Mother and Baby Guide

Increasing nutrients pregnancy / Foods & Drink to Avoid / Importance of Breastfeeding / Mother Nature Knows Best / Formula Feeds / Four to Six Months / Six to Eight Months / Eight to Twelve Months / Survival Tips / Note on Nuts / What to eat each day for health - pre and post pregnancy/ Foods for Weaning/ Recipes for Toddler

Pregnancy

A balanced vegetarian or vegan diet provides all the nutrients needed for a healthy pregnancy. Healthy babies are being born to sixth and seventh generation vegetarians and vegans in the UK and, of course, around the world, whole cultures have been vegetarian for thousands of years! It is the most natural, healthful diet and perfect for nurturing your unborn child.

A healthy pregnancy should just be an extension of your normally healthy diet. If you eat well anyway, then eating right for your unborn child won't be such a radical change. If, however, your diet has always been based around junk food, meat and dairy produce, then it's time it wasn't! For both your sakes.

The secret of a healthy diet is to eat a variety of foods, but focusing on wholegrains, pulses (peas, beans and lentils of all types), unsalted mixed nuts and seeds and fresh fruit and vegetables. This table shows what you need to eat each day. Eggs, meat, milk and cheese are high in cholesterol, animal fats and hormones (cows' milk contains 35 hormones and 11 growth factors!) and are not needed (or even desirable) for a healthy diet, so they are not included.

There is plenty of scope for adventurous, creative cookery. With herbs, spices, stock cubes, flavourings such as soya sauce and creamed coconut, soya cheese and a host of other extras, you can create the most wonderfully exotic dishes, as well as all the traditional favourites.

Increasing your nutrients for pregnancy

During pregnancy, your daily nutrient requirements increase considerably. Iron, folic acid, thiamin, niacin, riboflavin as well as vitamins A, C and D, calcium and protein are all needed in greater amounts. It's not surprising - you're making a whole new person and you'll need more nutrients than you do normally! If your diet includes plenty of fresh fruit and vegetables, you will probably be getting more than enough of vitamins A and C, folate and thiamin, but it doesn't hurt to give them all a bit of a boost.

The recommended amount of fruit and veg we should all eat is, of course, five a day - but this is the minimum, not the maximum! Aim for eight to 10 portions daily. If you find that challenging - buy a juicer. They range in price from about £40 to several hundred but are a great investment because fruit and vegetable juices are a wonderful source of many vitamins, minerals and trace elements, including iron, calcium, zinc and folic acid.

Make it part of your routine to juice any fruit you enjoy - try apples, pears, tangerines with any berries (fresh or frozen) for a huge vitamin and antioxidant boost! About five of these fruits makes a smallmedium glass of juice and tastes phenomenally good. Also try mixing fruit and veg together such as carrots with apples and a little ginger root for zest and even more goodness. For more inspiration see one of the many juicing books - the VVF stock some lovely ones at www.vegetarian.org.uk/shop. Here's more on how to boost your nutrient intake during pregnancy...

Protein
Protein is needed for growth, repair of tissue and protection against infection. Protein can be found in all pulses (all types of beans, peas and lentils), nuts, seeds, brown rice, wholegrains and wholegrain products such as breakfast cereals, brown bread and pasta. The humble soya bean - used in many soya products such as soya burgers, soya milk and tofu (soya bean curd) - is nutritionally equivalent to meat, containing as it does all the building blocks (amino acids) of protein.

The seed, quinoa is also high in protein, containing all essential amino acids and so, as with soya, is known as a complete protein. Use it like a grain - many people use it in place of rice or potatoes in stirfries, soups and so on. It's easy to cook, taking about 15 minutes to prepare. It's available in most supermarkets.

Preeclampsia, a syndrome of high blood pressure, reduced blood flow to the placenta and premature delivery, has been attributed to insufficient protein intake and so it is prudent to increase your intake in the final trimester. The good news - medical studies on 775 vegan mothers showed them to be less prone to preeclampsia.

