Vegan Nutrition in Pregnancy and Childhood
By Reed Mangels, Ph.D., R.D. and
Katie Kavanagh-Prochaska, Dietetic Intern
From the Vegetarian Resource Group
Basic Needs in Pregnancy
During pregnancy, the body requires extra calories, protein,
vitamins, and minerals in order to support the baby's growth and to
allow for changes in the mother's body. Important considerations in
pregnancy include calories, protein, vitamin B12, iron, calcium, vitamin
D, zinc, and folate.
Calories
Pregnant women, in general, need an additional 300 calories per day,
beginning in the second trimester. The extra calories allow for the
mother's body to change and the baby to grow. Your calorie needs may
vary according to your pre-pregnancy weight and the amount of weight
which you need to gain. Adding nutritious snacks to your daily routine
is one way to get extra calories. A sample meal plan for vegan
pregnancy, which includes three snack ideas, can be found inside this
brochure.
Protein
Protein recommendations in pregnancy call for an additional 10 grams
(for 25-50 year olds) or 14 grams (for 19-24 year olds) of protein. Some
examples of protein-rich foods are plain, enriched soymilk; tofu;
tempeh; cooked beans; and nuts and nut butters. Eating a wide variety of
nutritious foods will help pregnant women get the additional protein
they need.
Vitamin B12
Vitamin B12 is used for tissue synthesis and requirements are increased
during pregnancy. Some good sources of vitamin B12 are vitamin B12
fortified soymilks and fortified tofu, some fortified ready-to-eat
cereals, and Vegetarian Support Formula nutritional yeast. A little more
than a tablespoon of Vegetarian Support Formula will provide the
recommended amount of vitamin B12. This is a critical nutrient, so if
your diet does not include these foods daily, use a vegetarian prenatal
vitamin with vitamin B12.
Iron
Iron is needed for increased maternal blood volume and to form the
baby's blood. Anemia can be a problem during any pregnancy, regardless
of your diet. All pregnant women need to eat foods rich in iron, such as
green leafy vegetables, dried beans and legumes, and dried fruits.
Eating iron-rich foods with citrus fruits can increase iron absorption.
An iron supplement may be necessary if you cannot get enough iron from
your diet.
Calcium/Vitamin D
Calcium and vitamin D work together for bone and teeth health and
development. Calcium absorption increases in pregnancy and may
compensate for increased needs. Pregnant women should eat 4 or more
servings of calcium-rich foods daily, including some green leafy
vegetables, and calcium-fortified tofu, soymilk, and orange juice.
Calcium supplements, on days your appetite is poor, are also an option.
Vitamin D is found in fortified soymilk and fortified breakfast cereals.
Zinc
Zinc is necessary for growth and development. The recommended intake for
zinc increases during pregnancy. Good sources of zinc include peas,
beans, brown rice, spinach, nuts, tofu, and tempeh.
Folate
Folate is important even before you know you are pregnant, so all women
of childbearing age should be getting at least 400�g (micrograms) per
day. The need for folate increases in pregnancy, to 600�g per day. Dark
leafy greens, whole grains, and orange juice are rich sources of folate.
Vegan diets are often high in folate.
Basic Needs During Breastfeeding
The best diet for breastfeeding is very similar to the
diet recommended for pregnancy. Calorie, protein, and vitamin B12 needs
are slightly higher, while the need for iron is reduced. 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 years)
The ideal food for a vegan baby's first year of life
is breast milk. Benefits to the breastfed baby include enhancement of
the immune system, protection against infection, and reduced risk of
allergies. Benefits to the mom include 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
The most reliable way to get vitamin D is from
fortified 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 any sunlight exposure, dietary
or supplemental vitamin D is needed. Babies under 6 months of age should
not be exposed to the sun for long periods of time. After 6 months of
age, use a sunscreen formulated specifically for baby's skin. Breastfed
infants should be supplemented with 5�g (200IU) of vitamin D daily.
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 may not need the supplement since infant
formula contains iron. Iron-fortified cereals provide additional iron.
If you give iron supplements to your baby, ask your pediatrician for the
correct dose.
DHA
DHA is a fatty acid which appears to be important for eye
and brain development. It is found primarily in animal derived foods.
However, babies can make DHA from another fatty acid called linolenic
acid which is found in breast milk if the mother's diet includes good
sources of linolenic acid (flaxseed oil, ground flaxseed, canola oil,
soy oil).
Soy Formula
There are several soy-based formulas
available. Vegan families should choose these if breastfeeding is not an
option. Some soy-based formulas may contain animal�derived fats, so
check the ingredient label. Unfortunately, at the time of this writing,
in the US the food industry does not offer ANY soy-based formulas that
do not include vitamin D derived from lanolin, 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, rice milk,
and homemade formulas should not be used to replace breast milk or
commercial infant formula during the first year. These foods do not
contain the right amounts of nutrients for babies.
Introducing Solid Foods
Solid foods should be introduced between 4 and
6 months 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. Vegetables must be well-mashed or pur�ed. Well-mashed
potatoes, 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 8
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 pur�ed, 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.
For a more detailed discussion of vegan pregnancy,
you can purchase
Simply Vegan, by Debra Wasserman and Reed Mangels, Ph.D., R.D. This
book is available from The Vegetarian Resource Group. Healthcare
practitioners may wish to consult the "Nutrition Management of the
Vegetarian Child" chapter from the Pediatric Manual of Clinical
Dietetics, from The American Dietetic Association.
Feeding Vegan Children
Toddlers through School-Age
Children, especially toddlers and
preschoolers, often tend to eat less than most 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 to monitor 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 foods may not give them enough 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 source of 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 each
meal 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
rice milks, and calcium-fortified orange juice, tofu made 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 a major 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 rice milk, and some dry cereals.
Vitamin D supplements are needed for children who have no dietary source
of vitamin D. Sun exposure has traditionally 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 always 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, no matter 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.
http://www.vrg.org/nutrition/pregnancy.htm
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