Vegan Nutrition with Dina Aronson, M.S. R.D.

Dina Aronson, MS, RD is a vegan dietitian whose specialties include chronic disease prevention, vegetarian/vegan nutrition, and lifestyle management. She is the founder and director of VeganRD.com, a nutrition consulting company. Active in many vegetarian nutrition organizations, Dina was the recipient of the American Dietetic Association's Recognized Young Dietitian of the Year Award in 2002.

Question 1: Hi, I have a vegan friend who has a baby with an allergy to soy formulas. She is breastfeeding exclusively at this time but is wondering if there are any alternative formulas when weaning her, such as formulas based on rice, etc. Any help would be appreciated.

Question 2: What should I feed my infant when she weans from breastmilk? I keep reading about soy milk causing cancer and the rice milk I just bought says on the label not to give to anyone under 5yrs.

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The only acceptable and safe alternative to breast milk is commercial infant formula. For the first year of life at least, infants need breastmilk and/or formula as the predominant source of food in order to thrive. There is no need to wean an infant to formula; healthy breastfeeding moms can gradually wean her healthy, growing child to regular food after one year of age. The longer the infant gets mother's milk, the better, of course, but the most important benefits of breastmilk are seen in the first year. Vegan families are encouraged to breastfeed for at least 2 years (not exclusively, of course; babies should be introduced to regular food around 6 months), as mother's milk is a concentrated source of nutrients needed for the rapid growth that occurs during the first two years.

For families following a plant-based diet and whose babies who are allergic to soy, the only other option at this time is what is called elemental formulas. These are designed for infants who cannot tolerate soy and/or cow's-milk-based formula, and they are the most expensive of the formulas. Examples are Nutramigen, Neocate, Pregestamil and Alimentum. I am not aware of a 100% vegan elemental formula at this time, thought they are closer to a vegan product than is a cow's milk-based formula.

As far as a "milk" substitute after one year of age, the best choice for vegans is fortified soy milk. Soy is perfectly safe and does not cause cancer or hormonal imbalances in babies. For those with soy allergy, other milks based on rice, nuts, or hemp are adequate ONLY if they are fortified with calcium and vitamin D and B12 and contain at least five grams of protein per cup (seven to eight grams is best). Read labels, because products are always changing. Soy, rice, and other plant "milks" are NOT acceptable substitutes for breast milk and formula; they are healthy beverages for children over the age of 1. Caregivers should aim to provide about 2 cups a day.

I cannot emphasize enough that for infants not getting breast milk, commercial infant formula is the only acceptable main source of nutrition during the first year of life. Some groups and organizations provide recipes for home-made formulas for infants, and I strongly caution against them. Too many infants have gone malnourished on these concoctions; some have even died. Store-bought infant formulas are not perfect, but they approximate the nutritional value of breast milk to the best of the manufacturers' ability; they utilize the current scientific knowledge base regarding infant nutrition.

Disclaimer: The advice given here is for eductional purposes only. You should not use this information to diagnose or treat a health problem or disease without consulting with a qualified health care provider.

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