Feeding your Baby, a Vegetarian Diet?

Feeding your Baby, a Vegetarian Diet?

Disclaimer:
This “Feeding your Baby a Vegetarian Diet” material is of a general nature and has been provided for informational purposes only. If considering feeding your baby a vegetarian or vegan diet we recommend that you consult your doctor, dietitian, pediatrician or Plunket nurse to make sure you have all the right information. Vegan diets are more difficult to achieve a nutritionally adequate diet for young children. If you are considering a vegan diet for your child, always consult a qualified health professional for individual advice and supplementation as required.

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There are different types of vegetarianism eating patterns which exclude meat, chicken and fish:

  • Lacto-ovo Vegetarian (vegetarian): Excludes all meat, poultry and seafood from their diet;   consumes eggs and milk products.
  • Lacto Vegetarian: Excludes all meat, poultry, seafood and eggs from their diet; consumes milk products.
  • Pescatarian: Excludes all meat and poultry; consumes seafood, eggs and milk products.
  • Vegan: Excludes all animal products from their diet (meat, poultry, seafood, eggs, milk and animal derived ingredients)

An appropriately planned lacto-ovo vegetarian diet with plenty of variety from the essential food groups can be nutritionally adequate for infants, but care must be taken. Be aware that some poorly planned vegetarian diets can be low in energy, protein, iron, vitamin B12, calcium and zinc.  The inclusion of dairy milk products and eggs in a lacto-ovo vegetarian diet makes it easier to provide baby with a nutritionally balanced diet, compared to a vegan diet. Eggs and milk products provide essential nutrients such as vitamin B12, which is not present naturally in plant foods.

A vegan diet is more restrictive, and it can be difficult for babies to receive all the nutrients, protein and energy they require from food. In a vegan diet at risk vitamins and minerals include calcium, iron, zinc, Vitamin D, and Vitamin B12. Appropriate supplements need to be prescribed, such as Vitamin B12. If considering a vegan diet, always involve a qualified health professional for individual dietary advice to ensure nutrient requirements can be met. Talk to your doctor for a dietitian or pediatrician referral.

Herein, this article refers to a lacto-ovo vegetarian diet (vegetarian).

The food journey:

Breast milk is the perfect food for your baby. Breast milk (or infant formula) is all baby needs for around the first 6 months. A vegetarian diet may be introduced in conjunction with breast milk once baby is ready to start solids. Introduce solids at around 6 months when baby shows the cues of readiness to begin - they can hold their head up well, are interested in watching you eat, opens their mouth when food approaches, they can keep food in their mouth and swallow it and their tongue doesn’t push food out of their mouth.

Gradually introduce foods in an appropriate texture to your baby, starting with cooked puréed vegetables, fruit and iron rich foods. During the first year of life introduce a variety of foods from the four food groups to provide new flavours, energy and essential nutrients. There is no need to add salt or sugar to baby’s food.

The vegetarian food groups are:

Vegetables and fruit – include a variety of colours e.g. yellow, red, orange and green vegetables

Legumes, nuts, seeds and eggs e.g. lentils, tofu, beans

Grain foods e.g. breads, iron fortified infant cereals, rice, pasta

Milk products e.g. yoghurt, cheese

 

Always offer food in a soft texture that is safe and appropriate for your baby’s developmental stage. Modify foods to a suitable texture and shape by cooking or chopping to reduce the choking risk e.g. offer thinly spread smooth nut butters and cooked mashed legumes.

 

Nutrients of concern in vegetarian diets:

Energy intake

Young children require energy and nutrient dense foods to fuel their rapid growth and development.

Many plant-based foods are bulky because of their higher dietary fibre content. Babies and children’s stomachs are small, and they may feel full quickly from bulky fibre foods, before they have had adequate energy and nutrient intake. To ensure young children get the nutrition they need, offer small meals and snacks throughout the day, and offer lower fibre grain foods such as white or wholemeal bread and rice.

Be careful with high fibre foods, as not only are they filling but the phytates in plant foods can impair nutrient absorption. It is best to avoid heavy grain breads, bran cereals and remove the fibrous strings from fruits and vegetables.  Babies get all the fibre they need from vegetables, fruit, legumes, infant cereals and breads. 

Protein

Protein requirements for infants are high due to the rapid growth and development they undergo. Offer your baby a variety of protein rich foods every day to ensure their needs are being met.

Food sources of vegetarian protein for infants include:

  • Milk products such as full-fat yoghurt and cheese
  • Eggs
  • Beans, chickpeas, lentils and soy products, and foods made from them such as hummus, tofu and dahl. Ensure these foods are modified into an age appropriate texture before feeding and have no added salt.
  • Smooth nut and seed butters – offer ground or as a smooth thinly spread butter for children under 5 years to reduce choking risk.
  • Wholemeal grains such as pasta and rice.

