Nutrition
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The Vegetarian/Vegan Pregnancy

Get the nutrients you and your baby need

Appropriate food choices are important, as the right nutrition can have an impact on helping to prevent, as well as treat, disease. Diets rich in fruits, vegetables or grains are becoming more popular in developed countries like the U.S. These diets include vegetarian or vegan diets. But are these types of diets safe for you and your baby?

According to the American Dietetic Association, “Well-planned vegetarian diets are appropriate during all stages of the life cycle, including pregnancy.” However, it is important to discuss your diet with your healthcare provider, as all diets need to include a wide variety of foods to be healthful.

The research on the safety of vegetarian and vegan diets is difficult to interpret, because the expectant moms included in these studies did not eat the same foods, had different levels of exercise and differed in other lifestyle factors. However, there is no consistent evidence of the impact of a vegetarian or vegan diet on infant birth weight or most major birth defects. Studies have shown both lower and higher birth weights among infants whose mothers had vegetarian or vegan diets.

The only birth defect that may be associated with a plant-based diet is hypospadias, a deformity of the opening in the penis. The development of this condition may be related to a high consumption of soy products during pregnancy. However, other factors may also affect the risk of having a child with hypospadias, and the relative impact of expectant mother’s diet on this condition is not conclusive. There is also no consistent data that what you eat during pregnancy can cause or prevent chronic health issues in your baby, such as asthma or diabetes.

There is no consistent evidence of the impact of a plant-based diet on your health during pregnancy. Studies have shown that expectant moms who have vegetarian diets either gain less or just as much weight as those who included animal products in their diets. However, plant-based diets typically provide high quantities of fiber and are low in sugar and fat. In addition to regular exercise, these diets may help to decrease your risk of developing hypertension or pre-eclampsia.

However, as with all diets, it’s important to make sure that you are getting the appropriate vitamins and minerals. This means that you need to eat a wide variety of foods.

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People who eat a plant-based diet — especially vegans — are at risk of vitamin and mineral deficiencies, especially vitamin B12, iron, calcium and vitamin D. Vitamin B12 is typically found in meat, and supplementation is typically recommended for all people who have a plant-based diet, whether they are pregnant or not. However, getting sufficient B12 is especially important when you are pregnant, as this vitamin is crucial in the production of red blood cells. In addition, it is needed for brain development. So it’s also important to make sure that you continue to take in enough B12 while you are breastfeeding, as your baby needs this vitamin for continues neurologic development.

Vegetarians and vegans are also at risk for iron deficiency. Iron is needed to develop red blood cells. Taking in enough iron during pregnancy is associated with higher birth weights.

Calcium and vitamin D are needed to help your baby develop her skeleton, as well as to keep your bones strong. You need to make sure that you are getting enough of this mineral and vitamin during pregnancy, as well as when you are breastfeeding. Dairy products normally contain calcium but at much lower levels. Many nondairy beverages and foods are also supplemented with calcium. Check with your provider about how much calcium you need, but 1,000 mg per day is usually recommended. Become a label reader!

Vitamin D is needed to help you absorb calcium. Although referred to as the “sunshine vitamin,” it is actually difficult to take in enough vitamin D with sun exposure alone. Unlike calcium, vitamin D is found naturally in very few foods — primarily fatty fish and egg yolks — putting vegetarians and, especially vegans, at risk for vitamin D deficiency. Some foods have vitamin D added to them, in variable quantities. This is another opportunity to read labels and check with your provider. The recommended daily dose of vitamin D during pregnancy and while breastfeeding is still under debate. You may need to take additional supplements to get the amount of vitamin D that your provider recommends.

Much more research needs to be done to determine what impact your diet has on your baby. However, until we know more, make sure that you eat a wide variety of foods — whether you maintain a vegetarian or vegan diet or not. Discuss your diet with your provider before, during and after pregnancy to make sure that you are getting in the right number of calories, the right amount of protein and all of the vitamins and minerals that you and your baby need.

For more information on pregnancy nutrition, visit youandyourfamily.com.

Kimberly Templeton, MD, is President of the American Medical Women’s Association (AMWA) and Professor of Orthopaedic Surgery at the University of Kansas Medical Center in Kansas City.

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Written by Kimberly Templeton, MD

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