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Is a vegan diet suitable for young children?

A number of food trends have become popular over the last few years, including a shift towards a vegan diet. According to Google searches, the vegan trend quadrupled between 2012 and 2017. It now gets almost 3 times more interest than vegetarian and gluten free searches. The Vegan Society reports there are currently 600,000 vegans (1.16% of the population) in Great Britain. While it is thought the number of vegan children is on the rise in the UK, current figures only accounts for people aged the age of 15. The Veganuary campaign, which encourages people to go vegan for the month of January, grew by 183% in 2018, with 168,500 participants!

So what does a vegan diet look like?

A vegan usually follows a plant-based diet, generally no meat, fish or other substances that come directly from killing an animal or from agricultural practices which lead to unnecessary death or suffering of any animal. Vegans do not eat:

  • dairy products such as cows’ (or other animal) milk
  • milk products such as cheese and yoghurt
  • eggs or foods containing eggs
  • honey
  • any foods which contain gelatin or animal fats
  • products fortified with vitamins that have come from an animal source (for example, vitamin D which is added to some foods and drinks, and which usually comes from sheep wool lanolin).

What are the recommendations for vegan children?

The recommended age to introduce vegan and vegetarian babies to solid foods is around 6 months (the same advice for non vegan and vegetarian babies). You can find further information and advice on introducing solid foods and feeding toddlers by checking out our other blogs.

The British Dietetic Association, has stated that a well-planned vegan diet can “support healthy living in people of all ages”. The First Steps Nutrition Trust also state that “vegan diets can be safely given to infants and children providing that care is taken that all nutritional needs are met”.

Infants and young children, in particular, need enough energy (calories) to grow and be active, and enough nutrients (protein, fat, carbohydrate, vitamins and minerals) to ensure they remain healthy, fight infections, and support learning and levels of activity. It is possible for infants and children to get all the nutrition they need from a vegetable-based diet, but it does take thought and planning.

It’s essential that early years staff speak to parents and understand what families do and don’t eat. It is also important for families to seek advice on diet and health from an appropriate health professional and receive guidance if using specialist vegan supplements, e.g. vitamin drops, to ensure dosage is correct.

Eating Well in the First 6 months

Breast milk meets all the nutritional needs of infants in the first 6 months of life. There are no infant formulas suitable for vegan infants currently for sale in the UK because, even if they contain no animal-derived ingredients (for example, if they are made from soya rather than cows’ milk), the vitamin D that is added to them is sourced from sheep’s wool. The following should also be considered for other infant formulas:

  • Soya-based infant formula is suitable for vegetarian infants, but should not be given to infants under 6 months of age, and not used as the main milk drink for infants up to 1 year of age, unless recommended by a health professional. Although these milks are available, there is no evidence they prevent food allergies or intolerance. They are not recommended for infants who have cows’ milk intolerance, as these infants may be, or may become, allergic to soya protein. Soya-based formulas are more likely to cause dental decay, as they contain glucose rather than lactose. There are also some concerns about the high levels of phyto-oestrogens which can pose a risk to future reproductive health
  • A rice-based infant formula is available in Europe but this is not currently approved for sale in the UK. Families who buy this formula should be advised that the instructions for making the powdered milk up safely are not in line with UK recommendations and they should seek advice from a health professional. Any milk alternative made from rice that is not a highly modified formula (e.g. rice drinks), must not be offered to children under 5 due to the arsenic content.
  • Unsweetened calcium-fortified soya milk alternative can be used in cooking for vegan children from 6 months, but should not be used as the main milk drink until after 1 year of age. Breast milk, or an appropriate first infant formula, should remain the main milk drink from 6-12 months. Unsweetened calcium fortified soya milks are widely available and are usually inexpensive.

Eating well for vegan infants from 6 months

Child eating brocoliFirst foods for babies around 6 months of age include a wide range of unprocessed foods including vegetables, potatoes, cereal foods (such as rice, oats, polenta, semolina, pearl barley), pulses (peas, beans and lentils), tofu, ground nuts (whole nuts should not be offered to under 5’s due to the risk of choking) and seeds, and fruits.

