Response to Health24's "Do vegan diets endanger child health?"

Recently a French couple were found guilty of neglect and sentenced to five years after their 11 month old baby died from infections as a result of malnourishment, specifically Vitamin A and B12 deficiencies. Many articles covering the case are confusing bad parenting with veganism. Veganism is being implicated as the sole cause of this baby’s very sad death, despite there clearly being other factors at play – such as the parents’ ignorance of their own and their infant’s nutritional requirements, and their refusal to follow their doctor’s advice and rather use homeopathic remedies when the baby became ill.

A few years ago, there was a similar case in Atlanta where veganism was attacked for a baby’s death – despite the prosecutor in that case concluding that “[t]he vegan diet is fine…These parents lied about what they fed him. He just was not fed enough…They’re not vegans. They’re baby-killers. Think about how long they had to listen to his screams and hollers.”

The judgement in the French case reveals the same thinking - that the parent’s insistence on using natural remedies was more a factor in the baby’s death than the vegan diet. The judge acknowledged that the prosecutor tried to blame the mother’s veganism for the death, but that expert testimonies argued over that. Rather, the conclusion was that the parents were neglectful of the baby’s nutritional needs and chose to use natural remedies to treat pneumonia as opposed to following their doctor’s advice to take the 11 month old to casualty.

Despite all this, Health24’s DietDoc goes so far as to attribute the baby’s death to veganism:

“The parents, Sergine and Joel Le Moaligou, had literally starved their child to death because of their adherence to a vegan diet” (emphasis added).

Despite being aware that the baby was ill, the parents neglected to take their child for proper medical treatment. They also seemed to be ill-informed about what constitutes a healthful vegan diet at different life stages.  Hopefully, all parents whether carnist or vegan, would research the nutritional needs of their child at various life stages and ensure that these requirements are met through a balanced diet.

The South African Vegan Society would like to provide some information to show that the child died because of neglect and bad parenting, and not death-by-veganism. Parents who opt to place their child on a strict vegetarian should be sure to follow the links at the end of the article for nutritional information for pregnancy, infancy and childhood.

Using the same sub-headings as DietDoc with regards to “what went wrong”, we provide information on how the parents could have avoided the death of their baby whilst remaining vegan.

1) The mother's breastmilk was deficient in vital nutrients

In their official position paper on plant-based diets, the American Dietetic Association (ADA) concludes that “appropriately planned vegetarian diets, including total vegetarian or vegan diets, are healthful, nutritionally adequate, and may provide health benefits in the prevention and treatment of certain diseases. Well-planned vegetarian diets are appropriate for individuals during all stages of the life cycle, including pregnancy, lactation, infancy, childhood, and adolescence, and for athletes.”

The same view is shared by many major health organizations across the world. Yet, DietDoc and other authors writing on the case blame the vegan diet for deficiencies.

True to many people who are ignorant about veganism, DietDoc exposes her lack of knowledge of a vegan diet, when she states that

“[a] vegan diet not only prohibits adherents to eat any foods of animal origin, but also restricts the plant foods that can be eaten. In some cases, strict vegans eat only brown rice and certain vegetables”

As we know, this is not the definition of veganism – vegans avoid all animal products, there is nothing to suggest that vegans eat only brown rice and vegetables. Of course, some vegans have allergies, or choose not to support products such as palm oil or imported foods, but they can still follow a nutritionally diverse and complete diet in this way.

DietDoc rightly suggests that vegetables rich in beta-carotene may have reduced any chances of a Vitamin A deficiency in the mother’s breast milk. This is quite easy to achieve by mom and/or baby eating pumpkin, butternut, carrots, sweet potatoes and so on: http://www.veganhealth.org/articles/vitamina

She then goes on to suggest that the mother should have eaten eggs and dairy products to get “high quality protein…calcium…iron…Vitamin B12 and zinc”.

Not only can all of the above be met in a vegan diet, but often in better quality and without risks associated with meat and dairy:

· High quality complete proteins can be found in a plant-based diet. This useful table describes the different proteins found in legumes, grains and other plants. If one compares DietDoc’s recommended eggs and milk to legumes (beans, lentils) and nuts (almonds, walnuts), for example, it is clear that fewer portions of the plant-based sources are required to meet the recommended daily allowances for various proteins.

