Last update: Oct. 11, 2017

Vegetarian Diets

Low Risk for breastfeeding


Moderately safe. Probably compatible.
Mild risk possible. Follow up recommended.
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According to the Academy of Nutrition and Dietetics (Melina 2016), well-planned vegetarian diets are healthy, nutritionally adequate and can provide benefits for the prevention and treatment of various chronic diseases. They are appropriate for all stages of the life cycle, including pregnancy, breastfeeding and childhood and are environmentally sustainable.

However, they must be "appropriately planned" (Melina 2016) since there may be difficulties in balancing them if one does not have experience and knowledge of nutrition (Brzezińska 2016).

The vegan diet does not contain meat, eggs, milk or, sometimes, honey. Milk from vegan mothers contains low concentrations of vitamin B12 (Specker 1990).
In practice, many cases of megaloblastic anemia have been reported in recent years and have a severe impact on physical and neurological development (including cerebral atrophy) in infants breastfed by vegan mothers (Kocaoglu 2014, Guez 2012, Mariani 2009, Roed 2009 , Erdeve 2009, Lücke 2007, Baatenburg 2006 and 2005, Codazzi 2005, Wagnon 2005, Reghu 2005, Roschitz 2005, Weiss 2004, CDC 2003, Fogarasi 2001, Smolka 2001, Renault 1999, Monfort 1993, Kühne 1991, Cheron 1989, Sklar 1986 , Lacroix 1981).
There are also cases of neonatal hypothyroidism in infants of vegan mothers (Borak 2005, Shaikh 2003).

Vegetarian women need, during pregnancy and breastfeeding, regular and adequate sources of vitamin B12 (Melina 2016, Brzezińska 2016, Committee LM AEP 2012 p.7, Academy N&D 2010). If these are deficient, in addition to treating the mothers, you have to treat their infants with supplements (CDC 2003).

Infants and milk from vegetarian mothers (and especially vegan mothers) have lower levels of docosahexaenoic acid (DHA) and higher levels of linoleic and α-linolenic acids than that from omnivorous mothers (Melina 2016, Brzezińska 2016, Sanders 2009 and 1992 ), without there being evidence of adverse effects on their health or cognitive function (Sanders 2009).

There is a greater concentration of selenium in the breast milk of ovo-lacto-vegetarian mothers than that of non-vegetarian mothers (Debski 1989).

The concentration of taurine in plasma and milk of vegan mothers was slightly lower than that of omnivorous mothers (Rana 1986).

The lowest levels of organochlorine contaminants were found in the milk of vegetarian mothers (Norén 1983).


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Suggestions made at e-lactancia are done by APILAM´s pediatricians and pharmacists, and are based on updated scientific publications.
It is not intended to replace the relationship you have with your doctor but to compound it.

Jose Maria Paricio, Founder & President of APILAM/e-Lactancia

Your contribution is essential for this service to continue to exist. We need the generosity of people like you who believe in the benefits of breastfeeding.

Thank you for helping to protect and promote breastfeeding.

José María Paricio, founder of e-lactancia.