Salt, sugar and artificial sweeteners should not be added to foods for infants. Naturally sweet fruits (such as apples or bananas) and vegetables (such as carrots, sweet potatoes or butternut squash) can be used to sweeten foods rather than adding sugar. If using commercial  baby foods (such as jars and pouches), follow the manufacturer’s instructions carefully. However, these foods are usually expensive, less nutritious, sweet, bland in taste and often too smooth compared to foods you can make yourself.

Important nutrients in vegan diets for 1- 4 year olds?

Offering children a variety of foods will help to ensure they get all the nutrients they need to grow and develop. Vegan children must be offered adequate amounts of foods that supply these nutrients, or be offered fortified foods and/or supplements. Vegetarian and vegan foods can be higher in fibre and lower in calories than a diet that includes meat. When it comes to starchy foods, in addition to wholegrain and wholemeal versions, children need some lower-fibre foods, such as white bread and rice, until they are 5 years old. This is because wholegrains are high in fibre and can fill children up before they have taken in enough calories and nutrients. The following are the key nutrients that need to be considered when following a vegan diet:

Iron

Iron is essential for the function of several body systems, particularly the pigmentation of red blood cells, called haemoglobin, which carry oxygen. A deficiency in iron can cause anaemia. This results in less oxygenated blood,  meaning the body receives less oxygen than it needs which limits the ability to be physically active. Children with iron deficiency will often appear pale, tired and their general health, resistance to infection, appetite and vitality will be impaired. Families should be encouraged to speak to a healthcare professional if they are concerned about their child’s iron levels. Suitable sources of iron for vegan children include:

  • fortified cereals (some may contain Vitamin D which may not be suitable for vegans based on how it is sourced)
  • dark-green leafy vegetables
  • wholegrains, such as wholemeal bread and brown rice (please note that children need a variety of while and wholemeal)
  • beans and lentils
  • nut butters
  • tofu
  • quinoa
  • dried fruit, such as apricots, figs and prunes. Remember to offer these with meals, rather than as a snack between meals, to help prevent tooth decay
  • The absorption of iron may be enhanced if foods or drinks rich in vitamin C are consumed at the same meal

Protein

Children need one to two portions of protein-rich food every day to make sure they get enough. Protein is needed for growth and maintaining and repairing body tissues, and to make the enzymes that control many body functions. Good sources of protein for children who eat some animal foods include:

  • dairy 
  • eggs 
  • fish

Plant foods that contain protein include:

  • beans and lentils, and foods made from them – such as tofu, hummus and soya mince
  • soya milk alternative and yoghurt (unsweetened varities)
  • seeds
  • finely ground nuts or smooth nut butters

Please note: peanuts and allergies

If a child already has a diagnosed food allergy, or there is a history of allergies in the child’s immediate family – including asthma, eczema or hayfever – families should talk to their health visitor or GP before offering foods containing peanuts for the first time.

Calcium

Whole milk and full-fat dairy products are a good source of calcium. Requirements for calcium are high in children aged 1-4 years. Calcium is needed for building and maintaining good bone health, for the transmission of nerve impulses, muscle actions and for many other bodily functions.

Suitable alternatives to milk and dairy foods include:

Rice Milk

  • unsweetened calcium-fortified milk alternatives, such as soya drinks, from the age of 1 as part of a balanced diet (rice milk is not suitable for children under 5 years)
  • green leafy vegetables – such as broccoli, cabbage and okra, but not spinach
  • soya beans
  • tofu
  • ground nuts and smooth nut butters
  • bread and anything made with fortified flour.

Vitamin B12

Vitamin B12 interacts with folate and vitamin B6. Together, these vitamins help the body to build up its own protein. B12 is essential for the formation of red blood cells and a healthy nervous system. Vitamin B12 is found in animal foods including eggs, cheese and milk.

Children may show signs of a B12 deficiency more rapidly than adults. Deficiency may lead to loss of energy and appetite and failure to thrive and, if not corrected quickly, it can lead to permanent damage. Recommendations for the amount of vitamin B12 needed in fortified foods or as a supplement vary. As a sensible measure, The Vegan Society recommends that young children aged 1-4 years have about 1.5 micrograms a day from fortified foods and a supplement of 3 micrograms a day. There are no children’s vitamin supplements available which provide this amount. However, a children’s dose of the Vegan Society supplement VEG1 (half a tablet) would provide 12.5 micrograms a day, which is still a safe dose.