Fats
Fats can either be saturated (found in high concentrations in most animal-derived foods such as butter, hard cheeses, red and white meats etc) or unsaturated. Whilst it's best not to eat the saturated kind at all, we do need the unsaturated type - the so-called essential fatty acids or polyunsaturated fats. There are two types of essential fatty acids - omega-3 and omega-6.

These fats are essential in the diet for repairing body tissue, to carry some vitamins (vitamins A, D, E and K) and for manufacturing some hormones. Essential fatty acids are a main constituent of the brain and eyes and are vital for the healthy functioning of all cell membranes. Omega-3 is also particularly anti-inflammatory and important in combating many diseases such as heart disease and arthritis - plant omega-3s being the most powerful source (see the VVF guide, Fish-Free for Life: Why Plant Omega-3s are Better for You and the Environment for more information at www.vegetarian.org.uk/guides/guides.htm.

The developing foetus requires omega-3 fatty acids for cell membranes and physiological functions, as well as for the brain and retina. The foetus requires a constant supply of this from mum and so is dependent on the maternal supply.

The best plant source of omega-3 fats is flaxseed, also known as linseed. Try ground flaxseed (they must be ground, otherwise the seeds will go straight through your system without the fats being absorbed! - you can buy them from health shops and supermarkets). Try sprinkling them on your breakfast cereal. The other source is flaxseed oil. Don't cook with this oil as heat destroys the omega-3s; instead use it to make salad dressings and pour cold onto soups/casseroles/pasta dishes etc after you have cooked them. Add about 1tsp. Omega-3 fats are also found in hemp seeds and hemp oil (use as above), cold-pressed rape seed (canola) oil, dark green leafy vegetables such as broccoli, some nuts eg walnuts and walnut oil (use cold-pressed oils unheated in salad dressings), soya beans and soya oil and wheat germ.

Omega-6 fats are found in seeds and their oils (again use unheated) such as sunflower, sesame, corn, grapeseed, hemp and rape, some nuts (eg pecans, pistachios, walnuts), rice bran and soya beans.

Most Western diets tend to be high in the omega-6 fats (used in many processed and junk foods) but not so high in the omega-3 fats. We are supposed to eat four times as much omega- 6 as omega-3 oils - but many of us eat 15 to 30 times more omega-6 than 3. It's a good idea therefore to make sure you include a wide range of the omega-3 rich foods in your diet.

There are even some specially formulated oils that supply both the omega-3 and omega-6 fats in the right proportions available from most healthfood stores and the VVF's shop (see www.vegetarian.org.uk/shop). Hemp seed oil and rape seed oil naturally contain about the right proportions. Soya beans are pretty good too. Flax is much higher in omega-3 than 6 so is useful if you need to top up omega-3 levels. Probably the best oil to cook with is virgin olive oil. Although it does not contain omega-3 and is low in omega-6, it is high in another beneficial non-essential fatty acid (omega-9), has many health benefits and is relatively stable when heated.

A note on omega-3s from fish.
Basically, don't eat them! All pregnant women are strongly advised by government to limit their oily fish intake and to not take cod liver oil (see Foods & Drink to Avoid).

Calcium
This vital element is needed for the healthy functioning of the nervous system, blood clotting and bone and tooth formation in both mother and baby. Seeds (especially sesame), nuts* (especially almonds*), dark green leafy vegetables and pulses such as beans of all types, lentils, chickpeas and tofu (made from soya beans) are particularly rich in calcium. Contrary to popular belief, drinking cows' milk is no guarantee of strong bones. The Harvard Nurses' Health Study took 77,761 women, aged 34 to 59, and followed them for 12 years. The research found that those who got more calcium from milk actually had slightly, but significantly, more fractures than those who drank little or no milk. Another study of elderly men and women in Sydney, Australia, also showed that higher dairy product consumption was associated with increased fracture risk. Those with the highest consumption had approximately double the risk of hip fracture than those with the lowest consumption. (See Viva! & VVF Guides Nutrition in a Nutshell, Your Health in Your Hands and It's Easy to be Dairy-Free at www.vegetarian.org.uk/guides/guides.htm.

