Tuesday, June 30, 2009

Iron deficiency anemia?

Dear Monique, Hi. My daughter (16 months old, still breastfeeding, a life-long vegan) was just diagnosed with severe asymptomatic anemia. This was a surprise to me, since she eats a varied diet, nurses (and I take prenatal/lactation multi-vitamins), and she loves leafy greens and fortified grain products.

A lot of folks are advising that in addition to iron supplements (which she passionately hates in any form) she needs to have some sort of meat in her diet because she might have a body type which just can't adequately process non-heme iron. She also seems to crave fish - she frantically tries to grab it off other peoples plates when we eat out at omnivorous restaurants and order a vegan dish for ourselves.

I have been a vegetarian for 12 years and a vegan for 8, for moral as well as health reasons, so it would be hard for me to introduce meat to our diet without a big struggle. Is there any basis to this idea that she might just be that rare individual who actually DOES need a small amount of meat?

One last question - my pediatrician has asked me to give her 60 mg of iron a day in supplement form. This is 4 times the recommended dosage. Is this safe? Thanks, Marnie

Answer: Iron deficiency anemia may be caused by too little dietary iron, poor absorption of iron, chronic bleeding or heavy menstruation. There are various forms of anemia, and their treatments depend upon their cause. Vegan women and their babies are particularly prone to anemia when they do not have an adequate supply of iron, folic acid or vitamin B-12.

Vegans need to make sure that they consume nutritional yeast to get the vitamin B-12 that they need in their diet. A great non-animal source is Red Star nutritional yeast (this is different from the yeast used for baking). They also need to eat iron and folic acid rich foods like green leafy vegetables, soy foods and dried fruits. Since your pediatrician advises 60 mg of iron a day in supplement form, I would suggest following this recommendation.

However, I would not follow the advice you are getting from other people that suggest feeding your baby meat. Your baby is probably not craving fish. Young children tend to be curious about new things, and want to put everything in their mouth. While increased protein may be required, it does not have to come from animal sources.

Babies and young children need more protein in their diet than adults. Children, between the ages of one to three, need 0.81 grams of protein per pound of body weight per day. Adults, on the other hand, only need 0.36 grams of protein per pound of body weight per day. (To calculate how much protein you and your baby need a day, multiply body weight by the grams of protein shown).

Again, increasing protein in the diet does not have to come from meat or fish! There are some wonderful vegetable protein sources to choose from, such as tempeh (a fermented, easy to digest, high protein and iron soy product); seitan (protein derived from wheat gluten);
textured soy protein (made from defatted soy flour); and legumes.

I would suggest trying to feed your little one more of these foods for increased protein and iron (especially
tempeh). Adding more raisins and prunes for iron and fiber; leafy green vegetables, tofu and fortified soymilk for iron and folic acid; and nutritional yeast for vitamin B-12.

For more information, read "Vegetarian Diets for Children: Right from the Start" at

and the books...

Dr. Spock's Baby and Child Care (8th edition)

The New Becoming Vegetarian: The Essential Guide To A Healthy Vegetarian Diet
by Vesanto Melina & Brenda Davis

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Monique N. Gilbert, BSc. has offered guidance in health, nutrition, fitness and stress management since 1989. Through her writings, Monique motivates and teaches how to improve your well-being, vitality and longevity with balanced nutrition, physical activity and healthy stress-free living.


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