Casual recommendations regarding vegan diets can and do take a toll on the health of some vegans. There is no reason why vegans should ever be at risk for nutrient deficiencies. But if they don’t have access to good advice, or don’t follow it, deficiencies can certainly happen. And as one reader of this blog (a vegan mom) mentioned to me after reading a somewhat alarming article on feeding vegan children, “all of these issues are magnified tenfold when children are involved.”

Vegan kids have some clear advantages; their diets are low in saturated fat, free of cholesterol, and rich in fiber plus all kinds of health-promoting plant chemicals. The trade-off is that some nutrients need a little bit of extra attention.

For breastfed infants, though, recommendations are exactly the same whether a family is vegan or not. First, babies—especially those with dark skin—can be at risk for vitamin D deficiency if they don’t have adequate sun exposure. Breast milk is low in vitamin D regardless of the mother’s diet. Unless you are very certain that your baby gets enough sunlight to make vitamin D—and this depends on where you live, the time of year, and your baby’s skin—vitamin D supplements are absolutely necessary. Failure to provide vitamin D supplements is a significant predictor of vitamin D deficiency in breastfed infants.

The only nutrient that could be a unique issue for vegan infants is vitamin B12. But as long as a mom is supplementing appropriately, her breast milk will be adequate in B12.

Babies start eating solids at around six months. Iron-fortified cereals are a good first choice for breast-fed infants in particular since their iron stores begin to run low at this stage. From cereals, babies will progress to pureed or mashed fruits and veggies, and more protein- and iron-rich foods like mashed beans and tofu. As they begin to explore finger foods they can have small pieces of well-cooked vegetables or ripe fruit as well as nut butter spread thinly on bread.

Once children are weaned, it’s necessary to give some attention to calcium and vitamin B12. Toddlers need 700 milligrams of calcium per day and children aged 4 to 8 years need 1000 milligrams per day. It’s certainly possible to get that amount from foods that are naturally rich in calcium, but many children will need fortified foods to meet needs.

Simply eating a variety of whole plant foods does not guarantee adequate calcium for children (or for adults for that matter). Fortified plant milks can be a great option, and so can small amounts of fortified fruit juices (although juices should play a minor role in toddlers’ diets).

Toddlers should get a small chewable B12 supplement providing around 10 micrograms of cyanocobalamin per day, and preschoolers/school-aged kids should get around 15 to 20 micrograms per day.

Vegan toddlers have an advantage regarding iron because cow’s milk, which is extremely low in iron, often displaces iron-rich foods in the diets of omnivore children. But, even though plant foods are rich in iron, toddlers with sluggish appetites can fall short. This is especially true when higher fiber foods quickly fill those little tummies. Refined grains and cereals that are fortified with iron may help some children meet needs. It’s important to include lots of vitamin C rich foods in vegan children’s diets to give iron absorption a little boost.

Higher-fat foods like nuts, seeds and soyfoods can help vegan children meet nutrient needs. Unless children have allergies, there is no reason ever to eliminate these foods from their diets. Make sure that children get small daily amounts of ground flaxseed, walnuts, or a teaspoon or so of canola or walnut oil to ensure adequate intake of the essential omega-3 fatty acid.

Sub-optimal diet advice for vegan children can definitely place them at risk. But, there is no doubt about the fact that when they eat a healthy diet, vegan kids thrive.

For more information about feeding vegan children, I recommend this article by Dr. Reed Mangels.