Feeding Vegan Kids
by Reed Mangels, Ph.D., R.D.
From the Vegetarian Resource Group
Many members of The Vegetarian Resource Group are glowing testimony to
the fact that vegan children can be healthy, grow normally, be extremely
active, and (we think) smarter than average. Of course it takes time and
thought to feed vegan children. Shouldn't feeding of any child require
time and thought? After all, the years from birth to adolescence are the
years when eating habits are set, when growth rate is high, and to a
large extent, when the size of stores of essential nutrients such as
calcium and iron are determined.
The earliest food for a vegan baby is ideally breast milk. Many
benefits to the infant are conveyed by breast feeding including some
enhancement of the immune system, protection against infection, and
reduced risk of allergies. In addition, breast milk was designed for
baby humans and quite probably contains substances needed by growing
infants which are not even known to be essential and are not included in
infant formulas.
Many books on infant care have sections on techniques and timing of
breast feeding, and we suggest that you refer to one of these for more
information. Be forewarned that the books may discourage vegetarianism.
They are wrong. With a little attention to detail, vegetarianism and
breast feeding are a good combination. In fact, several reports show
that milk of vegetarian women is lower in pesticides than the milk of
women eating typical American diets (1,2).
If you choose to breast feed, be sure to see the preceding section on
lactation to make sure that your milk is adequate for your child. Be
especially careful that you are getting enough vitamin B-12. If your
diet does not contain reliable sources of vitamin B-12, your breastfed
infants should receive supplements of 0.4-0.5 micrograms of vitamin B-12
daily.
See that your infant receives at least 30 minutes of sunlight
exposure per week if wearing only a diaper or 2 hours per week fully
clothed without a hat to maintain normal vitamin D levels (3).
Dark-skinned infants require greater sunshine exposure. If sunlight
exposure is limited, due to factors like a cloudy climate, winter, or
being dark-skinned, infants who are solely breastfed should receive
vitamin D supplements of at least 5 micrograms (200 IU) per day (4).
Vitamin D deficiency leads to rickets (soft, improperly mineralized
bones). Human milk contains only very low levels of vitamin D.
The iron content of breast milk is generally low, no matter how good
the mother's diet is. The iron which is in breast milk is readily
absorbed by the infant, however. The iron in breast milk is adequate for
the first 4 to 6 months or longer. Recommendations call for use of iron
supplements (1 mg/kg/day) beginning at 4-6 months to insure adequate
iron intake. Breast fed infants may require supplemental fluoride after
6 months if water intake is low and if supplements are prescribed by a
dentist or pediatrician.
If for any reason you choose not to breast feed or if you are using
formula to supplement breast feeding, there are several soy-based
formulas available. These products support normal infant growth and
development (5). Soy-based formulas are used by vegan families as the
best option when breast feeding is not possible. At this time all soy
formulas contain vitamin D derived from lanolin (sheep's wool). Some
soy-based formulas (such as Parent's Choice ® and some store brands) may
contain animal- derived fats so check the ingredient label. Soy formulas
are used exclusively for the first six months. Iron supplements may be
indicated at 4-6 months if the formula is not fortified with iron.
Soy milk, 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 proper ratio of protein, fat, and
carbohydrate, nor do they have enough of many vitamins and minerals to
be used as a significant part of the diet in the first year.
Supplemental food (food besides breast milk and formula) can be
started at different times in different children depending on the
child's rate of growth and stage of development but are usually begun
somewhere in the middle of the first year. Some signs of the time to
start introducing solid foods are: the ability to sit unsupported,
disappearance of the tongue extrusion reflex, increased interest in
foods others are eating, and an ability to pick up food and put it in
the mouth.
Introduce one new food at a time so that any source of allergies can
be later identified. Many people use iron-fortified infant rice cereal
as the first food. This is a good choice as it is a good source of iron
and rice cereal is least likely to cause an allergic response. Cereal
can be mixed with expressed breast milk or soy formula so the
consistency is fairly thin. Formula or breast milk feedings should
continue as usual. Start with one cereal feeding daily and work up to 2
meals daily or 1/3 to 1/2 cup. Oats, barley, corn, and other grains can
be ground in a blender and then cooked until very soft and smooth. These
cereals can be introduced one at a time. However, they do not contain
much iron, so iron supplements should be continued.