Foods that may be fortified with vitamin B12 include baby and breakfast cereals, soya yoghurts, and non-dairy milks such as soya, oat and almond (300-400ml of fortified unsweetened milk alternatives will provide adequate vitamin B12 (about 1.5 micrograms a day). Vitamin B12 is also found in yeast extract, which is suitable for vegans – parents should choose a brand with no added salt if offering to their child. Parents or guardians should consult a GP if they are worried that their child may have vitamin B12 deficiency.

Omega-3

Omega-3 fatty acids are mainly found in oily fish, such as salmon and mackerel. Other sources of omega-3 include:

  • flaxseed (linseed) oil
  • rapeseed oil
  • soya oil and soya-based foods, such as tofu
  • walnuts – offer these ground or as a nut butter for children under 5 to reduce the risk of choking
  • eggs enriched with omega-3 (for non vegan children).

Omega-3 fats are found in both animal and vegetable foods, but vegetable sources of omega-3 fats do not provide the same fatty acids as those from animal (fish) sources.

Although alpha-linolenic acid (ALA) is present in vegetable oils and seeds such as rapeseed, soy, flaxseed, hemp, chia and walnuts for example, ALA is poorly converted into DHA and EPA – the fatty acids that are associated with better heart health and that are found in fish oils. Any health consequence of lower amounts of DHA and EPA in vegans is poorly understood, but eating a good mixed diet including good sources of ALA is recommended. Micro-algal sources of omega-3 fats have been suggested for vegans, but the impact of these on health is not yet known.

Vitamins supplements for children

The Department of Health recommends that all children aged 6 months to 5 years are given vitamin supplements containing vitamins A, C and D every day. It’s also recommended that babies who are being breastfed are given a daily vitamin D supplement from birth, whether or not mums are taking a supplement containing vitamin D. Babies who are having more than 500ml (about a pint) of infant formula a day don’t need vitamin supplements because formula is fortified with vitamins. Vitamin D2 is suitable for babies and children who have a vegan diet, and you can also get supplements containing vitamin D3 derived from lichen. It is important to speak to your health visitor for advice on vitamin drops for babies and young children.

Vitamin supplements for breastfed infants

It is also recommended that all breastfed babies have a supplement of 8.5-10 micrograms of vitamin D a day from birth (or in some areas, from 1 month).

Healthy Start vitamin drops will be suitable for use from birth from 2018/2019, but vegan families may not want to use these for their infants as they include vitamin D sourced from sheep’s wool lanolin.

Baby DDrops contain 10 micrograms of vitamin D and the manufacturer suggests that the drops can be put directly on the breast when breastfeeding. However, parents are advised to put the drops on a sterilised spoon to give to their infant as this can be a safer way of getting the right dose. The manufacturers say the vitamin D is sourced from sheep’s wool lanolin, but that animals are not harmed in the process.

A number of other supplements are marketed as suitable for vegan infants – for example, Abidec and BioCare Baby A, C, D Plus drops. These supplements contain a range of other nutrients as well as vitamin D, but neither provide the new recommended dose of 8.5-10 micrograms of vitamin D. If there is any concern about vitamin D intakes specifically, then vegan vitamin D supplements are available and families should talk to their pharmacist or GP.

Information about suitable supplements can also be found on The Vegan Society website. Families are strongly advised to seek advice from a health professional to ensure they do not provide harmful doses of any nutrients to infants.

Challenges for vegan children

If families choose to follow a vegan diet it’s important they understand that growing children need plenty of energy (calories) and nutrients (protein, fat, carbohydrate, vitamins and minerals) to ensure they grow and develop well. Vegan diets are based on vegetable foods only, so extra care must be taken to make sure that vegan children get a good variety of foods that can provide all the nutrients they need. Planning is key and parents therefore need to be very well informed to ensure they reduce the risk of vitamin D, calcium, iron and possibly vitamin B12 deficiency. In the toddlers years, fussy eating can be common and children typically have small appetites, so achieving their daily calorie needs can be a challenge. It is important for families to liaise with a health professional if choosing a vegan diet for their child and refers to the resources listed below for practical support.

Useful Resources:

Early Start Nutrition for blogs, recipes and e-learning

Eating well: vegan infants and under-5s from First Steps Nutrition Trust for lots of recipe ideas

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