Vegan Nutrition with Dina Aronson, M.S. R.D.
Dina Aronson, MS, RD is a vegan dietitian whose specialties include chronic disease prevention, vegetarian/vegan nutrition, and lifestyle management. She is the founder and director of VeganRD.com, a nutrition consulting company. Active in many vegetarian nutrition organizations, Dina was the recipient of the American Dietetic Association's Recognized Young Dietitian of the Year Award in 2002.
The media was buzzing last month about the tragic death of a 6-week old infant, who died of malnutrition. The parents are vegan. Do we have good reason to worry about raising our babies and children as vegans?
Unfortunately, people jumped to conclusions before actually reading the article describing the circumstances of baby Crown's death. Please take a minute to read the original story "Vegan Parents Get Life In Prison For Death Of Son."
Despite the last sentence of the article ("They noted that Crown was born in a bathtub in an apartment across the street from a hospital and never received professional medical care.") which I believe to be one of the most significant players in this tragedy, the media buzz over this case stemmed from an opinion piece in the New York Times, eerily entitled Death By Veganism.' It was written by Nina Planck, a food writer. Her letter was so wrought with lies and errors, that a correction was later printed by the New York Times.
Fortunately, Dr. John McDougall accurately addresses Ms. Planck's nutritional errors. I agree wholeheartedly with each scientific explanation Dr. McDougall offers. In addition, Amy Joy Lanou, PhD wrote an excellent letter to the NYT editor.
Unfortunately, Nina Planck did some serious damage to the credibility of the vegan diet, and it is a shame that people will believe what they read, even without a shred of scientific evidence to back it up.
The bottom line is that this poor baby died as a result of not being fed enough. Soy milk is inappropriate for infants (as anyone who can read knows, as this statement appears in bold letters on soy milk cartons), and apple juice is equally inappropriate for newborns. Vegans and non-vegans alike know this. If this baby were fed nothing but beef-and-water puree, would readers conclude that a meat-containing diet were to blame? Of course not. Veganism was a lame attempt of an excuse to get the parents out of a jail sentence. Fortunately, it did not work, because veganism did not kill the baby; negligence did.
Regarding Ms. Planck's letter, here is one such damaging statement:
"I was once a vegan. But well before I became pregnant, I concluded that a vegan pregnancy was irresponsible."
Beyond the fact that Ms. Planck offers no scientific explanation whatsoever for this statement (as one does not exist), one may read between the lines. This is just my opinion, but I wonder if it's possible that Ms. Planck's frank condemnation of veganism is her feeble attempt to justify her own personal failure at being a vegan? Why was she vegan in the first place, and what changed her mind? Something had to compel her to shun animal products, so she's obviously not blind to the cruelty inherent in the animal agriculture industry, the devastating consequences of a meat-based diet on the environment, and the injurious health outcomes brought about by the consumption of animal foods. What caused her to reintroduce animal foods, and was the switch made with a clear conscience? If she were comfortable with her own lifestyle, would she be compelled to slam one that she once embraced? I wonder this especially as a registered dietitian, as well as a mother of a 1-year old vegan who enjoys outstanding health (I also had an entirely vegan pregnancy). I am proud that my son speaks in complete sentences (yes, he shocks nearly everyone with his language skills), is bright and attentive, has grown perfectly since birth (at which he was a healthy 7lbs, 14 oz), and runs circles around his peers. Evidently, my son's veganism has served him quite well.
Nevertheless, this incident may have left people confused (at best) about the appropriateness of vegan diets for infants.
[Editor's note: For an update regarding the Nina Planck article see our news feature NY Times Reprimanded by its public editor for "Death By Veganism" piece.]
A book can be written on the subject, but here are the main points regarding a safe and healthy vegan pregnancy, lactation period, and first year of life for healthy moms and babies (those with health issues, vegan or not, may have additional nutritional needs). This is not meant to be a substitute for personalized diet advice from a qualified health practitioner; it is intended for informational purposes only.
During pregnancy, it is essential to consume a wide variety of wholesome plant foods with sufficient quantity, providing the right balance of energy, vitamins, minerals, and fats, as the nutritional status of the mom directly affects that of the baby. All mothers, regardless of type of diet, should take a multi-vitamin and mineral supplement during pregnancy and follow a balanced, nutrient-rich diet with enough energy to support expected weight gain.
Pregnant women require an additional 200-300 calories per day during the second and third trimesters, an additional 10-15 grams of protein, 600 micrograms of folic acid, and 1000 milligrams of calcium (same as the recommendation while not pregnant). These guidelines are the same for all women, regardless of diet.
Here's what a pregnant vegan needs to pay closer attention to. She needs 2.6 micrograms of vitamin B12, 5 micrograms (200 International Units) of vitamin D, 27 milligrams of iron (not necessarily all from a supplement; this may cause problems), and 11 milligrams of zinc. She should optimize her intake of omega-3 fatty acids (from flax, rapeseed oil, etc.), and insure she's getting enough by adding a supplement containing 200-300 milligrams of DHA.
Bottom line: Optimal intake of energy and nutrients is not difficult using a well-planned, nutrient dense vegetarian diet, with a reliable source of vitamin D, vitamin B12, and omega-3 fatty acids.
During lactation (breast feeding period), the daily recommendations are 500 extra calories, 2.8 micrograms of vitamin B12, 5 micrograms (200 International Units) of vitamin D, 9 milligrams of iron, 12 milligrams of zinc, and the same fatty acid guidelines as during pregnancy. As always, the breast feeding mom needs to optimize her intake of nutrient-dense, wholesome plant foods from all of the food groups.
During the first four months of life, the ONLY food given should be breast milk or infant formula, in amounts to sustain normal growth and development (the vast majority of healthy infants regulate their own intake beautifully, especially those that are breast fed). If the mother was and is careful with her B12 intake, infant supplementation is not necessary; if there is any question of the mother's B12 status, then a B12 supplement for the baby is recommended (0.4 micrograms). Unless the baby has significant amounts of sun exposure in non-northern climates, a daily vitamin D supplement (5 micrograms or 200 International Units) is recommended (caretakers must be careful not to give more than this).
From four months to a year, breast milk or iron-fortified infant formula is the primary source of nutrition, with other foods being introduced as tolerated (more detailed information on starting foods can be found in other features on this web site). Breastfed infants needing a B12 supplement after 6 months should receive a slightly higher dose (0.5 micrograms); 5 micrograms of vitamin D is still the right amount for supplementation. Breast feeding is encouraged beyond a year to help optimize nutrient intake in the infant.
Bottom line: Breastfed infants may need vitamin D drops, and breastfeeding moms should maximize her B12 and omega 3 intake via supplements and/or fortified foods, as well as obtain excellent nourishment from a variety of whole plant foods. Formula-fed infants should be given a formula with DHA/ARA added.
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