Iron
The need for iron increases during pregnancy because both mother and baby are busy creating new blood. The best sources are dried fruits such as figs, apricots, dates and prunes, nuts* and seeds (especially sunflower, pumpkin and sesame seeds) and black treacle. Lentils, kidney beans, baked beans and other pulses, tofu and soya milk, hummus, cocoa, fortified breakfast cereals, wholewheat and wheatgerm, green leafy vegetables and wholegrains (brown rice, oats etc) are also useful sources. Because vitamin C greatly increases the absorption of iron from the food in your body, it is essential to make sure you are eating plenty of fresh fruit and vegetables. The British Medical Association states that vegetarians are no more prone to iron-deficiency anaemia than meat eaters.

Vitamins A, C and E
Vegetarians and vegans get plenty of vitamin A from eating foods containing betacarotene.

We convert beta-carotene into vitamin A in our bodies. Beta-carotene is high in carrots, sweet potatoes, red/yellow peppers, tomatoes, green leafy vegetables, watercress, mangoes, apricots, pumpkins, cantaloupe melons and romaine lettuce.

You'll find high amounts of vitamin C in kiwi fruit, berries and currants, fresh oranges, grapefruit, broccoli, spinach, cabbage, peas, blackcurrants, strawberries, green peppers and other fruit and vegetables. It's not in meat. Beta-carotene, vitamins C and E (this latter vitamin is found in vegetable oils, wholegrains, tomatoes, nuts* (esp. almonds*), asparagus, spinach, apples, carrots, celery and avocado) are antioxidants and help protect you from several diseases including heart disease, stroke, diabetes type II and cancer.

The B Vitamins
These vital vitamins comprise B1 (thiamin), B2 (riboflavin), B3 (niacin), B5 (pantothenic acid), B6 (pyridoxine), biotin, folic acid and B12 (cobalamin).

Many B vitamins are involved in releasing energy from food and help to aid growth and repair of the body.

They are widely available in wholegrains including wholemeal bread, brown rice and wholemeal pasta, yeast extracts (eg Marmite), pulses (peas, beans, lentils), nuts, seeds, dark green leafy vegetables, avocados and bananas. Many breakfast cereals are also fortified with B vitamins.

Folic acid is required for protein synthesis, formation of blood, metabolism of DNA (our genetic blueprint) and helps prevent neural tube defects in the developing foetus.

It is therefore necessary before conception and during early pregnancy to help prevent this condition. Folic acid is found widely in most vegetables (especially dark green leafy vegetables), nuts, pulses (peas, beans, lentils) and avocados.

Vitamins B6, B12 and folic acid are also necessary for helping to keep the arteries healthy.

Vitamin D
Just 15 minutes of exposure to sunlight on the face and arms is all that is required by the body to manufacture vitamin D. This vitamin aids the body's absorption of calcium and is needed for a healthy immune system. Because it is stored in the liver, a summer of moderate sun is normally enough to see us through the winter as well. Fortified breakfast cereals and vegetable margarines can be useful dietary sources if exposure to sunlight is not practicable.

Foods and Drinks to Avoid

If you are a vegetarian or vegan then (wisely) you won't be eating fish; if you are not then consider stopping! The government's Food Standards Agency (FSA) conservatively advises that pregnant and breastfeeding women should limit their consumption of oily fish to no more than two portions a week. They, along with children under 16, should avoid shark, marlin and swordfish entirely and limit the amount of tuna they eat due to contamination with potentially deadly pollutants.

There is overwhelming science highlighting the dangers of consuming deadly pollutants such as dioxins in herring, salmon, mackerel and, to a lesser degree, trout. What's more, most of the world's fish are contaminated with mercury - a neurotoxin which causes neurological damage, developmental delays and learning deficits.

The FSA also advises that pregnant women: "shouldn't take supplements containing cod liver oil, or other types of fish liver oil. This is because fish liver oil contains high levels of vitamin A, like liver and liver products such as liver pâtè. If you have too much vitamin A, levels could build up in your body and may harm an unborn baby."

Approximately 95% of food poisoning cases are due to meat and dairy products.

