Feeding vegan children

1. Raising Vegan Children
Ashwani Garg, MD
Lifestyle Medicine / Family Medicine
Clinical Assoc. Professor, North Central College
Family Physician, Advocate Good Shepherd – Barrington Fitness

3. Agenda
• Review position statements of national medical organizations
• How to talk to your doctor about nutrition and a vegan diet
• Breastmilk, formula and milk
• Assembling healthy meals at every stage
• Important nutrients
• Questions/discussion

4. Position statements of organizations
• Physicians go by guidelines and position statements
• There is limited time in a schedule, and physicians rely on experts
• Guidelines simplify the tomes of medical literature into easy evidence-based
snippets

5. Academy of Nutrition and Dietetics
It is the position of the Academy of Nutrition and Dietetics that
appropriately planned vegetarian, including vegan, diets are
healthful, nutritionally adequate and may provide health benefits in
the prevention and treatment of certain diseases. These diets are
appropriate for all stages of the life cycle, including pregnancy,
lactation, infancy, childhood, adolescence, older adulthood and
for athletes. Plant-based diets are more environmentally sustainable
than diets rich in animal products because they use fewer natural
resources and are associated with much less environmental damage.

6. USDA Guidelines

7. American Medical Association

8. American Academy of Pediatrics
Some people believe that patients following vegan or vegetarian diets suffer
from nutritional deficiencies. Although there have been case reports of children
failing to thrive or developing cobalamin deficiency on vegan diets, these are
rare exceptions. Multiple experts have concluded independently that vegan
diets can be followed safely by infants and children without compromise of
nutrition or growth and with some notable health benefits.
Vegan Diets in Infants, Children, and Adolescents
Brita C. Moilanen
PIR May 2004, 25 (5) 174-176; DOI: https://doi.org/10.1542/pir.25-5-174

9. How to talk to your doctor
• Physicians are caring, and helping and often have the right intent, but
misguided by outdated information. Point them the right way! And to
resources
• Let them know that veganism is important in your family, much as religious
dietary preferences are honored. They would not force someone with
religious prohibitions to eat that food, would they?
• Physicians are detailed by pharmaceutical and formula companies, even dairy
and meat industry. However, vegans never “detail” physicians.

10. Liquid nutrition
• Often, children have limited stomachs and eat on the “go”
• Sometimes with a fiber rich diet, they get full too fast
• Liquid nutrition offers a rich source of calories to supplement the food
• In the past, dairy was considered an integral part of nutrition for children
• Today, we have many protein and calorie rich alternatives
• Breastmilk is best, as long as can be continued
• We should compare other “milks” to breastmilk and not cow’s milk

11. Breastmilk composition
Per 1 cup:
Calories 171
Protein 2.5g
Fat 10g
Carbohydrate 17g
Benefits: Immune health, digestive system, probiotics, cognitive development, dental health,
maternal-child bond, reduced cancer in mothers, and MANY others. Breastmilk is also a means of
communication between mother/child
Milk sharing, milk banks may be alternatives if mother isn’t able. Lactation Consultants may help in
difficult situations, sometimes with aid of herbals. La Leche is a resource.
Preemies: Prolacta Bioscience offers a human milk formula for preemies which is high nutrition

12. Formula (soy)
• Use for over 50 years
• Recent review “in normal full-term infants – even during the most rapid phase of
growth – SIF produces normal anthropometric growth, adequate protein status,
bone mineralization and normal immune development”
• Contains lanolin from sheep’s wool, only vegan ones are from Europe (Premiriz
and Baby Mandorle)
Vandenplas Y, Castrellon PG, Rivas R, et al. Safety of soya-based infant formulas
in children. Br J Nutr. 2014;111(8):1340-60.
Bhatia J, Greer F. Use of soy protein-based formulas in infant feeding. Pediatrics.
2008;121(5):1062-8

