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Infant Nutrition in Vegetarian and Vegan Families

25 June 2024

Babies and children who are fed a varied, balanced and healthy vegetarian or vegan diet demonstrate satisfactory growth and development. Ensuring that they are receiving everything they need, and particularly B12 for infants and for vegan mothers who breastfeed is critical since plant-based food does not naturally contain Vitamin B12.

Breastfeeding is the healthiest and best way to feed your baby, whether you are vegetarian, vegan or meat-eater. The recommendation is to give vegan babies, starting at the age of six months and upon establishing meals a B12 supplement.

From the age of six months and up to the age of one year, the recommendation is to incorporate at least 2-3 meals per day that includes food that naturally contains protein and iron along with grains, vegetables and fruit. For more information about the transition to supplementary foods.

Foods recommended in a vegan diet from six months of age:

  • Legumes: lentils, chickpeas, mung beans, beans, edamame, etc. Legumes may be cooked after soaking and served as a spread, in soup, in a stew or as a side dish. Remember to serve soup that has been adjusted to the age and ability of your infant and child. When eating legumes, it is extremely important to incorporate food rich in Vitamin C, as this significantly helps the absorption of iron found in the legumes.
  • Grains: grains should be incorporated in the daily diet: rye, spelt, oat, millet, corn, wheat (bread, pasta, Israeli couscous, couscous, bulghur), rice, buckwheat, quinoa, etc.
  • Vegetables: vegetables in all colors, and particularly with texture that has been adapted for infants. Initially begin with cooked or steamed extremely soft or ground vegetables, and later grate or serve the vegetables in a rougher form.
  • Fruit: it is important to offer a variety of fruit of all colors, sliced into tiny bites, crushed or grated.
  • Nuts and seeds: walnuts, almonds, cashews, pecan, hazelnut, pistachios, peanuts, sesame (tahini), flax seeds, chia seed. Extremely important: for children under the age of 5, walnuts must be pureed or ground into a natural nut spread with no additives. Do not give children whole or split walnuts, as they pose a choking hazard due to their hard texture and shape.
  • Dietary fiber: children’s diet should include dietary fiber, which is easier to digest and is found in legumes, oats, fruits and vegetables. If you eat whole wheat bread, whole wheat pasta, whole grain rice and whole grains in general, please remember to include them in large quantities and frequently in the child’s diet as it may lead to gastric distress.

A balanced, healthy and diverse vegetarian and vegan diet can satisfy all our dietary requirements from infancy to old age, while also providing health benefits. The rapid growth rate of infants requires that parents provide them with a nutritious balanced diet that includes healthy food. For vegetarian and vegan families, emphasis must be placed on creating balanced meals that contain everything that infants and toddlers need.

In any case, it is important to consult dieticians who specialize in vegetarian and vegan nutrition for children to make sure that the children are receiving all the nutritional values that are important for them. For your convenience, the Family Health Centers employ dieticians for infants and children who may be consulted. You can check this out with the Family Health Center nurse who assists you.

Breastfeeding

  • Breastfeeding is the healthiest and best way to feed your infant. As with any mother, mothers who are vegetarian or vegan should breastfeed their newborns. The mother must herself eat a balanced diet and take Vitamin B12 supplements. Consult with a dietician on supplementing any deficiencies with food or dietary supplements, whenever necessary.
  • If breastfeeding is established, and the infant is nursing on demand, they will receive the quantity of breastmilk they need, and will satisfactorily grow and develop.
  • From six months of age, and with the establishment of supplementary meals, the recommendation is to provide every child on a vegan diet a B12 supplement (the recommendation also applies to nursing infants and children who are fed with infant formulas).
  • The recommendation is to continue breastfeeding after supplementary food is added to the menu, at least until the age of two, as long as it suits you and your infant.
  • Additional dietary recommendations for every breastfeeding woman: iodine at a dosage of 150-250 micrograms, Vitamin D at a dosage of 200-400 International Units (parallel to 5-10 micrograms), iron supplement – up to 6 weeks post-partum and during the years of childbearing potential, every woman should take 400 mcg of folic acid on a daily basis.

Infant formula

  • If the family is living a vegan lifestyle, infants can be given normal food that is based on cow’s milk before and up to the age of one.
  • If you completely avoid eating animal-based food, the infant can be given soy-based infant formula.

Important

Important

In the first year of life, infants must not be given liquid milk such as soy milk, rice beverage, almond beverage, etc. in lieu of mother’s milk or infant formula. These beverages are not suitable for infants or for the preparation of formula. Replacing breastmilk or infant formula with soy milk or oat, almond or rice beverage might result in nutritional deficiencies and affect growth.

Vegetarian infant formula

Vegan families occasionally choose, instead of nursing or pumped breastmilk, to give their infant soy-based infant formula. According to the American Academy of Pediatrics (AAP), vegetarian formula is a safe and acceptable dietary alternative to milk-based infant formula.

Use of vegetarian infant formula is not recommended in the following cases:
  • Premature infants whose birth weight is less than 1.800 kg.
  • Infants with renal insufficiency.
  • Congenital hypothyroidism (vegetarian infant formula affects absorption of the medication and in this case, closer monitoring is required, as well as a higher dosage of medication).
  • Infants suffering from enterocolitis or enteropathy that is attributed to allergy to cow’s milk.
  • Prevention of colic or allergy.