When cereals are well accepted, fruit, fruit juice, and vegetables
can be introduced. Fruits and vegetables should be well mashed or
puréed. Mashed banana is one food that many infants especially enjoy.
Other fruits include mashed avocado, applesauce, and puréed canned
peaches or pears. Citrus fruits and juices are common allergens and
should not be introduced until the first birthday. Mild vegetables such
as potatoes, carrots, peas, sweet potatoes, and green beans should be
cooked well and mashed. There is no need to add spices, sugar, or salt
to cereals, fruits, and vegetables. Grain foods such as soft, cooked
pasta or rice, soft breads, dry cereals, and crackers can be introduced
as the baby becomes more adept at chewing. By age 7-8 months, good
sources of protein can be introduced. These include well-mashed cooked
dried beans, mashed tofu, and, soy yogurt. Children should progress from
mashed or pureed foods to pieces of soft food. Smooth nut and seed
butters spread on bread or crackers can be introduced after the first
birthday.
Many parents choose to use commercially prepared baby foods. There
are products available for vegan infants. Careful label reading is
recommended. Since commercial products contain limited selections for
the older vegan infant, many parents opt to prepare their own baby
foods. Foods should be well washed, cooked thoroughly, and blended or
mashed to appropriate consistency. Home-prepared foods can be kept in
the refrigerator for up to 2 days or frozen in small quantities for
later use.
By 10-12 months, most children will be eating at least the amounts of
foods shown in Table 17.
Certainly it makes sense for vegans to continue breast feeding for a
year or longer, if possible, because breast milk is a rich source of
nutrients. Vegan infants should be weaned to a fortified soy milk
containing calcium, vitamin B-12, and vitamin D. Low-fat or non-fat soy
milks should not be used before age 2. Rice milks are not recommended as
a primary beverage for infants and toddlers as they are quite low in
protein and energy.
Several studies have been reported showing that the growth of vegan
children is slower than that of non-vegans (see 6-8). Studies such as
these are often cited as evidence that vegan diets are inherently
unhealthy. However, when the studies are examined more closely, we find
that they are often based on vegans who have very low calorie or very
limited diets (only fruit and nuts for example). In addition, many vegan
infants are breast fed. Compared to formula-fed infants, breast-fed
infants generally gain weight at about the same rate for the first 2-3
months and then gain weight less rapidly from 3 to 12 months (11). This
means by 12 months, breast fed infants will tend to be leaner than
formula-fed infants. New growth charts are being developed which will be
based on the growth of breast-fed infants.
An additional question that must be asked is, "What is a normal
growth rate?" Growth rate is assessed by comparing changes in a child's
height, weight, and head circumference to rates of growth that have been
established by measuring large numbers of apparently healthy US
children. There is no one ideal rate of growth. Instead, height, weight,
and head circumference are reported in percentiles. If your child's
height is at the 50th percentile, this means that 50% of children of
that age are taller and 50% are shorter. Similarly, a weight at the 25th
percentile means 25% of children weigh less and 75% weigh more.
Table 17: 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 & fruits. |
4 oz juice. Pieces of soft/cooked
fruits & vegetables. |
Table-food diet. Allow 4 svgs per
day (1 svg=1-6 TB fruit & vegetable, 4 oz juice).
|
LEGUMES & NUT BUTTERS |
None |
None |
Gradually introduce tofu. Begin
casseroles, pureed legumes, soy cheese, & soy
yogurt. |
2 svgs daily each about 1/2 oz. Nut
butters should not be started before 1 year. |
Adapted from (10).
*Overlap of ages occurs because of varying rate of
development.
|
While some studies show that vegan children are at a lower percentile
of weight and height than are other children of a similar age, a recent
study shows that vegan children can have growth rates which do not
differ from those of omnivorous children of the same age (9). At this
time we cannot say that a child growing at the 25th percentile is any
more or less healthy than a child growing at the 75th percentile. What
seems to be more important is that the child stays at about the same
percentile. For example, a child who is at the 50th percentile for
height at age 2 and only at the 25th percentile at age 3 has had a
faltering in growth rate. The cause of this faltering should be
determined.
