article by Mangels PhD and Kavanagh-Prochaska

[Guest guest]

Sharing the article by Mangels on vegan nutrition I

mentioned in an earlier message. So much information on the

Vegetarian Resource Group's website www.vrg.org . Wish I knew of

this information when I was pregnant with my son.

Blessings, Em

Vegan Nutrition in Pregnancy and Childhood

by Mangels, Ph.D., R.D. and

Kavanagh-Prochaska, Dietetic Intern

Summary: A well-planned vegan diet can easily be used during

pregnancy, breastfeeding, and childhood.

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 400µg

(micrograms) per day. The need for folate increases in

pregnancy, to 600µg 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 5µg (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.

Basic Needs for Infants (0-1 years)

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 puréed.

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 puréed, 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 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.

A diet plan for vegan toddlers and children is included below.

Special Tips for Feeding Preschoolers

Offer choices of foods. Letting the child make some decisions

can increase acceptance of foods. Offer a variety of foods,

repeatedly. Children's food preferences often change. The food

they refuse today may become tomorrow's favorite. Keep mealtime

a pleasant time. Do not force a child to eat or use food as a

reward. Try to remain low-key about food refusals. Studies show

that a new food can be offered up to 15 times before the child

will try it.

Make food fun. Try pancakes in different shapes, offer

vegetables and dips, and hide small pieces of soft fruit in soy

yogurt. Set a good example. Let the child see you eating healthy

foods. Foods that are not a particular favorite may be added to

foods the child likes, for example, chopped or puréed vegetables

can be added to pasta sauce or soup. Tofu can be blended into a

fruit shake. Fruit purées can be added to baked goods. Involve

the child in food preparation. Even young toddlers can tear

lettuce and help put cut-up vegetables into a pot. Some children

may prefer eating single foods in separate bowls rather than a

mixture of foods such as a casserole.

Choking risks

Toddlers and preschoolers are at increased risk of choking

because they are still learning to chew and swallow, they may

not have a full set of teeth yet, and they may not want to take

the time to chew food carefully. To minimize choking risk, the

following foods should be avoided or eaten only with

supervision:

Nuts, except when finely ground.

Nut butters by the spoonful.

Vegetarian hot dogs, unless sliced into tiny pieces the size of

a pea.

Cherry tomatoes, unless halved or quartered.

Grapes, unless cut in half. Peeling may be needed for young

toddlers.

Raw cherries, unless pitted and sliced.

Raw celery and whole raw carrots.

Popcorn.

Meal Planning Ideas

Popular foods with vegan children include:

Pizza, without cheese, and topped with vegetables, tofu, or meat

analogs.

Pasta with marinara sauce.

Oven-baked French fries.

Soy yogurt.

Macaroni and soy cheese.

Milkshakes made with calcium-fortified soymilk and fruit.

Peanut butter and jelly sandwiches.

Fresh or dried fruit.

Pancakes and waffles.

Noodles with peanut butter sauce.

Raw vegetables with dip.

Muffins.

Mashed potatoes.

Veggie burgers.

Tofu dogs.

Bagels with nut butter or hummus.

Interested in teen nutrition? Check out our Vegetarian Nutrition

Guide for Teenagers for more information, or call

for a paper copy.

General Tips

Use an iron skillet when preparing acidic foods, such as tomato

sauce. This helps " unlock " the iron.

Be sure your non-dairy milk alternative is fortified with

vitamins D and B12, as well as calcium.

Good sources of zinc are peas, beans, brown rice, nuts, spinach,

tofu, wheat germ, fortified breakfast cereals, and tempeh.

Introduce one new food at a time to your baby in order to

identify possible allergens.

Do not restrict fat in your baby's diet before 2 years of age.

Babies need fat for brain development. Some sources of fat are

avocados, olive oil, and nut butters.

Nuts and nut butters are possible allergens, so watch your child

carefully for signs of an allergic reaction. Nut butters should

only be given to babies over one year of age, and only with

supervision. Whole nuts should never be given to a child under 3

years of age because they are a choking hazard.

Sample Meal Plan for Vegan Pregnancy, Infancy, and Childhood

Sample Meal Plan for Vegan Pregnancy

Breakfast

½ cup oatmeal with maple syrup

1 slice whole wheat toast with fruit spread

1 cup fortified soymilk

½ cup calcium-fortified orange juice

Morning Snack

½ whole wheat bagel with margarine

1 banana

Lunch

Veggie burger on whole wheat bun with mustard and ketchup

1 cup steamed collard greens

Medium apple

1 cup fortified soymilk

Afternoon Snack

¾ cup ready-to-eat cereal with ½ cup blueberries

1 cup fortified soymilk

Dinner

¾ cup tofu stir-fried with 1 cup vegetables

1 cup brown rice

Medium orange

Evening Snack

Whole grain crackers with 2 Tbsp. peanut butter

4 ounces apple juice

This sample meal plan provides approximately 2500 calories, 94

gm protein, 70 gm fat (24% of calories), and 396 gm

carbohydrate. This sample meal plan meets the RDA for iron,

calcium, zinc, vitamin B12, folate, vitamin D, thiamin,

riboflavin, and niacin.