Supplementary food

From the age of six months, once the baby appears ready, you can begin introducing your child to supplementary foods. Begin with soft, pureed food and then move on to rougher textures (crumbled, grated or mashed), based on their development and Ministry of Health guidelines. Up to the age of one, at least 2-3 meals a day that naturally includes protein and iron, along with grains, fruits and vegetables.
For more information about the transition to supplementary food

Vegetarian families may include any of the following in their daily menu

  • Yogurt
  • Cheeses
  • Thoroughly cooked eggs
  • Whole cow’s milk after the age of one

You can also combine a little seaweed and use iodine-enriched salt in moderation – use of salt in the food of infants, children and adults should be limited.

Recommended food in a vegan diet for infants from six months of age

Lentils of all colors (orange, green, brown and black), chickpeas, mung beans, beans (white, red, black, pinto, adzuki, etc.), peas, fava beans, soy and soy products such as tofu, edamame, unsweetened soy milk, etc. Legumes may be cooked after having been soaked and served as a spread, in soup, in a stew or as a side dish. Prepared legume flour may be purchased in nature food stores, Spices or in the large supermarket chains, or to puree at home. The legumes and flour should be incorporated in an omelet, in patties, in quiches and in various baked goods.

Important: more delicate legumes with thinner peels such as lentils and mung bean, should first be introduced as they require less soaking and cooking times.

It is strongly recommended to eat legumes with food rich in Vitamin C, which significantly helps in iron absorption. These foods include grated tomatoes, red, orange and yellow pepper without the peel, kiwi some lemon juice, etc.

The incorporation of grains in the daily diet is strongly recommended: rye, spelt, oat (quaker), millet, corn, wheat (bread, pasta, Israeli couscous, couscous, burghul), rice, buckwheat, quinoa, amaranth, etc.

Babies should be offered vegetables of all colors, with emphasis on texture that corresponds with their ability to eat it. Babies who are beginning eaters should start with extremely soft or pureed cooked or steamed vegetables.

From 7 months of age, fresh vegetables can be roughly grated and cooked vegetables can be mashed. As their ability to eat develops, more complex textures can be given to babies or toddlers.

The inclusion of leafy greens in the menu, such as arugula, lettuce, cabbage, celery, basil, etc. is important (spinach and beet leaves – Swiss chard, are less recommended as they contain limited and unavailable minerals).

It is important to offer a variety of fruits of all colors, sliced into small pieces or pureed or grated, and should be eaten in the presence of an adult.

The menu should include natural sources of healthy fats such as nuts and seeds such as walnuts, almonds, cashew, pecan, hazelnut, pistachio, peanuts, sesame, flax seed, chia seeds, pumpkin seeds, sunflower seeds, pine nuts.

In addition, avocado, avocado oil, whole tahina spread, coconut oil, grapeseed oil, etc., are extremely health and should be incorporated in the daily menu.

Extremely important:
  • For children under the age of 5, grind nuts until smooth or offer a nut spread. Do not offer whole or split nuts, as they may cause choking due to their hard texture and shape.
  • Pumpkin and sunflower seeds as well as pine nuts – grind until smooth, as they may be difficult to chew and pose a choking hazard.
  • Chia seeds and flax seeds contain Omega 3 oil, which is important and beneficial but must be carefully given in moderation since large quantities may cause gastric distress in infants and toddlers.

Read here about safe eating of infants and children

Until the age of one, babies’ diet should include soluble fiber since it is easier for the body to break them down. This includes legumes, oats, fruit and vegetables.

Rough fiber found in whole wheat bread, whole wheat pasta, whole rice and whole grains in general should be included from the age of one, and only partially – i.e. in only some of the meals. The reason being that whole grains in every meal may cause gastric distress and occasionally constipation.

At the same time, if you have quality bread at home that includes whole grain flour, there is no special need to buy white bread. Babies can be introduced to some whole grain bread to see how they react, and to limit the quantity of rough fiber in their diet by incorporating other sources of carbohydrates that are not bread.

Note: until the age of one, babies must not be introduced to honey and liquid milk. For more information about safe eating in babies

Dietary supplements

Beginning at six months, and with the establishment of supplementary food meals, vegan babies should be given a B12 supplement (the recommendation applies to nursing infants and to infants fed with infant formula). If the baby’s diet does not include all food groups and is not varied, it is important to contact a dietician who specializes in vegetarianism or veganism to ensure that the diet is sufficient and includes a variety of ingredients such as Vitamin B12, iron, zinc and iodine.

Recommended dietary supplements:
  • Vitamin B12: beginning at the age of six months, and upon establishment of meals for babies who are fed on a vegan diet, the recommendation is to add B12 supplement (for both nursing infants and for babies fed with infant formula). Vegan mothers who are breastfeeding (and occasionally even vegetarian mothers) must take a B12 supplement on a regular basis.
  • Iron: the Ministry of Health recommends giving all infants an iron supplement, beginning at 4 months of age. If plant-based food that contains iron is provided, the meal should also include food that contains Vitamin C to increase iron absorption.
  • Vitamin D: the Ministry of Health recommends giving all infants a Vitamin D supplement from birth to the age of one.
  • Zinc: if a zinc deficiency is diagnosed, the recommendation is to give the baby food rich or enriched with zinc, or a dietary supplement.
  • Omega 3 fatty acid: good sources of this acid include walnuts, canola oil, flax seeds, flax oil and chia seeds. Remember that according to Ministry of Health guidelines, babies must be given nuts and seeds that have been ground until they are smooth.
  • Iodine: make sure to prefer iodine-enriched salt, and to limit the use of salt when cooking.

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