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Pregnancy

A Vegan Diet During Pregnancy

A plant-based diet is a healthful choice at every stage of life, including pregnancy and breastfeeding.

A healthful, well-planned, plant-based diet provides all the nutrients you and your developing baby need. The Academy of Nutrition and Dietetics states in their position paper that a well-planned plant-based eating pattern is appropriate for all stages of life, including pregnancy.1

Benefits of a Plant-Based Diet for the Mother

Gestational diabetes, a form of diabetes that occurs during pregnancy, increases the risk of negative outcomes for the mother and infant. Diets centered around plant-based whole foods are associated with a significantly lower risk of developing gestational diabetes.2 The Nurses’ Health Study II found that fiber may be one of the reasons for this protective effect. The study found that every 10-gram increase in daily fiber was associated with a 26% reduction in risk.3 Research published in 2023 found that women who ate the most animal protein were almost three times more likely to develop gestational diabetes than those eating the least. Meanwhile, women eating the most plant protein were less than half as likely to develop gestational diabetes than those eating the least.4

Similarly, diets centered around plant-based whole foods are also associated with lower risks of gestational hypertension and pre-eclampsia, which are disorders of high blood pressure that can develop during pregnancy.5

Benefits of a Plant-Based Diet for the Infant

Maternal dietary choices may also influence infant and toddler health. Children who are raised on healthful vegan diets have a reduced risk for heart disease, cancer, obesity, diabetes, and other conditions.6-9 Adolescents raised on a plant-based diet often find they have an easy time maintaining a healthy weight. They also have fewer problems with acne, allergies, and gastrointestinal problems than their peers who eat animal products.10-11

Children start to develop taste preferences in the womb and while breastfeeding. The more fruits, vegetables, whole grains, legumes, and plant-based foods the baby is exposed to during pregnancy and while breastfeeding, the more inclined the child will eat these foods later in life.12 Vegan and vegetarian diets and especially maternal consumption of certain vegetables and nutrients is associated with a lower risk of eczema in their offspring.13-14

The mother’s diet also impacts their child’s development. A study from 2023 of more than 76,000 women found that low fiber intake during pregnancy was associated with neurodevelopmental delay in their offspring, including delayed communication, delayed fine motor skills, and delayed developmental in problem solving and social skills.15

To learn more about how a plant-based diet affects pregnancy and fertility, listen to the Exam Room podcast episode with Dr. Debra Shapiro and Jeanne Schumacher.

To learn more about the benefits of a plant-based diet for children, read more here.

Calorie Needs

Calorie needs increase only modestly during pregnancy. According to the 2020-2025 Dietary Guidelines for Americans, pregnant individuals need about 340 extra calories per day in the second trimester and about 452 extra calories per day during the third.16

It’s recommended to maintain a steady rate of weight gain. How much weight should be gained depends on prepregnancy weight status. Minimal weight is expected to be gained during the first trimester, amounting to 1.1-4.4 pounds. During the second and third trimesters, the Dietary Guidelines for Americans recommend a weekly weight gain of 1 pound for women who are of normal weight or are underweight and a weekly weight gain of 0.5 and 0.6 pounds for women who are obese or overweight, respectively.16

Nutrient Needs

During pregnancy, your nutrient needs increase.  For example, calcium, protein, and folic acid requirements increase, despite only modest increases in caloric requirements. Limiting empty calories found in highly processed foods and sweets is beneficial to maximize nutrient intake. Discuss with your doctor the appropriate nutrients you require for a healthy pregnancy and if you should take a supplement.

Protein

Protein needs are slightly higher during pregnancy. An adult who is not pregnant and not physically active should get about 0.36 grams of protein per pound of body weight. For an average woman this would be about 46 grams of protein per day. During pregnancy (especially the second and third trimester), women should eat an additional 25 grams of protein per day, or 70 grams of total protein per day (0.5 grams of protein per pound of body weight).17 This is usually an easy goal to meet by eating a variety of plant-based foods, including beans, lentils, quinoa, tempeh, tofu, whole grains, nuts, seeds, and vegetables.

A day’s menu could include oatmeal with fruit, walnuts, and chia seeds for breakfast; lentil soup and a hummus sandwich for lunch; brown rice, broccoli, and chickpea bowl for dinner; and a slice of whole-wheat bread with peanut butter for a snack.

Calcium

The recommended amount of calcium to consume is 1,000 milligrams per day.18 Calcium is important during pregnancy, but the amount a woman needs does not increase. It’s important to include plenty of calcium-rich plant-based foods in one’s diet, like tofu, dark green leafy vegetables, beans, figs, sunflower seeds, tahini, almond butter, and calcium-fortified soy milk, cereals, and juices.