13. Milk (Courtesy of Dr. Jackie Busse)

15. Assembling healthy meals
• Resources: PCRM, Plantbasedpediatrician.com, and plantrician.org
• Infants
• Toddlers
• Children
• Teens

16. Infants
• Infants: breastmilk/soy formula exclusively (6 months)
• After 6 months – fortified cereals and foods
• consider BLW or baby-led weaning – lots of work but pays off in the end
• 6-8 months: veggies, including potatoes, peas, carrots, sweet potatoes, green
beans; fruits – apples, banana, peaches, avocado
• 8 months: tofu, legumes, dry cereals, nut butters (depends on development)
• No eggs? No problem. No cheese? No problem. No meat? No problem.
• Remember, the breastmilk/formula is the primary source of nutrition.

17. Toddlers
• Often todders are busy people, on the go, and get full easily
• Focus on calorie rich foods such as avocado, nut butters, legumes, and most definitely full-
fat tofu and soy products (if tolerated)
• Protein rich foods such as legumes (hummus) are helpful, finger foods are perfect
• Encourage self-feeding and give choices
• REMEMBER, keep the foods separate!
• Limit the nuggets, fries, but try to make them yourself if possible (baked fries)
• Nutritional yeast is a great source of b12
• Seaweed can give iodine – try some vegan sushi with your toddler.

18. Children
Focus on those calorie rich healthy foods, such as whole grains, legumes, nut
butters, avocado as a good base.
Breakfast ideas: pancakes made with flaxseeds and soymilk; oats made with
soymilk, flax and berreies
School lunch: consider sending a packaged individual soymilk along, with a
whole grain sandwich or veggie burger, side of veggies and fruits
Dinners: Eat as a family and give some choices, for picky eaters, puree veggies
into spaghetti sauce, make tofu curries with rice, mac & cheese can be veggie
based. Get children involved in the cooking/prep process!

19. Teens
• Develop and refine their food choices.
• Adjust calorie intake for activity level
• Try ethnic meals
• Batch Cooking / food prep once a week
• Smoothies for teens “on the go”
• Focus on fiber, protein, and calorie rich choices
• Soy is best for plant-based milks.
• Acne – some teens are sensitive to higher fat and processed foods

21. Nutrients of concern

22. • Phytonutrients are compounds only in
plants that promote health
• There is no daily reference intake for
phytochemicals
• New research shows they may very well
be essential to life, and for prevention
of cardiovascular diseases and cancer
• ONLY about 1/5 of Americans meet
the minimum intake
PhytoNUTRIENTS

23. Bright colors,
excellent health
Plant foods naturally contain
antioxidants, phytonutrients,
and fiber which can reduce
inflammation, scavenge free
radicals, optimize immune
function and angiogenesis,
improve overall wellness

24. Nutrients of concern
• Choline - memory, mood, muscle control, and other brain and nervous system
functions; found in soy, mushrooms, veggies, potatoes, legumes
• Calcium – found in greens, legumes, and fortified plant-based milks
• Vitamin D – from sunlight, should be supplemented as per age. Found in
fortified plant based milks
• B12 – supplement (found in plant-based milks and nutritional yeast)
• DHA – precursor is ALA found in soy, avocado, nuts/seeds; FLAX
• Iron – legumes, nuts/seeds, leafy greens, fruits, whole grains
better absorbed with vitamin C
• Protein – veggies, legumes, whole grains (need adequate calories)

31. Questions?
Resources:
• PCRM.ORG
• Vegetariannutrition.net
• PlantBasedPediatrician.Com – Dr. Busse
• www.veggiefitkids.com (featuring how to order at Taco Bell) – Dr. Yami
• theveganpediatrician.com
• NutritionStudies.Org
• InternationalVegan.Org
• FreeFromHarm.org (great article on soy)
• https://www.drfuhrman.com/elearning/blog/43/feeding-your-children-right
• http://healthyschoolfood.org/
• Dreena Burton, Plant Powered Families