Iron

Iron is an essential mineral and is needed for carrying oxygen in our blood, our muscles and brain, energy production and strengthening our immune system.

There are two forms of iron:

  • Haem iron - present in meat, poultry and fish. Haem iron is more easily absorbed than non-haem iron from plant foods.
  • Non-haem iron - present mainly in plant foods. Including foods containing vitamin C in the same meal will help baby absorb non-haem iron. Vitamin C rich foods include tomato, capsicum, citrus fruits, kiwifruit and berries.

 

Sources of iron in a vegetarian diet include:

  • Breast milk or infant formula
  • Iron fortified baby cereals (e.g. Farex rice cereal)
  • Legumes – lentils, chickpeas, beans, tofu
  • Seeds and nuts – ground or as a smooth nut butter
  • Eggs
  • Green leafy vegetables – kale, broccoli, spinach, silverbeet

Some babies may still not get enough iron from food. Signs of iron deficiency are developmental and behavioral problems, reduced immunity and tiredness. Always see your doctor for diagnosis and treatment.

Vitamin B12

Vitamin B12 is only found naturally in animal products such as meat, fish, milk and eggs. It is essential for producing healthy red blood cells and for neurological functions.

Sources include:

  • Breast milk (if mother has adequate vitamin B12 status) or infant formula
  • Eggs
  • Milk products

Foods that may be fortified with vitamin B12 include (always check the packaging label as not all these products will be fortified):

  • Soy products e.g. yoghurt, cheese
  • Yeast spreads
  • Plant based meat alternatives (check salt suitability for babies). 

 

Babies born to vegan mothers can have a vitamin B12 deficiency. Both mother and baby are likely to need supplementation as prescribed by a health professional. Vegan breastfeeding mothers must also pay careful attention to their vitamin B12 status. Contact your health professional for advice.

Vitamin D

Vitamin D helps our bones absorb calcium for strong bones. Some Vitamin D is found in fatty fish, such as salmon and tuna (if eaten), eggs, and some fortified milk and soy products and margarines.

Our bodies make the rest of our vitamin D in our skin from sunshine.  As their skin is sensitive, babies can’t safely get the sun exposure required to meet their vitamin D requirements. Adequate vitamin D intake from diet alone is hard to achieve. If your baby is higher risk of Vitamin D deficiency, discuss supplementation with a health professional.

Calcium

Adequate calcium intake is essential for development of strong bones and teeth. Milk products are an excellent source of calcium.

Sources of calcium include:

  • Breast milk (or infant formula) until 12 months. Full-fat cow’s milk or fortified soy milk for toddlers.
  • Milk products – full-fat yoghurt, cheese
  • Tofu
  • Almonds – ground or as a smooth paste
  • Leafy green vegetables – spinach, bok choy, collard greens

Omega-3 Fatty Acids

Omega-3 fatty acids play a role in neurological development. This is particularly important in infants. Food sources of omega-3 fatty acids are fish and seafood (if eaten).  Avocado, ground nuts and seeds (walnuts, hazelnuts, chia or linseeds) and plant oils (canola, soybean, olive, flaxseed) provide omega-3 fatty acids from alpha-linolenic acid.

Zinc

Zinc is needed for wound healing and maintaining a healthy immune system. Vegetarian food sources of zinc include milk products, eggs, legumes, ground seeds and nuts, wholemeal breads and cereals.

Iodine

Our bodies need iodine to make thyroid hormones which control our metabolism and it is necessary for normal brain function. Sources of iodine include milk products, eggs and iodine fortified bread. Avoid iodised salt as babies don’t need salt added to their food.

 

What about milk?

Babies need breast milk (or infant formula) as their main milk drink until at least 12 months. Cow’s milk and plant-based milk alternatives do not provide the correct balance of nutrients and are not a suitable replacement.

Toddlers over 12 months old can be offered full-fat cow’s milk or soy milk fortified with calcium and vitamin B12 as a drink. Soy milk is higher in protein and fat than other plant-based milk alternatives. Limit milk to around 350mL (2 small cups) per day and encourage your toddler to begin drinking milk from a cup rather than a bottle.

 

A note about legumes:

If you choose to buy dried legumes, make sure you soak them before cooking as this helps reduce phytates, a compound that can interfere with iron, zinc and calcium absorption.

Canned legumes are a convenient alternative, but check the labels to ensure you are choosing varieties with no added salt. Drain and rinse them before using.

 

We also advise those considering a vegetarian diet to consult a pediatrician, dietitian or health professional to help along the journey.

 

Download our guide to ‘Feeding your baby a varied and balanced vegetarian diet’ here.

 

References:

Ministry of Health. 2021. Healthy Eating Guidelines for New Zealand Babies and Toddlers (0-2 years old). Wellington: Ministry of Health.

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