A vegan diet is OK during pregnancy and early childhood
-- provided you mind your peas and quinoas.
From baby guru Benjamin Spock to the American Dietetic Association, the diet gets the nod during these nutritionally demanding periods, though pediatricians and dietitians alike say the key is knowing what you are doing.
"Vegan diets are becoming more and more popular, and parents who are vegan and adhere to a vegan diet are likely to raise a child on a vegan diet," said Staci Nix, director of the nutrition clinic at the University of Utah. "There are some concerns, but an educated person can do it safely."
Often referred to as "pure vegetarians," vegans eat no animal products for ethical reasons: no flesh, no dairy products, no eggs or honey. Vegans rely instead on vegetables, grains, fruits, seeds, beans and nuts.
Nix said pregnancy is not the time for a beginner to switch to veganism. "It takes a lot of energy and education to do the diet," she said. "It's learning a whole new way of eating."
For moms-to-be who are already committed vegans, the challenge is ensuring she and her baby are getting adequate amounts of calcium, vitamin B-12 and iron. (See box, D3.)
Babies who are breast-fed should be just fine, provided the mother's diet is nutritionally sound. If a mother chooses not to or can't breast feed, the baby can be given a soy- or rice-based formula -- not cow milk, which is inadequate for infants -- though Nix said some infants don't do as well on those products.
When it's time for solid foods, most infants start out on a vegetarian diet anyway -- mashed vegetables and fruits and iron-fortified cereals.
On occasion, parents make the news after taking a vegan diet to an extreme or being uninformed about what it takes to meet a growing child's nutritional needs. Some examples: A 9-month-old British child died of malnutrition in 2001 after her parents, who followed a fruitarian diet of raw fruits and vegetables and nuts, provided her with only tomato juice and water.
That same year, a 6-month-old Australian boy died of complications associated with a deficiency of vitamin B-12, which usually comes from animal sources and must be supplemented through other means for vegans. He had been breast-fed, but the vitamin was lacking in the breast milk of his mother, a vegan and Seventh-day Adventist who refused conventional medical intervention for the boy on religious grounds.
In Utah, Christopher and Kyndra Fink ran afoul of the law in 1999 after their toddler became severely malnourished on a diet of fruits, vegetables and nuts.
More recently, Joseph and Silva Swinton of New York City were convicted of child endangerment after their 16-month-old daughter nearly died of malnutrition while being fed a diet of nuts, milk, fresh-squeezed fruit juices, herbal tea, beans, cod-liver oil and flax-seed oil.
The common thread in the cases, experts said, is that they reflect a lack of understanding of the nutritional needs of children and the complexities of a restricted diet.
"The fact there may have been an absence of animal products doesn't mean it was a vegan diet," said Robin Robertson, a former chef and author of Vegan Planet. The diets "had no basis in sound nutrition, which the vegan diet does."
Being vegan requires more than eliminating meat, dairy and eating whatever is left over on the plate, Robertson said. "You're going to be missing an awful lot of nutrition. That's how people end up feeling hungry, tired or weak. That's the wrong way to do it."
Nix adds that what adults can survive on is not the same as what infants need or can tolerate.
"When they are fed food they can't digest, they get a lot of allergies and reactions," Nix said.
Some medical studies highlight the care that must be taken to meet nutritional needs of children fed a vegan diet.
A Swedish study published in the American Journal of Clinical Nutrition last year found that vegans may be deficient in calcium and some B vitamins, of particular concern for growing teens.
Earlier this year, a report by the U.S. Centers for Disease Control and Prevention documented the cases of two toddlers in Georgia who suffered brain impairment attributed to vitamin B-12 deficiencies traced to their vegan mother's breast milk and vegan diets they were later fed. subsequent vegan diets.
So what's the right way to stay vegan during pregnancy and early childhood and avoid problems? Get educated, recheck what you're eating, see a nutritionist, use supplements and fortified foods and be vigilant about ensuring you and your child are getting adequate amounts of critical nutrients. (See box at right.)
A pregnant women should stay attuned to how she feels. Lack of energy could be a sign of problem. Behavior is a good indicator in babies and toddlers; delays in reaching developmental milestones may be an indicator a diet is inadequate.
"You have to know what you're doing and be conscious of how you create your diet covering all aspects of nutrition," said Robert Baker, a professor of pediatrics at Children's Hospital of Buffalo, N.Y., and a member of the American Academy of Pediatrics' nutrition committee. "It's not impossible, but it's difficult. If you do work to make it adequate, you can."
Seven Degrees of Vegetarianism
Fruitarians exclude all foods made by or from animals, eating mostly raw and dried fruits, nuts, honey and olive oil.
Ovo-lacto vegetarians eat eggs and milk products, but avoid other animal products. Diet is mostly vegetables, grains, fruits, seeds, beans and nuts.
Ovo vegetarians eat eggs but no other animal products. Diet is mostly vegetables, grains, fruits, seeds, beans and nuts.
Lacto vegetarians eat milk products but avoid other animal products. Diet is mostly vegetables, grains, fruits, seeds, beans and nuts.
Pesco vegetarians eat fish, vegetables, grains, fruits, seeds, beans and nuts.
Pollo vegetarians eat chicken, vegetables, grains, fruits, seeds, beans and nuts.
Vegans exclude all foods made by or from animals, often including honey, choosing instead to eat vegetables, grains, fruits, seeds, beans and nuts.
Want to know more? Check out these resources:
Pregnancy, Children and the Vegan Diet by Michael Klaper
Vegan Planet by Robin Robertson
Becoming Vegan by Vesanto Melina and Brenda Davis
New Vegetarian Baby by Sharon Yntema and Christine Beard
Vegan Nutrition: Pure and Simple by Michael Klaper
On the Web:
http://www.eatright.com (American Dietetic Association)