Vegan Nutrition with Dina Aronson, M.S. R.D.

I am currently pregnant and planning on nursing this baby, but my first child had multiple food allergies and the doctor is recommending that I avoid the main allergens while nursing. I don't have any problem avoiding eggs and milk, obviously. However, I remember that I couldn't eat beans while nursing last time - and I relied on soy proteins quite a bit. If I can't have beans, soy, or tree-nuts I'm kind of at a loss for what I can do! Is it feasible to continue planning on nursing this baby? With all these limitations, I'm having a hard time figuring out what I can eat!
Thanks!
Andi

Article continues below

Dear Andi,
It is indeed challenging to design a diet during lactation that will both reduce the risk food allergy and supply adequate nutrition for both you and your baby. Yes, it is feasible to plan on nursing your baby! Even though there is a risk of passing an allergy to your baby through your breastmilk (and of course, formula feeding is not risk-free either), breastfeeding is still the superior method of nutrition for your baby due to immunity benefits, reduced risk of infection, and a host of other benefits - many of which actually protect the baby against food allergies in the long run! (See this article for information and resources about breastfeeding.)

First, the bean issue. I'm not sure why you couldn't eat beans while nursing the last time, however these high protein legumes make an excellent contribution in minerals, B vitamins such as folate, and fiber and it is likely that some among this group can be your mainstays. About twenty types of legumes are commonly eaten, and it is probably that some will have little tendency to trigger reactions, so it would be good to revisit the possibility of including at least some legumes in your diet during lactation. If the beans repeated on you (or your baby), there are several things you can do to eat legumes with ease:

1. Since some beans are harder to digest than others, rely on small beans such as lentils, split peas, adzuki beans, and small white beans. These are easier to tolerate than other legumes and are unlikely to cause an allergic reaction.

2. Cook beans, split peas, and lentils extremely well. Peas and lentils do not require presoaking, though they should be well cooked (and pre-soaking is optional). Rinse beans several times during the soaking and cooking stages, discarding the bean water along the way. This will eliminate most of the oligosaccharides, the carbohydrates that are often the culprits for belly discomfort and gas some get from eating beans.

3. Eat lentils and beans in small quantities, with other foods and with plenty of water. If your first baby was allergic to beans, then it is a good idea to avoid beans while nursing. But it is unlikely that babies are allergic to ALL beans - usually they are allergic to only one or two types (if any at all), with lentils being the least allergenic. Split peas are a good bet too, so you can enjoy some lovely pea soups. I hope you are able to tolerate some beans and lentils while nursing, because they are so versatile and such an excellent source of important nutrients.

Second, the allergy issue. Because your first baby had food allergies, it is definitely a good idea to avoid certain allergens while you nurse, because food allergies run in families and the risk of your baby getting the food proteins from your milk - and leading to food allergy in your baby (called "sensitization") - is a real possibility.

I agree that it's a good idea for you to eliminate from your diet all the foods that you know your first baby was or is allergic to. Your doctor also recommends that you avoid the "main allergens," which include:

Dairy products, eggs, fish, shellfish (none of which you will consume because you are vegan)
Peanuts
Tree nuts
Soy
Wheat

Based on the scientific literature on food allergy risk, I recommend avoiding all peanuts and other nuts while breastfeeding, whether or not your first baby had reactions to them. This is because peanuts and tree nuts are the most likely to cause life-threatening allergic reactions, and allergies to nuts are not typically outgrown. But if your first baby never had a problem with soy or wheat, since they are such important sources of nutrients in the vegan diet (especially during lactation), it is probably OK to eat these in small amounts and observe whether your baby has any adverse reactions two to eight hours after you eat a certain item.

Because of your family history, no matter what you decide while breastfeeding your new baby, I recommend keeping a detailed food diary with everything you consume, the time you ate the food, and the amount you consume. At the same time, track any allergic symptoms your baby may display. These symptoms include skin rashes, changes in the stool, runny nose, colic, and excessive spitting up. (Should your baby appear to have difficulty breathing, seek emergency medical help immediately.) Write down the symptoms, the severity of the symptoms, and the times they appear and disappear. This data can help you identify food triggers that your baby is not tolerating well, and you can eliminate those foods from your diet.

Here is a list of just a few nutrient dense, low allergenic foods:

seeds
If your first baby has not had reactions to seeds, you can eat about 1/2 cup a day these little gems for a blast of protein, vitamins, and minerals. Spread them over one or more meals/snacks, and of course watch for a possible reaction in your baby. Best choices are flax seeds (grind them first), pumpkin seeds, sesame seeds, and sunflower seeds. You can also enjoy them as seed butters (ground up seeds) to spread on rice crackers and raw vegetables.

leafy greens
About 1/3 of the calories from leafy greens comes from protein. Not only that, but they are chock full of calcium and other important nutrients. Because you need 500 extra calories per day, and greens are quite low in calories, maximize your intake of greens (especially collard greens, kale, turnip greens, and Chinese greens) by cooking them. Try to include cooked greens in at least one meal per day. It's easier to eat 2 cups of chopped, sauteed, seasoned kale, for example, than a 4-cup raw green salad (which have approximately the same nutrition content). (Note that spinach, beet greens and Swiss chard are not in this group as the calcium in these is not easily absorbed.)

dried fruits
Dried fruits are nature's candy, and they are a concentrated source of calories and minerals. Have a few pieces a day, but don't go overboard because they are also high in sugar.

whole, intact grains
When most people think of whole grains, they think of bread. But the healthiest way to eat whole grains is by consuming the intact form. For example, buckwheat groats, millet, and quinoa are all high in vitamins, minerals, fiber, and moderate in protein, and very low in allergenicity.

Here's a low-allergy sample menu, providing about 2500 calories. It is close to meeting the RDA for all nutrients. This menu is adapted from Food Allergy Survival Guide, an upcoming book on food allergies, written by Vesanto Melina, Jo Stepaniak, and myself. If you and your baby can tolerate soy products, include 2-3 servings per day of foods like tofu, tempeh, and fortified soy milk and soy yogurt. I recommend that you take a daily multivitamin/mineral supplement while breastfeeding; choose a hypoallergenic vegan brand, such SISU, Nutricology, Kirkman, Quest and NuLife.

Breakfast
1 cup calcium-fortified beverage (juice, soy or rice milk, or half cup of each)
1 cup whole grain cereal
1/4 cup toasted pumpkin seeds
1 banana

Snack
2 wheat free vegan cookies or other treat with tolerated ingredients

Lunch
1 cup mashed seasoned lentils
4 brown rice cakes
1 cup carrot sticks or other raw veggies
1 apple

Snack
1 oz organic corn chips with 1/4 cup mashed avocado (or guacamole) and 1/4 cup salsa

Dinner
2 cups mixed vegetable and potato curry
1 cup quinoa with fresh or dried herbs
1 cup steamed kale sprinkled with toasted sesame oil and ground flax seeds (added after cooking)

Snack
1 cup fruited, fortified soy yogurt (if tolerated) or Rice Dream beverage or frozen dessert

Disclaimer: The advice given here is for eductional purposes only. You should not use this information to diagnose or treat a health problem or disease without consulting with a qualified health care provider.
See full index of questions

Sponsors: