Vegan Nutrition in Pregnancy and Childhood

By Reed Mangels, PhD, RD and
Katie Kavanagh-Prochaska, RD

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Basic Needs During Breastfeeding

The best diet for breastfeeding is very similar to the diet recommended for pregnancy. Protein recommendations are the same, vitamin B12 recommendations are higher, and the recommendations for iron and calories are lower than during pregnancy. Vitamin D, calcium, iodine, and DHA continue to be important. It is a good idea to use a standard prenatal vitamin shortly before, during, and after pregnancy, along with eating a well-balanced diet.

Basic Needs for Infants (0-1 year)

The ideal food for a vegan baby’s first year of life is breastmilk. Benefits to the breastfed baby include enhancement of the immune system, protection against infection, and reduced risk of allergies. Benefits to themominclude reduced risk of premenopausal breast cancer, release of stress-relieving hormones, and convenience. Breastfeeding may also help you lose weight, though you should not restrict calories when trying to establish milk supply. There may be other benefits we are not aware of yet.

VITAMIN D

Themost reliable way to get vitamin D is fromfortified foods or supplements. Vitamin D is synthesized in our skin with sunlight exposure. This synthesis is greatly reduced by sunscreen use. Since sunscreen should be used with sunlight exposure, dietary or supplemental vitamin D is needed. To prevent vitamin D deficiency in breast-fed babies, the American Academy of Pediatrics recommends that breast-fed babies be given a 400 IU/day vitamin D supplement beginning during the first few days after birth. Infant formula supplies adequate amounts of vitamin D. Vitamin D deficiency leads to rickets (soft, improperly mineralized bones).

IRON

The breastfed infant should be started on iron supplements or iron-fortified foods (like baby cereal) between 4 and 6 months. Formula fed babies will probably not need the supplement since infant formula contains iron. If you give iron supplements to your baby, ask your pediatrician for the correct dose.

SOY FORMULA

There are several soy-based formulas available. Vegan families should choose these if breastfeeding is not an option. Some soy-based formulasmay contain animal-derived fats, so check the ingredient label. Unfortunately, at the time of this writing, in the United States the food industry does not offer ANY soy-based formulas that do not include vitamin D derived fromlanolin, which comes from sheep’s wool. There are no other acceptable options for formula-fed vegan infants. Only consumer outcry is likely to change this situation.

It is important to note that soymilk, ricemilk, and homemade formulas should not be used to replace breastmilk or commercial infant formula during the first year. These foods do not contain the right amounts of nutrients for babies.

INTRODUCING SOLID FOODS

Most babies are ready to eat solid foods between 4 and 6months of age. Try to introduce one food at a time, waiting 2 to 3 days before trying another food, to see if the baby has a reaction to the food. If an allergic reaction occurs, the offending food is more easily identified.

Iron-fortified infant rice cereal is a good first food. It is an excellent source of iron, and rice cereal is least likely to cause an allergic response. Once the baby eats this cereal well, begin introducing other cereals such as oats, barley, and corn. Vegetables may be introduced next, again, one at a time to check for allergies. Vegetablesmust be well-mashed or puréed. Well-mashed potatoes and puréed carrots, peas, sweet potatoes, and green beans are good first vegetables.

Fruits are usually introduced after vegetables, theoretically in order to allow acceptance of vegetables before the sweet taste of fruits is experienced. Good first fruits are well-mashed bananas, pears, or peaches.

Protein foods are generally introduced around 7 to 10 months. Some good sources of protein include mashed, cooked dried beans; mashed tofu; and soy yogurt. Smooth nut and seed butters spread on bread or crackers can be introduced after the first birthday.

Some parents choose to use commercial baby foods. There are products made for vegetarian babies, but careful label reading is recommended. Many parents wish to make their own baby foods. These should be prepared without added sugar, salt, or spices. Foods should be well cooked, mashed or puréed, and handled under clean conditions.

Babies under age 2 need more calories and fat than at any other time in their lives. Fat is important in brain development. Some foods used to increase fat in the diet are mashed avocado, vegetable oil, and nut and seed butters spread on crackers (in children older than 1 year).

If a breast-feeding mother is not using a reliable source of vitamin B12, the baby needs a vitamin B12 supplement.

Feeding Vegan Children Toddlers through School-Age

Children, especially toddlers and preschoolers, often tend to eat less thanmost parents think they should. This is generally due to a developing sense of independence and a slow down in growth. All parents should schedule regular check-ups with their child’s pediatrician, in order tomonitor growth, development, and health. All parents need to make sure that what their child does eat, gives the child the nutrients he or she needs. The preschool years are an important time for developing healthy eating patterns, which can set the stage for a healthful adult diet.

CALORIES AND FAT

Young children have small stomachs and eating a lot of high fiber foodsmay not give themenough calories. A diet rich in fresh fruits, vegetables, and whole grains is also usually high in fiber. The fiber content of a vegan child’s diet can be reduced by offering him or her some refined grain products, fruit juices, and peeled fruits and vegetables. Foods like avocado, nut and seed butters, dried fruits, and soy products can pack a lot of calories into small quantities, which is great for the growing child. To promote synthesis of DHA, an important fat, include sources of alpha-linolenic acid like canola oil, flaxseed oil, and soy products in your child’s diet.