Vitamin D

The natural source of vitamin D is sunlight. If a woman does not get regular sunlight, vitamin D is also available in vitamins and in fortified foods. Many brands of cereal and plant milks are fortified with vitamin D.

Vitamin B12

The amount of vitamin B12 a woman needs during pregnancy is 2.6 micrograms; this is a little higher than the 2.4 micrograms that nonpregnant people need.19 Vitamin B12 is not naturally found in plant foods, however many plant-based foods are now fortified with vitamin B12, including plant-based milk alternatives, cereals, and nutritional yeast. To ensure vitamin B12 needs are being met, pregnant women should be encouraged to take a supplement regularly. Vitamin B12 is found in all standard multivitamins and in prenatal vitamins, but a dedicated B12 supplement may be a good idea to ensure you’re getting enough. We suggest getting 100 micrograms per day or 2,500 micrograms once a week.

Iron

During pregnancy, iron needs increase considerably, from 18 milligrams to 27 milligrams per day.20 Iron is abundant in plant-based diets. Beans, dark green vegetables, dried fruits, blackstrap molasses, nuts and seeds, and whole-grain or fortified breads and cereals all contain plenty of iron. Most prenatal vitamins will contain iron but check with your health care provider to discuss iron supplements based on your blood levels.

Omega-3 Fatty Acids

Omega-3 fatty acids are important to support a baby’s growth and development. Plant foods contain very little DHA and EPA, but your body can make them from ALA (a plant omega-3 source), however, conversion rates are low.21 The Adequate Intakes (AIs) or recommended amount of ALA per day is 1.4 milligrams during pregnancy. You can easily get this from chia seeds, ground flaxseed, or walnuts. Microalgae-based DHA and EPA supplements are also available. Discuss with your health care provider whether a DHA and EPA supplement is necessary.

Choline

Choline deficiency is rare, but pregnant women may be at higher risk. A well-balanced diet that is not deficient in other nutrients (like B12) usually provides enough choline. Certain vegetables and beans are a great source of choline, with grains, nuts, and seeds being reliable sources in general. In fact, soybeans have more choline than beef and chicken; potatoes and most beans have more than dairy and tuna. Check out our page on choline for more plant sources.

Breastfeeding

The guidelines for breastfeeding mothers are similar to those for pregnant women. Milk production requires even more calories than pregnancy, so you will need to boost your food intake a little bit. During the first six months of breastfeeding, you need 500 calories a day more than you did before you became pregnant. This drops to 400 additional calories a day during the second six months of breastfeeding, because it is recommended that children start eating some solid foods (like infant cereals, soft fruits and vegetables, and baby foods). Protein needs are the same as during the second and third trimesters of pregnancy.22

Plant-Powered Prescription

  • Increase calories during the second and third trimesters to ensure a healthy weight gain.
  • Increase protein intake to 0.5 grams per pound of body weight by eating more tofu, tempeh, beans, and wholes grains.
  • Meet your iron needs by eating beans, dark green vegetables, dried fruits, blackstrap molasses, nuts and seeds, and whole-grain or fortified breads and cereals.
  • Be sure to take a perinatal multivitamin that includes vitamin B12.
  • Eat chia seeds, ground flaxseed, or walnuts daily for omega-3s which are important for baby’s brain development.
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References

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  2. Zhu Y, Zheng Q, Huang L, et al. The effects of plant-based dietary patterns on the risk of developing gestational diabetes mellitus: a systematic review and meta-analysis. PLoS One. 2023;18(10):e0291732. doi:10.1371/journal.pone.0291732
  3. Zhang C, Liu S, Solomon CG, Hu FB. Dietary fiber intake, dietary glycemic load, and the risk for gestational diabetes mellitus. Diabetes Care. 2006;29(10):2223-2230. doi:10.2337/dc06-0266
  4. Luo T, Chen H, Wei H, Yang Y, Wei F, Chen W. Dietary protein in early pregnancy and gestational diabetes mellitus: a prospective cohort study. Endocrine. doi:10.1007/s12020-023-03517-1
  5. Mitsunami M, Wang S, Soria-Contreras DC, et al. Prepregnancy plant-based diets and risk of hypertensive disorders of pregnancy. Am J Obstet Gynecol. 2024;230(3):366.e1-366.e19. doi:10.1016/j.ajog.2023.07.057
  6. Desmond MA, Sobiecki JG, Jaworski M, et al. