PBHP for Kids –
Frequently Asked Questions
Is a plant-based diet safe for babies and young children?
A well-planned plant-based diet is safe for babies and young children and may offer long-term health benefits compared to other eating patterns. All major medical and dietetic associations (including the British Dietetic Association, the American Academy of Nutrition, Dietitians of Canada and the NHS) agree that well-planned vegan diets are adequate and feasible at all stages of life, including pregnancy, breastfeeding and childhood.
What does ‘well-planned’ mean?
A well-planned diet is based on unprocessed and minimally processed foods from all the important food groups in the right proportions.
In the case of a vegan diet, this means that the diet should include a good variety of whole grains, legumes (beans), vegetables, fruit, nuts and seeds on a daily basis. It should also include vitamin B12 supplements; and in some individual cases, other supplements as well, such as vitamin D and iodine.
In addition, a well-planned diet, vegan or not, should include ultra-processed and sugary foods only occasionally.
A well-planned diet for babies and young children should be somewhat different from an adult diet. Young children need more calorie-dense foods because they grow very fast in a short time. They do not need large amounts of vegetables, but they do need foods rich in calories and nutrients such as peanut butter and other nut butters, potatoes and sweet potatoes, hummus, bananas and avocados, bread and other cereals, tofu, and of course breastmilk or an appropriate alternative.
Another important difference between the diet of young children and that of older children or adults is the way some foods are served. Children under five years of age are at risk of choking on small, hard, round foods, such as whole olives or grapes, popcorn, whole or chopped nuts and seeds, dried fruit, cherry tomatoes, ice cubes, hard raw vegetables or fruit (carrot, apple), seeds and pits from fruit. All these foods should be prepared to the right shape, size, and texture for each child’s developmental stage.
How do I convince my GP and health visitor that it is ok to raise my infant vegan?
Some health professionals are still not well informed about vegan diets for babies and children and may react with hostility when they learn that you are going to raise your child vegan.
If you feel that your health professional is genuinely concerned, you can show them the position statement from the British Dietetic Association.
Here is information on vegan diets provided by the NHS
However, it is not your role to educate or convince your GP, health visitor, midwife or anyone else. If you feel that they do not respect and support you as a parent, you should consider finding another professional who does. In any case, remember that it is your responsibility to ensure that your children are getting adequate nutrition; and the right supplements for their age. Check out reliable websites, such as the Vegan Society’s or ours at Pbhp.uk. There are also excellent books on vegan nutrition for babies and children. If you need personalised advice, a consultation with a paediatric plant-based dietitian can be very helpful.
Will a vegan diet negatively affect my child’s growth?
Recent studies on vegan children living in Europe, the USA and Canada have shown that the vast majority of them were growing within the normal range.
You may have seen in some headlines that the vegan children in these studies were a few centimetres shorter than the non-vegans. They were also thinner.
This does not mean that vegan children will be shorter when they reach adulthood. These studies have not looked at final height or growth rate; they have just examined a single measurement at the time of the study. It is quite possible that vegan children, being thinner, grow more slowly, but for longer. Overweight and obesity in childhood may accelerate the onset of puberty and thus limit final height.
As long as a child receives enough calories and nutrients, the main determinant of height after the first year of life is the height of the child’s parents. This is called genetic potential height, or target height, and is calculated as follows:
In girls: (Father’s Height – 13cm / 5 in + Mother’s Height) / 2.
In boys: (Father’s Height + Mother’s Height + 13 cm / 5 in) / 2.
For example, if your child’s target height is on the 25th centile and she is growing along the 25th centile, or between the 9th and the 25th centile, this means that she is growing well. Growth charts for boys and girls can be found here (https://www.rcpch.ac.uk/resources/growth-charts).
Another important measure is the growth velocity of your child. Average growth between 1 and 10 years is 5-8 cm per year (2-3 in per year). During puberty, average growth is 9-10 cm per year (3.5-4 in per year).
If your child is growing below his or her target height centile or is growing more slowly than the normal values for their age, ask your GP to refer your child for a paediatric evaluation. At the same time, review your child’s diet with a plant-based dietitian to make sure it is well-balanced and provides enough energy; and that your child is taking the right supplements.