PROTEIN

A child will meet protein needs if a variety of plant foods are eaten and calorie intake is adequate. It is unnecessary to precisely plan and complement amino acids within eachmeal as was once thought, as long as children eat several meals and snacks a day. Variety is the key to a healthy diet. Sources of protein include legumes, grains, soy products, meat analogs, and nut butters.

CALCIUM

Calcium is very important for growing bones and teeth. Good sources of calcium include fortified soymilks, fortified ricemilks, and calcium-fortified orange juice, tofumade with calcium, blackstrap molasses, vegetarian baked beans, and textured vegetable protein (TVP). Because of the small size of a child’s stomach and the amount needed, leafy greens are not amajor source of calcium. However, the older child may be able to consume enough kale, collard greens, turnip, and mustard greens, along with other good sources of calcium, to meet needs.

ZINC

There is little available information on the zinc content of diets of vegan children. Zinc sources include legumes, whole grain pasta, wheat germ, fortified cereals, tofu, nut butters, and miso.

VITAMIN D

Dietary sources of vitamin D include some brands of fortified soymilk, fortified ricemilk, and some dry cereals. Vitamin D supplements are needed for children who have no dietary source of vitamin D. Sun exposure traditionally has been recommended for vitamin D production. Current recommendations call for the use of sunscreen, which greatly reduces vitamin D production by the skin, so sun exposure should not be relied on for vitamin D adequacy. Remember that children need to wear sunscreen outdoors.

VITAMIN B12

Vegan children should use foods fortified with vitamin B12 or vitamin B12 supplements. A variety of foods fortified with vitamin B12 are available, including some brands of soymilk,meat analogs, fortified nutritional yeast, and some breakfast cereals.

IRON

Iron deficiency anemia is a common childhood nutritional problem, nomatter what the diet. Good iron sources include whole or enriched grains and grain products, iron-fortified cereals, legumes, green leafy vegetables, and dried fruits. Vitamin C helps the body absorb iron, so offer citrus fruits with iron-rich foods.

CHOKING RISKS

Toddlers and preschoolers are at increased risk of choking because they are still learning to chew and swallow, they may not have a full set of teeth yet, and theymay not want to take the time to chew food carefully. Tominimize choking risk, the following foods should be avoided or eaten only with supervision:

  • Nuts, except when finely ground.
  • Nut butters by the spoonful.
  • Vegetarian hot dogs, unless sliced into tiny pieces the size of a pea.
  • Cherry tomatoes, unless halved or quartered.
  • Grapes, unless cut in half. Peeling may be needed for young toddlers.
  • Raw cherries, unless pitted and sliced.
  • Raw celery and whole raw carrots.
  • Popcorn.
  • Bagels with nut butter or hummus.

MEAL PLANNING IDEAS

Popular foods with vegan children include:

  • Pizza, without cheese, and topped with vegetables, tofu, or meat analogs.
  • Pasta with marinara sauce.
  • Oven-baked French fries.
  • Soy yogurt.
  • Macaroni and soy cheese.
  • Milkshakes made with calcium fortified soymilk and fruit.
  • Peanut butter and jelly sandwiches.
  • Fresh or dried fruit.
  • Pancakes and waffles.
  • Noodles with peanut butter sauce.
  • Raw vegetables with dip.
  • Muffins.
  • Mashed potatoes.
  • Veggie burgers.

GENERAL TIPS
  • Use an iron skillet when preparing acidic foods, such as tomato sauce. This helps “unlock” the iron.
  • Be sure your non-dairymilk alternative is fortified with vitamins D and B12, as well as calcium.
  • Good sources of zinc are peas, beans, brown rice, nuts, spinach, tofu, wheat germ, fortified breakfast cereals, and tempeh.
  • Introduce one new food at a time to your baby in order to identify possible allergens.
  • Do not restrict fat in your baby’s diet before 2 years of age. Babies need fat for brain development. Some sources of fat are avocados, olive oil, and nut butters.
  • Most foods, such as pancakes or muffins, can also bemade vegan.

Sample Meal Plan for Vegan Pregnancy

BREAKFAST
1/2 cup oatmeal with maple syrup
1 slice whole wheat toast with fruit spread
1 cup fortified soymilk
1/2 cup calcium-fortified orange juice
MORNING SNACK
1/2 whole wheat bagel with margarine
1 banana
LUNCH
Veggie burger on whole wheat bun with mustard and ketchup
1 cup steamed collard greens
Medium apple
1 cup fortified soymilk
AFTERNOON SNACK
3/4 cup ready-to-eat cereal with 1 cup blueberries
1 cup fortified soymilk
DINNER
3/4 cup tofu stir-fried with 1 cup vegetables
1 cup brown rice
Medium orange
EVENING SNACK
Whole grain crackers with 2 TB peanut butter
4 ounces apple juice
This sample meal plan provides approximately 2200 calories, 100 gm protein, 55 gm fat (22% of calories), and 336 gm carbohydrate. This samplemeal plan meets recommendations for calcium, zinc, vitamin B12, folate, thiamin, riboflavin, and niacin. Supplemental iron and vitamin D may be needed.