The best way to assure that your children achieve their ideal rate of
growth is to make sure that they have adequate calories. Some vegan
children have difficulty getting enough calories because of the sheer
bulk of their diets. Children have small stomachs and can become full
before they have eaten enough food to sustain growth. The judicious use
of fats in forms like avocados, nuts, nut butters, seeds, and seed
butters will provide a concentrated source of calories needed by many
vegan children. Dried fruits are also a concentrated calorie source and
are an attractive food for many children. Teeth should be brushed after
eating dried fruits to prevent tooth decay.
Are very low fat diets appropriate for children? Some parents wish to
reduce their children's risk of developing heart disease later in life
and markedly restrict the fat in the children's diets (10 to 15 percent
of calories from fat). In some cases, a very low fat diet can compromise
a child's growth because the child is not getting enough calories. There
is no evidence that a very low fat diet is any healthier for a vegan
child than a diet which has somewhat more fat (20 to 30 percent of
calories from fat). Before 2 years, children should generally not have
any restriction of fat because of the rapid growth and high need for
calories during this time (12). For children, age 2 and older, a diet
which contains between 20 and 30 percent of calories from fat is
recommended (12). If you are using a lower fat diet than this check that
the child's growth is normal and that the child is eating enough food to
meet nutrient needs.
Diets of young children should not be overly high in fiber since this
may limit the amount of food they can eat. The fiber content of a vegan
child's diet can be reduced by giving the child some refined grain
products, fruit juices, and peeled vegetables.
Sources of protein for vegan children include legumes, grains, tofu,
tempeh, soymilk, nuts, peanut butter, tahini, soy hot dogs, soy yogurt,
and veggie burgers. Some of these foods should be used daily. Children
should get enough calories so that protein can be used for growth in
addition to meeting energy needs.
Table 18 shows one diet plan that has been used successfully by vegan
children (adapted from 13,14).
Table 18: Diet Plans for Vegan Children
|
TODDLERS AND PRESCHOOLERS (AGE
1-4)
|
FOOD GROUP |
NUMBER OF SERVINGS |
Grains |
6 or more (a serving is 1/2 to 1 slice of bread
or 1/4 to 1/2 cup cooked cereal or grain or pasta or
1/2 to 1 cup ready-to-eat cereal) |
Legumes, Nuts, Seeds |
2 or more (a serving is 1/4 to 1/2
cup cooked beans, tofu, tempeh or TVP; or 1-1/2 to 3
ounces of meat analogue; or 1 to 2 Tbsp. nuts,
seeds, nut or seed butter |
Fortified soymilk, etc |
3 (a serving is 1 cup fortified
soymilk, infant formula, or breast milk) |
Vegetables |
2 or more (a serving is 1/4 to 1/2
cup cooked or 1/2 to 1 cup raw vegetables) |
Fruits |
3 or more (a serving is 1/4 to 1/2
cup canned fruit or 1/2 cup juice, or 1 medium
fruit) |
Fats |
3 (1 tsp. margarine or oil) |
|
SCHOOL-AGED CHILDREN
|
FOOD GROUP |
NUMBER OF SERVINGS |
Grains |
6 or more for 4 to 6 yr olds; 7 or
more for 7 to 12 yr olds (a serving is 1 slice of
bread or 1/2 cup cooked cereal or grain or pasta or
3/4 to 1 cup ready-to-eat cereal) |
Legumes, Nuts, Seeds |
1 to 1/2 to 3 for 4 to 6 yr olds; 3
or more for 7 to 12 yr olds (a serving is 1/2 cup
cooked beans, tofu, tempeh or TVP; or 3 ounces of
meat analogue; or 2 Tbsp nuts, seeds, nut or seed
butter |
Fortified Soymilk, etc. |
3 (a serving is 1 cup fortified
soymilk) |
Vegetables |
1-1/2 to 3 for 4 to 6 yr olds; 4 or
more for 7 to 12 yr olds (a serving is 1/2 cup
cooked or 1 cup raw vegetables) |
Fruits |
2 to 4 for 4 to 6 yr olds; 3 or
more for 7 to 12 yr olds (a serving is 1/2 cup
canned fruit or 3/4 cup juice, or 1 medium fruit)
|
Fats |
4 for 4 to 6 yr olds; 5 for 7 to 12
yr olds (a serving is 1 tsp. margarine or oil) |
Adapted from (13) and (14). See Notes that follow.
