Considerations in planning vegan diets: infants

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Abstract

Appropriately planned vegan diets can satisfy nutrient needs of infants. The American Dietetic Association and The American Academy of Pediatrics state that vegan diets can promote normal infant growth. It is important for parents to provide appropriate foods for vegan infants, using guidelines like those in this article. Key considerations when working with vegan families include composition of breast milk from vegan women, appropriate breast milk substitutes, supplements, type and amount of dietary fat, and solid food introduction. Growth of vegan infants appears adequate with post-weaning growth related to dietary adequacy. Breast milk composition is similar to that of non-vegetarians except for fat composition. For the first 4 to 6 months, breast milk should be the sole food with soy-based infant formula as an alternative. Commercial soymilk should not be the primary beverage until after age 1 year. Breastfed vegan infants may need supplements of vitamin B-12 if maternal diet is inadequate; older infants may need zinc supplements and reliable sources of iron and vitamins D and B-12. Timing of solid food introduction is similar to that recommended for non-vegetarians. Tofu, dried beans, and meat analogs are introduced as protein sources around 7-8 months. Vegan diets can be planned to be nutritionally adequate and support growth for infants. J Am Diet Assoc. 2001; 101:670–677.

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.

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