All charts reprinted from Simply Vegan, by Debra Wasserman and

Mangels, PhD, RD

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

breast milk or soy formula. 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=2-4 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.

*Overlap of ages occurs because of varying rate of development.

Table 18: Diet Plans for Vegan Children

TODDLERS AND PRESCHOOLERS (AGE 1-4)

FOOD GROUP NUMBER OF SERVINGS

Grains 6 or more servings. A serving is 1/2 to 1 slice of bread;

1/4 to 1/2 cup cooked cereal, grain, or pasta; 1/2 to 1 cup

ready-to-eat cereal.

Legumes, Nuts, Seeds 2 or more servings. A serving is 1/4 to 1/2

cup cooked beans, tofu, tempeh, or TVP; 1-1/2 to 3 ounces of

meat analog; 1 to 2 Tbsp. nuts, seeds, or nut or seed butter.

Fortified soymilk, etc 3 servings. A serving is 1 cup fortified

soymilk, infant formula, or breast milk.

Vegetables 2 or more servings. A serving is 1/4 to 1/2 cup

cooked, or 1/2 to 1 cup raw vegetables.

Fruits 3 or more servings. A serving is 1/4 to 1/2 cup canned

fruit, 1/2 cup juice, or 1/2 medium fruit.

Fats 3-4 servings. A serving is 1 tsp. margarine or oil.

SCHOOL-AGED CHILDREN

FOOD GROUP NUMBER OF SERVINGS

Grains 6 or more servings for five to six-year-olds; 7 or more

for seven to twelve-year-olds. A serving is 1 slice of bread;

1/2 cup cooked cereal, grain, or pasta; or 3/4 to 1 cup

ready-to-eat cereal.

Legumes, Nuts, Seeds 1-1/2 to 3 servings for five to

six-year-olds; 3 or more for seven to twelve-year-olds. A

serving is 1/2 cup cooked beans, tofu, tempeh, or TVP; 3 ounces

of meat analog; or 2 Tbsp. nuts, seeds, nut or seed butter.

Fortified Soymilk, etc. 3 servings. A serving is 1 cup fortified

soymilk.

Vegetables 2 or more servings for five to six-year-olds; 3 or

more for seven to twelve-year-olds. A serving is 1/2 cup cooked

or 1 cup raw vegetables.

Fruits 2 to 4 servings for five to six-year-olds; 3 or more for

seven to twelve-year-olds. A serving is 1/2 cup canned fruit,

3/4 cup juice, or 1 medium fruit.

Fats 4 servings for five to six-year-olds; 5 for seven to

twelve-year-olds. A serving is 1 tsp. margarine or oil.

Available from The Vegetarian Resource Group

Vegan Handbook, edited by Debra Wasserman and Mangels,

Ph.D., R.D. Includes homemade baby food recipes and healthy fast

food ideas for preschoolers. ($20)

Send check to VRG, Box 1463, Baltimore, MD 21203 or call (410)

366-8343, 9am to 5pm EST, to order with a Visa or MasterCard or

order online.

Also available from VRG for kids.

Leprechaun Cake and Other Tales: A Vegetarian Story-Cookbook, by

Vonnie Winslow Crist and Debra Wasserman. ($10)

For each item, send a SASE to the address below.

I Love Animals and Broccoli Coloring Book (3-8 year olds)

I Love Animals and Broccoli Shopping Basket (7-10 year olds)

I Love Animals and Broccoli Lesson Plan

Food Experience Projects for Young Children

Join The Vegetarian Resource Group

Receive the Vegetarian Journal, containing vegan recipes,

nutrition information, updates from the scientific community,

interviews with activists, and much more. Send $20 to The

Vegetarian Resource Group, Box 1463, Baltimore, MD 21203 or

subscribe online.

About VRG

The Vegetarian Resource Group is a non-profit educational

organization which educates the public about vegetarianism, and

the interrelated issues of health, nutrition, ecology, ethics,

and world hunger. The contents of this handout and other

publications are not intended to provide personal medical

advice. This should be obtained from a qualified health

professional.

www.vrg.org

Be sure to explore our website. You'll find more information on

vegan pregnancy, raising vegan children, traveling with vegan

children, and recipes for vegan families. We have sample

articles from previous issues of Vegetarian Journal, The

American Dietetic Association Position Paper: Vegetarian Diets,

books of interest to vegans, and links to related sites. Also

consider joining our online vegetarian parent list.

Order Simply Vegan

The information contained in this brochure has been modified

from Simply Vegan. This excellent resource contains 160 quick

and easy vegan recipes and an extensive vegan nutrition section

by Mangels, Ph.D., R.D., covering topics such as protein,

fat, calcium, iron, vitamin B12, Pregnancy and the Vegan Diet,

Feeding Vegan Kids, and a nutrition glossary. Also featured are

sample menus and meal plans. ($13) Send check to VRG, Box 1463,

Baltimore, MD 21203; call , 9am to 5pm EST, to

order with a Visa or MasterCard; or order online.

Let the beauty we love be what we do. Rumi

Let everything you do be done in love.

1 Corinthians 16:14

'Love is the measure.' Dorothy Day

'Gather yourselves...All that we do now must

be done in a sacred manner.' Hopi Elders 2001

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