Remember, your baby will eat what you eat, so think carefully! Ripened soft cheeses such as Brie and Camembert must be avoided as they may contain high levels of listeria which, in rare cases, can lead to listeriosis. This may result in miscarriage, still-birth or severe illness in the new-born baby. Listeria bacteria has also been found in a very small number of some cook-chill products. These must be reheated thoroughly until piping hot.

Eggs should be avoided as they carry risk of salmonella and contain significant amounts of cholesterol.

Vegetables and salads should be washed thoroughly to remove any contaminated soil and dirt. Buying organic fruit and veg will help to limit the chemicals, such as pesticides and herbicides, reaching your unborn baby.

Caffeine in coffee and cola has been suspected of leading to birth defects or miscarriages but studies have proved inconclusive. Although artificial sweeteners in food and drink are said to pose no threat, again there have been concerns regarding these. They cross the placenta and are eliminated very slowly from foetal tissues.

Smoking is clearly bad for you and your baby and is associated with low birth weight and cot death. It's never too late to give up. Any prescribed or over-the-counter medication may prove harmful to the baby, even aspirin, paracetemol and cold remedies. If you don't really need them, the advice is don't take them. If you do, consult your doctor.

Avoid eating peanuts and nuts while pregnant or breastfeeding if you, your partner or a child in the immediate family come from an atopic family - see the Note on Nuts.

Also never give cows' milk (whether full fat, semi or skimmed) - it is meant for calves and therefore contains the wrong proportions of nutrients for the human baby. For example it is too high in calcium and protein and too low in essential fatty acids. This is why companies make millions of pounds turning cows' milk into cows' milk formulas - they alter the nutritional content in an attempt to mimic human breastmilk. Also do not give soya milk to a baby - it's too low in fat and too high in protein - give soya milk formula until your child is about two years old (see Formula Feeds section).

The Importance of Breastfeeding

Breastfeeding is certainly the most natural form of nutrition during the infant's first year of life. Breastmilk is truly miraculous - the perfect food for baby which not only contains every nutrient needed but antibodies that bolster the baby's immune system. It is impossible to replicate the exact formula of breastmilk. Neither can a bottle replicate the closeness and skin contact which a baby gets when feeding from her mother.

Besides, breastfeeding is so much easier and more practical than bottlefeeding. There's no sterilising equipment, no buying of milk powder, no heating of milk during the wee small hours and no chance of forgetting the baby's milk if you go out for the day.

Also, if you're patient it's a natural means of losing any extra pounds you've put on during pregnancy.

The World Health Organisation (WHO) now recommends that most women should exclusively breastfeed their babies for six months. They conclude that, in general, this is the healthiest start to life for a baby.

There are many benefits for the baby too. Asthma, eczema and other allergies can all be triggered by dairy produce. Digestive problems, ear infections, respiratory problems and intestinal bleeding have also been linked to the consumption of dairy products by infants.

The American Academy of Pediatrics Committee on Nutrition has recommended since 1992 that cows' (and goats') milk should never be given during the first year of a baby's life. (See Foods & Drink to Avoid)

If you are concerned about calcium - remember that cows' milk has evolved for calves, not humans! It contains four times too much calcium for a human baby.

Nature never meant us to drink it as infants or at any other time in our life! Three-quarters of the world's population do not consume dairy products as they are lactose intolerant.

There are many studies showing that nations consuming very little dairy (such as Thailand) have considerably lower incidences of osteoporosis than nations which consume high amounts (such as the USA).

What's more, a review of the evidence on the effect of cows' milk on bone health (published in the Journal of the American Academy of Pediatrics in 2005) concluded that children and adolescents do not require cows' milk but instead must exercise regularly and eat plenty of fresh fruit and vegetables, avoid smoking, fizzy drinks and caffeine for strong bones and teeth.

(For more information see the VVF's report on the effects of cows' milk on human health, White Lies and the great pocket-sized shopping and health guide, It's Easy to be Dairy-Free at www.vegetarian.org.uk.) All good reasons why babies should be breastfed wherever possible.

Although breastfeeding is natural, there is a knack to it and it is a good idea to prepare yourself before the birth by reading some of the very good books which are now available.