Notes: 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 B-12 like Vegetarian Support Formula
nutritional yeast, vitamin B-12-fortified soymilk, vitamin
B-12-fortified breakfast cereal, vitamin B-12-fortifed meat analogue, or
vitamin B-12 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 (2, 4). If sunlight exposure is limited, dietary or
supplemental vitamin D should be used.
Although today more and more children are vegan from birth, many
older children also become vegan. There are many ways to make a
transition from a non-vegan to a vegan diet. Some families gradually
eliminate dairy products and eggs, while others make a more abrupt
transition. Regardless of which approach you choose, be sure to explain
to your child what is going on and why, at your child's level. Offer
foods that look familiar, at first. Peanut butter sandwiches seem to be
universally popular (beware: some kids are allergic to peanut butter)
and many children like pasta or tacos. Gradually introduce new foods.
Watch your child's weight closely. If weight loss occurs or the child
doesn't seem to be growing as rapidly, add more concentrated calories
and reduce the fiber in your child's diet.
Teenage Vegans
Teenage vegans
have nutritional needs that are the same as any other teenager. The
years between 13 and 19 are times of especially rapid growth and change.
Nutritional needs are high during these years. The teenage vegan should
follow the same recommendations that are made for all vegans, namely to
eat a wide variety of foods, including fruits, vegetables, plenty of
leafy greens, whole grain products, nuts, seeds, and legumes. Protein,
calcium, iron, and vitamin B12 are nutrients teenage vegans should be
aware of.
The recommendation for protein is 0.5 grams per pound for 11-14 year
olds and 0.4 grams per pound for 15-18 year olds (15). Those exercising
strenuously (marathon runners, for example) may need slightly more
protein. A 16 year old who weighs 120 pounds, needs about 44 grams of
protein daily. In terms of food, 1 cup of cooked dried beans has 14
grams of protein, a cup of soy milk or soy yogurt has 8-10 grams, 4
ounces of tofu has 9 grams, a tablespoon of peanut butter or peanuts has
4 grams, and 1 slice of bread or 1 cup of grain has about 3 grams.
Fruits, fats, and alcohol do not provide much protein, and so a diet
based only on these foods would have a good chance of being too low in
protein. Vegans eating varied diets containing vegetables, beans,
grains, nuts, and seeds rarely have any difficulty getting enough
protein as long as their diet contains enough energy (calories) to
support growth. There is no need to take protein supplements. There is
no health benefit to eating a very high protein diet and it will not
help in muscle building.
During adolescence, calcium is used to build bones. The density of
bones is determined in adolescence and young adulthood, and so it is
important to include three or more good sources of calcium in a
teenager's diet every day.
Cow's milk and dairy products do contain calcium. However, there are
other good sources of calcium such as tofu processed with calcium
sulfate, green leafy vegetables including collard greens, mustard
greens, and kale, as well as tahini (sesame butter), fortified soymilk,
and fortified orange juice.
By eating a varied diet, a vegan can meet his or her iron needs,
while avoiding the excess fat and cholesterol found in red meats such as
beef or pork. To increase the amount of iron absorbed from a meal, eat a
food containing vitamin C as part of the meal. Citrus fruits and juices,
tomatoes, and broccoli are all good sources of vitamin C. Foods that are
high in iron include broccoli, raisins, watermelon, spinach, black-eyed
peas, blackstrap molasses, chickpeas, and pinto beans.
It is important to consume adequate vitamin B12 during adolescence.
Vitamin B12 is not found in plants. Some cereals have vitamin B12 (check
the label). Red Star Vegetarian Support Formula nutritional yeast
supplies B12.