I have also read that the bones of vegan children are more fragile
A recent study in Polish children aged 5-10 years showed that vegans had 4-6% lower bone mineral density than non-vegetarians. This does not mean that the bones of vegan children are `fragile’, as the values were still within the normal range for their age.
In any case, it is important to make sure that your child’s diet provides adequate nutrients for bone growth, mainly calcium and vitamin D.
The main sources of calcium for babies and children are, in addition to breast milk or formula in the first and second year, calcium-fortified plant milks (especially soya milk), calcium-fortified soya yoghurts, calcium-set tofu, green vegetables such as broccoli, Brussels sprouts and kale; almonds, tahini, and chia seeds. Vegan children should have 1-2 servings of calcium-fortified plant-based milks and/or yoghurts daily, depending on their age, in addition to other calcium-rich foods on a regular basis.
Vitamin D is essential for absorbing calcium from food. In the UK most people, whether vegan or not, need vitamin D supplements to maintain optimal blood levels, at least in winter when there is less sunlight. Check our section on supplements.
Regular physical activity helps strengthen bones and muscles. Encourage your children to play and exercise every day, outdoors whenever possible.
What are my options if I choose not to or if I cannot breastfeed my baby?
During the first year of life, babies that cannot breastfeed need formula milk specifically designed for infants. There are several options available for vegan families; you can read more about them here. Plant-based milks are not suitable in the first year of life.
Will my child have anaemia if he/she does not eat meat?
Iron requirements in childhood are very high, and some children, whether or not they eat meat, have low iron stores and sometimes develop iron deficiency.
Studies of vegan children have shown that, although they tend to have lower iron stores, they do not become anaemic more often than children who eat meat.
Legumes, whole grains, tofu and tempeh, nuts, seeds, dried fruit and many vegetables are very good sources of iron. Fruit and vegetables have substances that increase iron absorption; therefore prioritising whole foods and fruit and vegetables is the best way to ensure a good iron intake.
If your child is tired, has less energy or a reduced appetite, or has pale lips or skin, talk to your GP. Iron deficiency is diagnosed using blood tests. Do not give iron supplements to your child without knowing whether or not they are deficient – they could be harmful. Read more about iron supplements for vegan children here.
My child has been diagnosed with coeliac disease, can she be vegan?
Yes. Children and adults with coeliac disease must follow a gluten-free diet for the rest of their lives. Gluten is found in three cereals: wheat, barley and rye. Oats contain avenin, which is a protein similar to gluten, but most people with coeliac disease tolerate oats well. However oats may get contaminated with gluten if they are processed in the same facilities as wheat, rye, and barley.
Children with coeliac disease can still eat a good variety of cereals and grains, including:
- certified gluten-free oats
- corn – cornmeal and polenta
In addition, children with coeliac disease can eat all types of beans and legumes, soya milk, plain soya yoghurt, tofu, tempeh, all nuts and seeds and of course all fruits and vegetables.
Some tips to replace common foods with healthy gluten-free alternatives:
- Gluten-free pasta is usually made with cornflour and rice flour. These varieties are low in protein and fibre. Try to choose brands that also include quinoa, sorghum or buckwheat flour. Another option is to combine corn/rice pasta with pasta made with chickpea, red lentil or pea flour in the same dish (50-50% or 75-25%). For noodle dishes, choose soba noodles made with 100% buckwheat flour; or soybean noodles.
- Many commercial gluten-free breads contain egg or other animal products, and many additives. They are usually made from a combination of rice and corn flour and tapioca and potato starch, and are therefore not very nutritious. For healthier alternatives, use corn tortillas for wraps, flatbread made with lentil or chickpea flour, and thinly-sliced sweet potatoes for toasts. Rice and corn cakes are good options, but again, try to choose those that also include other grains, lentil flour and / or seeds.
- Many vegan processed foods contain gluten. Plain tofu and tempeh are gluten-free, but some marinated versions may contain gluten. Tamari is usually made with 100% soya beans and therefore gluten free, whereas soya sauce includes wheat, but it is important to check each individual brand.
My child has multiple allergies; can he still have a well-balanced vegan diet?
Yes, but it is advisable to plan his diet with the guidance of a paediatric plant-based dietician, because if the diet excludes many different foods, it may be difficult to obtain some important micronutrients.