Dietary plant materials and development of diabetes in the BB rat
J Nutr
Macrobiotic nutrition and child healthResults of a population-based, mixed-longitudinal cohort study in the Netherlands
Am J Clin Nutr.
Growth of vegetarian childrenThe Farm study
Pediatrics.
Do children on macrobiotic diets show catch-up growth?
Eur J Clin Nutr.
Nutritional status of infants aged 4 to 18 months on macrobiotic diets and matched omnivorous control infantsa population-based mixed-longitudinal study. II. Growth and psychomotor development
Eur J Clin Nutr.
Differences in fatty acid composition of human milk in vegetarian and nonvegetarian womenLong term effect of diet
J Pediatr Gastroenterol Nutr.
Nutrients and contaminants in human milk from mothers on macrobiotic and omnivorous diets
Eur J Clin Nutr.
Effect of race and diet on human-milk vitamin D and 25 hydroxyvitamin D
Am J Dis Child.
Riboflavin levels in the diet and breast milk of vegans and omnivores
Proc Nutr Soc.
Taurine concentrations in the diet, plasma, and urine and breast milk of vegans compared with omnivores
Br J Nutr.
Carnitine
Daidzein and genistein concentrations in human milk after soy consumption
Clin Chem.
Pollutants in breast milk of vegetarians [letter]
N Engl J Med.
Fatty acid patterns in triglycerides, diglycerides, free fatty acids, cholesteryl esters, and phosphatidylcholine in serum from vegetarians and nonvegetarians
Atherosclerosis.
Cited by (79)
Medical management of vegetarian and vegan children in France: Medical practices and parents’ perceptions
2024, Archives de PediatrieConsensus on complementary feeding from the Latin American Society for Pediatric Gastroenterology, Hepatology and Nutrition: COCO 2023
2023, Revista de Gastroenterologia de MexicoPerspective: The Public Health Case for Modernizing the Definition of Protein Quality
2019, Advances in NutritionPlanning Well-Balanced Vegetarian Diets in Infants, Children, and Adolescents: The VegPlate Junior
2019, Journal of the Academy of Nutrition and DieteticsFood group intake of children and adolescents (6-18 years) on a vegetarian, vegan or omnivore diet: results of the VeChi Youth Study
2022, British Journal of NutritionComplementary Feeding: Tradition, Innovation and Pitfalls
2024, Nutrients