I just read an article by Reed Mangels, PhD, RD, Nutrition for Young Vegetarians: Birth to One Year, from the Vegetarian Nutrition Dietetic Practice Group’s newsletter (Vegetarian Nutrition Update Vol XXI, No. 4, 2013). It is not available to the public, so I cannot link to it. But it inspired me to add some info on infants and vitamin D to the article Calcium and Vitamin D:

“A 2010 study found that breast milk was not a sufficient source of vitamin D (1). A 1985 study recommended exposing babies to 30 minutes of sun a week wearing only a diaper in order to provide sufficient vitamin D (2), however, the American Academy of Pediatrics recommends no sun exposure for infants. The authors of the 2010 study recommend that all infants get the RDA for vitamin D of 400 IU via infant formula or vitamin D drops.”

Mangels’ article also pointed out a recent study (3) that found, to quote the abstract, “the risk of [celiac disease] was significantly reduced in infants who were breast feeding at the time of gluten introduction (pooled odds ratio 0.48, 95% CI 0.40 to 0.59) compared with infants who were not breast feeding during this period.”

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References

1. Liang L, Chantry C, Styne DM, Stephensen CB. Prevalence and risk factors for vitamin D deficiency among healthy infants and young children in Sacramento, California. Eur J Pediatr. 2010 Nov;169(11):1337-44. | link

2. Specker BL, Valanis B, Hertzberg V, Edwards N, Tsang RC. Sunshine exposure and serum 25-hydroxyvitamin D concentrations in exclusively breast-fed infants. J Pediatr. 1985 Sep;107(3):372-6. (Abstract only.) | link

3. Akobeng AK, Ramanan AV, Buchan I, Heller RF. Effect of breast feeding on risk of coeliac disease: a systematic review and meta-analysis of observational studies. Arch Dis Child. 2006 Jan;91(1):39-43. (Abstract only) | link

Based on some articles that were floating around the Internet suggesting that vegan infants might be at risk for vitamin A deficiency, I asked Reed Mangels, PhD, RD what evidence we have that the breast milk of vegan mothers is adequate in vitamin A. She wrote an article about it and posted it in the Vegetarian Resource Group’s blog:

Vitamin A and Breastfed Babies

Excerpt:

“The bottom line – Vegan women who are breastfeeding should make sure that their diet includes good sources of precursors of vitamin A. These are foods rich in beta-carotene such as winter squash, carrots, pumpkin, sweet potatoes, cantaloupe, and green leafy vegetables. Dietary fat is needed to promote beta-carotene absorption so it is important that lactating women not overly limit dietary fat.”

The Vegetarian Nutrition Dietetic Practice Group has released a 2-page PDF on feeding vegetarian (including vegan) infants (click here).

I have added a link to it on the VeganHealth.org article, Pregnancy, Infants, & Children.

For those of you with infants or thinking about infants, it could be a good resource not only for your own information, but to share with family, friends, doctors, and alternative medicine practitioners.

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Sadly, a report was published today of a vegan mother in Italy whose infant developed B12 deficiency and the typical neurological issues that go along with it.

The mother had taken a multivitamin with 2.5 µg of B12 during her 2nd and 3rd trimester. The baby had been born small (3rd percentile for weight). He was then exclusively breast fed and the mother ceased the multivitamin.

The infant developed both B12 and iron deficiency by five months. Seven months of treatment with B12 and iron resulted in drastic improvement in neurological symptoms, but not a full recovery at that time.

The case underscores the need for exclusively nursing mothers to ensure they have a reliable source of vitamin B12 so that their breast milk has adequate amounts. A baby should be born with iron stores to last 6 months, but this boy was not. Not much information was given about any attempts to monitor the mother’s iron levels during pregnancy or the baby’s after birth ― apparently not much was done.

I’m hoping for some better vegan health news as the week progresses…

Reference

Guez S, Chiarelli G, Menni F, Salera S, Principi N, Esposito S. Severe vitamin B12 deficiency in an exclusively breastfed 5-month-old Italian infant born to a mother receiving multivitamin supplementation during pregnancy. BMC Pediatr. 201 Jun 24;12(1):85. | link

A report from the National Birth Defects Prevention Study (1) was recently released. Counter to two previous studies, it found no association between vegetarian diets in pregnant women and having a boy with hypospadias. This makes six studies examining the association to date with four finding no association.

This is great news, but we are not completely out of the woods yet. There is still reason to make sure that pregnant vegans cover all of their bases.

I have revamped the article Hypospadias and Vegetarian Diets on VeganHealth.org where you can read the fine print.

Reference

1. Carmichael SL, Ma C, Feldkamp ML, Munger RG, Olney RS, Botto LD, Shaw GM, Correa A. Nutritional factors and hypospadias risks. Paediatr Perinat Epidemiol. 2012 Jul;26(4):353-60. (link)

With all the columnists telling parents not to feed their kids vegan, this was quite an enjoyable read:

Don’t Feed the Baby: In a live chat, Dear Prudence offers advice on a vegan infant,…

In addition to Ginny Messina’s response, Reed Mangles, PhD, RD has also written an informative response to Nina Planck’s NY Times article:

Vegan Children: Response to NYT Op-Ed

Excerpt:

“The New York Times opinion piece was concluded with a call to parents raise their children as nonvegetarians and to allow them to choose their own diets as adults. I don’t get the logic – parents are choosing what foods their children eat, even if they are raising them as meat eaters. I could just as easily say that all parents should raise their children as vegans and then, if the children grow up and want to eat meat, that would be their choice.”

Nina Planck is up to her old shenanigans of spreading joy to the world. Ginny’s response:

The New York Times, Nina Planck, and Safety of Vegan Diets

And Ginny and VeganHealth.org are mentioned in a seemingly related LA Times piece:

In vegan debate, one thing parents must agree on

Question:

I’m on my way to becoming an RD, and taking an advanced human nutrition class…I asked my professor if humans are able to produce the amount of cholesterol they need at all stages of life. He told me for adults yes, but it’s unclear whether babies can synthesize all they need because it raises the question of why there is cholesterol in breast milk. He noted that many animals won’t be able to keep up with the rapid brain and cell development without the immediate source of cholesterol from the mother. Since dietary sources of cholesterol typically come from animal sources, do you think it’s safe for babies who aren’t being breast fed to be fed a vegan formula?

Answer:

Here is what the Institute of Medicine says in their 2005 report Dietary Reference Intakes for Energy, Carbohydrate, Fiber, Fat, Fatty Acids, Cholesterol, Protein, and Amino Acids (Macronutrients):

“Formula-fed infants also have a higher rate of cholesterol synthesis. However, the available evidence suggests this effect is transient. Differences in cholesterol synthesis and plasma cholesterol concentration are not sustained once complementary feeding is introduced. Also no clinically significant effects on growth and development due to these differences in plasma cholesterol concentration have been noted between breast-fed and formula fed infants under one year of age. One explanation may be that the developing brain synthesizes the cholesterol required for myelination in situ and does not take up cholesterol from plasma.”

There is more information at the link above.

I just made the following VeganHealth.org update to Pregnancy, Infants, & Children:

In 2008, the American Academy of Pediatrics raised its recommendations for infants from 5 µg (200 IU) of vitamin D per day to 10 µg (400 IU). They stated, “It is now recommended that all infants and children, including adolescents, have a minimum daily intake of 400 IU of vitamin D beginning soon after birth.” (4)

4. Wagner CL, Greer FR, and the Section on Breastfeeding and Committee on Nutrition. Prevention of Rickets and Vitamin D Deficiency in Infants, Children, and Adolescents. Pediatrics 2008;122:1142-1152.