Vegan Breastfeeding with Dr Miriam Martinez-Biarge
By Dr Miriam Martinez-Biarge
Until not long ago, it was believed that the milk of vegan women was deficient in some nutrients and of inferior quality than that of non-vegan women, and in some hospitals vegan mothers were automatically excluded as potential milk donors.
But this is not justified; recent studies have shown that well-nourished vegan mothers produce milk that is nutritionally adequate. When vegan mothers eat a balanced diet and take the right supplements, their milk contains the same nutrients as other women’s milk. It even has some advantages, such as a more beneficial fatty acid composition and lower pesticide content.
As with any other dietary pattern, vegan mothers should make sure to include in their diet good sources of protein (beans and legumes, tofu and tempeh, nuts and seeds), calcium (kale, pak choi and other greens, calcium-set tofu, fortified plant milks and yoghurts, tahini, almonds…), vitamin A (sweet potato, carrot, pumpkin, peppers) and zinc (seeds, tempeh, whole grains).
There are four supplements that are essential for vegan mothers while they are breastfeeding: vitamin B12, vitamin D, DHA and iodine.
Vitamin B12 levels in breastmilk depend on maternal supplementation more than on the type of diet, and the milk of vegan women who regularly take supplements provides adequate amounts of this vitamin.
DHA is a long-chain omega-3 fatty acid that plays an important role in brain and vision development. Both vegan and non-vegan women with low fish intake have low levels of DHA in their milk, but supplementation with microalgae oil has been shown to raise milk levels to values comparable to those of women who regularly eat fish.
Iodine is essential for growth and brain development, and most plant foods provide only very small amounts of this nutrient. Although iodine can be found in sea vegetables in varying amounts, it is safer for vegan mothers to take an iodine supplement during pregnancy and lactation.
It is recommended that all breastfed babies take a supplement containing 400 IU of vitamin D daily for the first year of life, so vegan mothers would not need to take this vitamin to ensure good levels in their milk. However, vitamin D is essential for optimal calcium absorption in the gut, and vegan mothers need to protect their own bones while they are breastfeeding.
Some women prefer to take a multivitamin during pregnancy and lactation, and this is perfectly fine. There are now many vegan brands that provide all of the micronutrients that women need during this period.
Moving away from breastfeeding
According to the World Health Organisation, ideally babies should be breastfed for up to 2 years and beyond. However, this is not always possible.
Babies usually start eating foods other than milk (complementary foods) around 6 months of age, but milk remains their main source of calories and nutrients until the baby turns one. If breastfeeding is no longer possible, babies should be given infant formula instead. Infant formula has been designed to provide all the nutrients that babies need at each age and that are found naturally in human milk. Vegan families can use soya infant formula.
During the second year of life, babies can continue to drink soya infant formula, or can begin drinking calcium-fortified soya milk. There are also some drinks specifically designed for toddlers from 1 to 3 years, based on soya or pea protein and fortified with calcium, iron, iodine and some vitamins that are a very good option at this age.
Dr Miriam Martinez-Biarge has over 20 years of medical experience, having trained in Paediatrics and Neonatal Medicine in Spain in 1999. She now runs a private paediatric practice in the UK and Spain, where she offers consultations on Paediatric Plant-Based Nutrition, amongst other things.