The very moment Hillary Cassells Milazzo let it be known that she was raising her daughters as vegetarians, the comments began. "Now is the time they are supposed to be eating meat," one relative told the Franklin Lakes, New Jersey, mother of two.
Jenny Henkel, who has a 3-year-old, heard much the same thing as soon as people learned she had started her infant son on a meatless diet. "Is it right to force your baby to be a vegetarian?" they would ask. A vegetarian since she was 16, Henkel, who is now 30 and lives in Richmond, Virginia, had a ready response. "Why not?" she would answer. "I was forced to be a non-vegetarian."
Telling people you’re a vegetarian can elicit a raft of questions from well-meaning friends as well as meddlesome strangers. For vegetarian women who are pregnant or nursing moms—or mothers raising children as vegetarians—there’s a whole new set of accusations. First and foremost is "But what about the baby?"
What about the baby? Sure, people can eliminate meat from their diets and still maintain good health, but can women continue a veg-etarian diet while pregnant or nursing? Is a meat-free diet nutritious enough for a baby just starting to eat whole foods?
"When nursing moms tell me they are vegetarians, I’m not concerned," says Vicki Nizin, a lactation consultant and clinical dietitian in Rutherford, New Jersey. "Vegetarians usually eat a balance of healthy foods."
Most doctors and nutritionists recognize that vegetarians can go through pregnancy and nursing without eating meat as long as they are aware of certain nutrients needed in their diets. Iffath Hoskins, MD, an obstetrician/gynecologist in Savannah, Georgia, says her main concern is that pregnant women get the extra calories they need to maintain a healthy pregnancy and help their babies grow. Pregnant women should add 250 to 500 calories per day to their diets. Those calories need to come from a balanced diet, Hoskins says. Vegetarians can replace meat protein with eggs and legumes. "There is no type of food that can’t be replaced by another," she says.
One major consideration for any woman during pregnancy is folic acid. According to the American College of Obstetricians and Gynecologists (ACOG), folic acid is key to a baby’s growth. Health care practitioners warn that women considering pregnancy must get enough folic acid or risk neural-tube problems that affect the fetus’s spine and skull. Folic acid also helps pregnant women produce the extra blood they need throughout pregnancy.
Drinking a glass of orange juice first thing in the morning is a good way to take care of folic acid needs right away. Whole oranges, strawberries, spinach, collards, turnip greens, romaine lettuce, broccoli, asparagus, dried peas and beans are also rich in this nutrient. But even with a wholesome diet, the ACOG says it is still important to take a folic acid supplement for one month before pregnancy-good luck predicting that!-and during the first three months of pregnancy.
Health care practitioners say that getting enough protein is especially important during pregnancy. One-half cup of dry beans, one egg, one ounce of low-fat cheese or two tablespoons of peanut butter provide vegetarians with protein equal to one ounce of meat.
Hoskins promotes what she calls "the rainbow diet." If you’re eating all the colors of the rainbow, you’ll get all the fruits and vegetables you need. "The only color I don’t recommend is white, which includes white bread or refined starches and sugar," she says.
Once your baby is born, life is different-very different-but nursing mothers confront the same diet choices and concerns they experienced during pregnancy. "There is particular concern for mothers who could be deficient in vitamin B12—either from long-term vegetarian diets or macrobiotic diets," says Carol Huotari, a board-certified lactation consultant with La Leche League International (LLLI) and manager for the Center for Breastfeeding Information in Schaumburg, Illinois.
Vitamin B12—a nutrient vital to nervous-system health—is primarily available from animal protein. Although vegetarians who eat dairy and eggs get some form of animal protein in their diets, vegan moms should take a vitamin B12 supplement or add fermented soybean foods or brewers’ yeast to their diets.
Pediatricians also recommend that mothers give their babies supplements that include important nutrients such as B12 and folic acid. But Nizin says a nursing mother should be the one taking the vitamins since the baby will get the vitamins through her milk. "It’s just extra protection," she says. "Women who are nursing should continue taking whatever vitamins their health care practitioners recommended during pregnancy."
Also important for nursing mothers is calcium. Milk is a good source, but for vegans or women sensitive to dairy products, other choices exist. Half a cup of ground sesame seeds contains twice as much calcium as milk. According to The Breastfeeding Answer Book, published by LLLI, a cup of cooked bok choy provides 86 percent as much calcium as a cup of milk. Other calcium sources include calcium-enriched tofu, blackstrap molasses, collards, spinach, broccoli, turnip greens, kale, almonds and Brazil nuts.
Keep It Simple
LLLI recommends that nursing mothers "drink to thirst." Keep liquids at hand while you work-and especially while nursing—and drink whenever you feel the urge. Avoid alcohol, and limit caffeinated drinks.
Huotari says that researchers who compared the breast milk of vegetarians and non-vegetarians found that vegetarians had a reduced amount of environmental contaminants such as PCBs (polychlorinated biphenyls) in their breast milk. PCBs are synthetic organic chemicals that were once used in electric lighting and appliances. Though the federal government banned their use in 1977, PCBs are still found in the environment, and mothers can pass them to their babies through their milk. Studies have linked PCBs to skin problems as well as liver, stomach and thyroid damage. Some studies suggest that children born to and nursed by mothers exposed to increased levels of PCBs may suffer immune system and behavior problems.
While breast-feeding is recommended for at least the first 12 months of life, solid foods can be introduced late in baby’s first year. At first, limit the amount of any new food, and introduce one new food at a time. "A quarter teaspoon is enough," Nizin says. Then watch for sneezing, a runny nose, changes in personality or digestive problems such as diarrhea. If you don’t see any problems, keep the new food in the diet, Nizin says.
Vegetables and whole foods are best for baby, Nizin says. And puréeing and freezing your own is simple and easy to do. "I don’t recommend baby cereals," she says. "They are simply white breads with vitamins." Instead, use whole oats with breast milk and no additives or flavorings such as salt or sugar. "You don’t need any of that," she says.
As many vegetarian mothers know, children raised on meat-free diets beginning in utero through nursing and beyond can grow to be healthy and strong adults. Milazzo says her two daughters, now 12 and 15, have never had any food allergies or aversions to certain types of food. Today, both girls are strong and healthy—and competitive swimmers—oh, baby!