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References

  1. Brzezińska M, Kucharska A, Sińska B. [Vegetarian diets in the nutrition of pregnant and breastfeeding women]. Pol Merkur Lekarski. 2016 Abstract
  2. Melina V, Craig W, Levin S. Position of the Academy of Nutrition and Dietetics: Vegetarian Diets. J Acad Nutr Diet. 2016 Abstract Full text (link to original source)
  3. Kocaoglu C, Akin F, Caksen H, Böke SB, Arslan S, Aygün S. Cerebral atrophy in a vitamin B12-deficient infant of a vegetarian mother. J Health Popul Nutr. 2014 Abstract
  4. 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. 2012 Abstract
  5. Comité de Lactancia Materna AEP. Preguntas frecuentes sobre lactancia materna. Folleto. 2012 Full text (link to original source) Full text (in our servers)
  6. Academy of Nutrition and Dietetics. Vegetarian Diets during Lactation. Resources for Consumers. 2010 Full text (link to original source) Full text (in our servers)
  7. Sanders TA. DHA status of vegetarians. Prostaglandins Leukot Essent Fatty Acids. 2009 Abstract
  8. Mariani A, Chalies S, Jeziorski E, Ludwig C, Lalande M, Rodière M. [Consequences of exclusive breast-feeding in vegan mother newborn--case report]. Arch Pediatr. 2009 Abstract
  9. Roed C, Skovby F, Lund AM. [Severe vitamin B12 deficiency in infants breastfed by vegans]. Ugeskr Laeger. 2009 Abstract
  10. Erdeve O, Arsan S, Atasay B, Ileri T, Uysal Z. A breast-fed newborn with megaloblastic anemia-treated with the vitamin B12 supplementation of the mother. J Pediatr Hematol Oncol. 2009 Abstract
  11. Lücke T, Korenke GC, Poggenburg I, Bentele KH, Das AM, Hartmann H. [Maternal vitamin B12 deficiency: cause for neurological symptoms in infancy]. Z Geburtshilfe Neonatol. 2007 Abstract
  12. Baatenburg de Jong A, Bekhof J, Zwart P, Langenhorst VJ, Roorda RJ. [Developmental delay in breastfed children due to inadequate diet of the mother]. Ned Tijdschr Geneeskd. 2006 Abstract
  13. Codazzi D, Sala F, Parini R, Langer M. Coma and respiratory failure in a child with severe vitamin B(12) deficiency. Pediatr Crit Care Med. 2005 Abstract
  14. Baatenburg de Jong R, Bekhof J, Roorda R, Zwart P. Severe nutritional vitamin deficiency in a breast-fed infant of a vegan mother. Eur J Pediatr. 2005 Abstract
  15. Borak J. Neonatal hypothyroidism due to maternal vegan diet. J Pediatr Endocrinol Metab. 2005 Abstract
  16. Reghu A, Hosdurga S, Sandhu B, Spray C. Vitamin B12 deficiency presenting as oedema in infants of vegetarian mothers. Eur J Pediatr. 2005 Abstract
  17. Roschitz B, Plecko B, Huemer M, Biebl A, Foerster H, Sperl W. Nutritional infantile vitamin B12 deficiency: pathobiochemical considerations in seven patients. Arch Dis Child Fetal Neonatal Ed. 2005 Abstract Full text (link to original source) Full text (in our servers)
  18. Wagnon J, Cagnard B, Bridoux-Henno L, Tourtelier Y, Grall JY, Dabadie A. [Breastfeeding and vegan diet]. J Gynecol Obstet Biol Reprod (Paris). 2005 Abstract
  19. Weiss R, Fogelman Y, Bennett M. Severe vitamin B12 deficiency in an infant associated with a maternal deficiency and a strict vegetarian diet. J Pediatr Hematol Oncol. 2004 Abstract
  20. Shaikh MG, Anderson JM, Hall SK, Jackson MA. Transient neonatal hypothyroidism due to a maternal vegan diet. J Pediatr Endocrinol Metab. 2003 Abstract
  21. Rachmel A, Steinberg T, Ashkenazi S, Sela BA. Cobalamin deficiency in a breast-fed infant of a vegetarian mother. Isr Med Assoc J. 2003 Abstract
  22. Centers for Disease Control and Prevention (CDC).. Neurologic impairment in children associated with maternal dietary deficiency of cobalamin--Georgia, 2001. MMWR Morb Mortal Wkly Rep. 2003 Abstract Full text (link to original source) Full text (in our servers)
  23. Fogarasi A, Neuwirth M, Békési A, Bocskai E. [Macrocytic anemia and neurological signs due to vitamin B-12 deficiency in a breast-fed infant of a strict vegetarian mother]. Orv Hetil. 2001 Abstract
  24. Smolka V, Bekárek V, Hlídková E, Bucil J, Mayerová D, Skopková Z, Adam T, Hrubá E, Kozich V, Buriánková L, Saligová J, Buncová M, Zeman J. [Metabolic complications and neurologic manifestations of vitamin B12 deficiency in children of vegetarian mothers]. Cas Lek Cesk. 2001 Abstract
  25. Renault F, Verstichel P, Ploussard JP, Costil J. Neuropathy in two cobalamin-deficient breast-fed infants of vegetarian mothers. Muscle Nerve. 1999 Abstract
  26. Monfort-Gouraud M, Bongiorno A, Le Gall MA, Badoual J. [Severe megaloblastic anemia in child breast fed by a vegetarian mother]. Ann Pediatr (Paris). 1993 Abstract
  27. Sanders TA, Reddy S. The influence of a vegetarian diet on the fatty acid composition of human milk and the essential fatty acid status of the infant. J Pediatr. 1992 Abstract
  28. Kühne T, Bubl R, Baumgartner R. Maternal vegan diet causing a serious infantile neurological disorder due to vitamin B12 deficiency. Eur J Pediatr. 1991 Abstract
  29. Specker BL, Black A, Allen L, Morrow F. Vitamin B-12: low milk concentrations are related to low serum concentrations in vegetarian women and to methylmalonic aciduria in their infants. Am J Clin Nutr. 1990 Abstract
  30. Debski B, Finley DA, Picciano MF, Lönnerdal B, Milner J. Selenium content and glutathione peroxidase activity of milk from vegetarian and nonvegetarian women. J Nutr. 1989 Abstract
  31. Cheron G, Girot R, Zittoun J, Mouy R, Schmitz J, Rey J. [Severe megaloblastic anemia in 6-month-old girl breast-fed by a vegetarian mother]. Arch Fr Pediatr. 1989 Abstract
  32. Sklar R. Nutritional vitamin B12 deficiency in a breast-fed infant of a vegan-diet mother. Clin Pediatr (Phila). 1986 Abstract
  33. Rana SK, Sanders TA. Taurine concentrations in the diet, plasma, urine and breast milk of vegans compared with omnivores. Br J Nutr. 1986 Abstract
  34. Norén K. Levels of organochlorine contaminants in human milk in relation to the dietary habits of the mothers. Acta Paediatr Scand. 1983 Abstract
  35. Lacroix J, Macher MA, Badoual J, Huault G. [Complication of a vegetarian diet in a breast-fed girl (author's transl)]. Arch Fr Pediatr. 1981 Abstract

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