Feeding Schedule for Vegan Babies Ages 4-12 Months

  4-7 MOS* 6-8 MOS* 7-10 MOS 10-12 MOS
Milk Breast milk or soy formula. Breast milk or soy formula. Breast milk or soy formula. Breast milk or soy formula (24-32 ounces).
Cereal & Bread Begin iron-fortified baby cereal mixed with milk. Continue baby cereal. Begin other breads and cereals. Baby cereal. Other breads and cereals. Baby cereal until 18 mos. Total of 4 svgs (1 svg=1/4 slice bread or 2-4 TB cereal).
Fruits & Vegetables None Begin juice from cup: 2-4 oz vit C source. Begin mashed vegetables and fruits. 4 oz juice. Pieces of soft/cooked fruits and vegetables. Table-food diet. Allow 4 svgs per day (1 svg=2-4 TB fruit and vegetable, 4 oz juice).
Legumes & Nut Butters None None Gradually introduce tofu. Begin casseroles, puréed legumes, soy cheese, and soy yogurt. 2 svgs daily each about 1/2 oz. Nut butters should not be started before 1 year.

*Overlap of ages occurs because of varying rate of development.


Diet Plans for Vegan Children
Toddlers and Preschoolers (Ages 1-3)

FOOD GROUP NUMBER OF SERVINGS
Grains 6 or more servings. A serving is 1/2 to 1 slice of bread; 1/4 to 1/2 cup cooked cereal, grain, or pasta; 1/2 to 3/4 cup ready-to-eat cereal.
Legumes, Nuts, Seeds 2 or more servings. A serving is 1/4 to 1/2 cup cooked beans, tofu, tempeh, or TVP; 1 1/2 to 3 ounces of meat analog; 1 to 2 TB nuts, seeds, or nut or seed butter.
Fortified Soymilk, etc. 3 servings. A serving is 1 cup fortified soymilk, infant formula, or breast milk.
Vegetables 2 or more servings. A serving is 1/4 to 1/2 cup cooked, or 1/2 to 1 cup raw vegetables.
Fruits 3 or more servings. A serving is 1/4 to 1/2 cup canned fruit, 1/2 cup juice, or 1 medium fruit.
Fats 3 servings. A serving is 1 tsp. margarine or oil. (Use 1/2 tsp. flaxseed oil or 2 tsp. canola oil daily to supply omega-3 fatty acids.)

Diet Plans for Vegan Children
Children (Ages 4-13)

FOOD GROUP NUMBER OF SERVINGS
Grains 8 or more for 4 to 8 yr olds; 10 or more for 9 to 13 yr olds. A serving is 1 slice of bread; 1/2 cup cooked cereal, grain, or pasta; 3/4 cup ready-to-eat cereal.
Protein Foods 5 or more for 4 to 8 yr olds; 6 or more for 9 to 13 yr olds. A serving is 1/2 cup cooked beans, tofu*, tempeh, or TVP; 1 cup fortified soymilk*; 1 ounce of meat analog; 1/4 cup nuts or seeds*; 2 TB nut or seed butter*.
Vegetables 4 or more. A serving is 1/2 cup cooked, or 1 cup raw vegetables*.
Fruits 2 or more. A serving is 1/2 cup canned fruit, 1/2 cup juice*, or 1 medium fruit.
Fats 2 or more for 4 to 8 yr olds; 3 ormore for 9 to 13 yr olds. A serving is 1 tsp. of margarine or oil.
Omega-3 Fats 1 per day. A serving is 1 tsp. flaxseed oil, 1 TB of canola or soybean oil, 1 TB ground flaxseed, 1/4 cup walnuts.
Starred Food Items 6 or more for 4 to 8 yr olds; 10 or more for 9 to 13 yr olds. A serving is 1/2 cup calcium-set tofu; 1 cup calcium-fortified soymilk, orange juice, or soy yogurt; 1/4 cup almonds; 2 TB tahini or almond butter; 1 cup cooked or 2 cups raw broccoli, bok choy, collards, kale, or mustard greens.

Notes:

For the starred servings, these also count as servings from the other groups at the same time. They aren’t additional. The items in the Starred Food Items listing are the foods you want since they are high in calcium. Serving sizes vary depending on the child’s age.

The calorie content of the diet can be increased by greater amounts of nut butters, dried fruits, soy products, and other high calorie foods.

A regular source of vitamin B12 like Vegetarian Support Formula nutritional yeast, vitamin B12 fortified soymilk, vitamin B12 fortified breakfast cereal, vitamin B12 fortified meat analogs, or vitamin B12 supplements should be used.

Adequate exposure to sunlight, 20 to 30 minutes of summer sun on hands and face two to three times a week, is recommended to promote vitamin D synthesis. If sunlight exposure is limited, supplemental vitamin D should be used.

The information in this brochure was modified from Simply Vegan, 4th edition. The contents of this handout and other VRG publications are not intended to provide personal medical advice, which should be obtained from a qualified health professional.


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