Vegetarian Eating for Children and Adolescents

Laurie Dunham, MS, RD, LD; Linda M. Kollar, RN, MSN

Disclosures

J Pediatr Health Care. 2006;20(1):27-34. 

In This Article

Growth and Development Issues

Similar to the majority of the population, vegetarians often can benefit from a multivitamin supplement (Willett & Stampfer, 2001). For children and adolescents who follow a vegetarian diet and may not be ingesting 100% of the recommended amounts of vitamins and minerals, a multivitamin or single vitamin/mineral supplements will help ensure that their needs are being met. Table 1 provides a list of the Dietary Reference Intakes of specific vitamins, minerals, and fatty acids that have been discussed in this article.

As mentioned earlier, many infants and children require supplementation of at least 200 IU of vitamin D daily. Vitamin B12 supplementation (0.4µ/day for the first 6 months, 0.5µ/day beginning at 6 months of age) is necessary for breastfed vegan infants if the mother does not take a supplement or if she does not include B12-fortified foods in her diet. Zinc supplementation also may be indicated for older breastfed vegan infants; however, intake of solid foods plays a role in this determination. Currently the American Academy of Pediatrics does not recommend zinc supplementation (Mangels & Messina, 2001). Recommendations for supplementation for vegan infants are otherwise the same as for omnivore infants.

Solids can be introduced to vegetarian infants at the same stage and pace as for omnivore infants (Mangels & Messina, 2001). Iron-fortified cereals can be given at 4 to 6 months, followed by fruits and vegetables around 6 to 8 months and alternate protein sources like mashed tofu, soy yogurt, and pureed beans and legumes around 7 to 10 months. Because of potential allergens, it is best to wait to introduce nut and seed butters until after age 1 year, or as directed by a health care provider.

If growth is not occurring at the expected rate and calories need to be increased, the following foods can help increase the calorie and fat content of the diet: avocado (sliced or mashed), tofu, bean spreads, vegetable oils, margarine, and nut or seed butters (after age 1 year). High-fiber foods can fill a small stomach very quickly; therefore, in addition to the concentrated calorie sources listed above, dried fruit, peeled fruits and vegetables, fruit juices, and some refined grain products can help add calories without adding bulk at any age (Mangels & Messina, 2001).

Nutrition assessment and counseling are important aspects of health promotion in pediatric and adolescent health care. Individuals and families following a vegetarian diet benefit from an NP who is knowledgeable in specific dietary recommendations as well as community resources for a variety of vegan foods. A developmental approach allows the NP to appropriately tailor the counseling and assist with planning vegetarian diets that support the growth and energy needs of children and adolescents. Key vegetarian diet counseling points for each age group are included in the Box . Careful nutrition assessment and counseling will allow NPs to play a key role in encouraging families to adopt healthy eating habits with regular exercise to assist in disease prevention.

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