· Calcium can similarly be found in a vegan diet, without the risks associated with dairy. Good sources include green leafy vegetables, sesame seeds, and fortified non-dairy milks and fruit juices.

· Vitamin B12 is a more tricky issue for vegans. There is a lot of different information available, with little consensus on the issue. The South African Vegan Society advocates caution in this regard, and suggests that vegans ensure they get their B12 requirements through supplements and/or fortified foods and beverages. Vitamin B12 relies on the presence of bacteria to form, and due to increasing use of sterilisation of food products, cases of B12 deficiency are being recorded in meat-eaters and vegans alike. As such, it is not difficult to find cereals, drinks and multivitamins containing B12.

· As for zinc, tofu, tempeh, walnuts, sunflower seeds, pumpkin seeds, lentils, almonds are just a few of the vegan sources of Zinc.

2) The baby did not receive any additional foods

DietDoc suggests introducing whole foods to a baby’s diet at aged 6 months. She recommends “baby cereals, pureed meat, chicken, liver and other organ meats, fish, dry, cooked and pureed beans, peas, lentils or soya, and egg yolk”.

As shown above, the nutrients concerned can all be found in a plant-based diet.

In agreement with DietDoc, the Physicians Committee for Responsible Medicine (PCRM) recommend introducing iron rich foods at 6 months. They, however, suggest using oat and barely based cereals and fortified rice milk (as opposed to soy or wheat which may cause allergies). From 6 to 8 months a variety of fresh fruit and vegetables (puréed) can be added, and from 8 months more protein rich foods like puréed beans or lentils can be introduced.

DietDoc once again states, without any evidence to support her conclusions that “[t]his child's death was, therefore, caused by ignorance and rigid adherence to a diet that in many cases does not support health in adults, much less in actively growing infants.”

DietDoc fails to see two things here. Firstly, that there is no scientific evidence to support her claim that a vegan diet does not support health in adults or infants – major health organisations such as the American and Canadian Dietetic Associations, Harvard University, British Medical Council, Cornells University, World Health Organisation and others all support the notion that a vegan diet can be as healthy and in fact healthier than a diet that includes meat and dairy.

The British Dietetics Association position on weaning a baby onto a vegan diet is that specialc are should be taken to meet the nutritional needs of the baby, which can grow and develop normally on a vegan diet.

Secondly, DietDoc fails to acknowledge that in many cases a carnist diet does not support health in adults or in children (high rates of obesity, diabetes, allergies, and many other diseases associated with meat and dairy, for example), yet when a child of a meat-eater dies we blame the parent, not carnism. She is guilty of ignoring the intervening variable here – ignorance and neglect on the part of the parents.

International child rights

For the first time we see DietDoc use citations. That children have the right to nutrition and that this is the responsibility of the parents is not under dispute here, however. The parents in this case are guilty of failing to honour that right. The judgement however was that this was due to ignorance, neglect, and a refusal to follow medical advice – all factors independent to veganism.

The swiftness with which a case of infant mortality when under the care of vegan parents is used to conclude, without any scientific evidence to back it, that vegans have selected a diet that “is not adequate and does not contain all the nutrients essential for infants or young children” is concerning. DietDoc’s conclusion that this single case of infant death “clearly indicates that a vegan diet not only poses a risk to the health of infants and young children, but that it can prove fatal” flies in the face of scientific process. Anecdotes do not prove a rule, more especially so when there is evidence to show that this was not a result of a baby following a well-planned, nutritionally diverse diet, but one who’s parents neglected to feed it enough, and also neglected to seek emergency medical care when the baby needed it. The way in which the case has been reported on reveals a lack of scientific integrity and/or a strong prejudice against veganism.

For more information on a well planned vegan diet for mothers, babies and children, please visit the following sources of research and advice:

http://www.pcrm.org/health/veginfo/pregnancy.html

http://www.pcrm.org/health/veginfo/veg_diets_for_children.html

http://www.veganhealth.org/#kids

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