Many teenagers are concerned with losing or gaining weight. To lose
weight, look at the diet. If it has lots of sweet or fatty foods,
replace them with fruits, vegetables, grains, and legumes. If a diet
already seems healthy, increased exercise -- walking, running or
swimming daily -- can help control weight. To gain weight, more calories
are needed. Perhaps eating more often or eating foods somewhat higher in
fat and lower in bulk will help. Try to eat three or more times a day
whether you are trying to gain weight or lose weight. It is hard to get
all of the nutritious foods you need if you only eat one meal a day. If
you feel that you cannot control your eating behavior or if you are
losing a great deal of weight, you should discuss this with your health
care provider.
Often there is just not enough time to eat. Below are some foods that
kids can eat on the run. Some of these foods can be found in fast-food
restaurants -- check the menu. Ideas for snacks that you can carry from
home include:
Apples, oranges, bananas, grapes, peaches, plums, dried fruits,
bagels and peanut butter, carrot or celery sticks, popcorn, pretzels,
soy cheese pizza, bean tacos or burritos, salad, soy yogurt, soymilk,
rice cakes, sandwiches, frozen juice bars.
References
1. Dagnelie PC, van Staveren WA, Roos AH, et al. Nutrients and
contaminants in human milk from mothers on macrobiotic and
omnivorous diets.
Eur J Clin Nutr 1992; 46: 355-366.
2. Hergenrather J, Hlady G, Wallace B, et al. Pollutants in
breast milk of vegetarians. N Engl J Med. 1981; 304: 792
(letter).
3. Specker BL, Valanis B, Hertzberg V, et al. Sunshine exposure
and serum 25-hydroxyvitamin D concentrations in exclusively
breast-fed infants. J Pediatrics 1985; 107: 372-376.
4. Standing Committee on the Scientific Evaluation of Dietary
Reference Intakes, Food and Nutrition Board, Institute of Medicine:
Dietary Reference Intakes for Calcium, Phosphorus, Magnesium,
Vitamin D, and Fluoride. Washington, DC: National Academy Press,
1997.
5. Committee on Nutrition, American Academy of Pediatrics. Soy
protein-based formulas: Recommendations for use in infant feeding.
Pediatrics 1998; 101: 148-153, 1998.
6. Fulton JR, Hutton CW, Stitt KR: Preschool vegetarian children.
J Am Diet Assoc 1980; 76: 360-365,.
7. Sanders TAB and Purves R: An anthropometric and dietary
assessment of the nutritional status of vegan pre-school children.
J Hum Nutr 1981; 35: 349-357.
8. Shinwell ED and Gorodischer R: Totally vegetarian diets and
infant nutrition. Pediatrics 1982; 70: 582-586.
9. O'Connell JM, Dibley MJ, Sierra J et al: Growth of vegetarian
children: The Farm study. Pediatrics1989; 84: 475-481.
10. The Pediatric Nutrition Practice Group, The American Dietetic
Association. Pediatric Manual of Clinical Dietetics. Chicago, IL:
The American Dietetic Association, 1998; 49-68.
11. Dewey KG, Peerson JM, Brown KH, et al. Growth of breast-fed
infants deviates from current reference data: a pooled analysis of
US, Canadian, and European Data Sets. Pediatrics 1995; 96:
495-503.
12. Committee on Nutrition, American Academy of Pediatrics.
Cholesterol in childhood. Pediatrics 1998; 101: 141-147.
13. Messina M, Messina V. The Dietitian's Guide to Vegetarian
Diets. Gaithersburg, MD: Aspen Publishers, Inc, 1996.
14. Fact Sheets on Vegetarian Toddlers and Preschoolers,
Vegetarian Nutrition for School-Aged Children. Vegetarian
Nutrition Dietetic Practice Group, 1996.
15. Food and Nutrition Board, National Research Council.
Recommended Dietary Allowances, 10th ed. Washington, DC:
National Academy Press, 1989.
|
This chapter appears in the fourth edition of
Simply Vegan by Debra Wasserman. Nutrition section by
Reed Mangels Ph.D., R.D. |
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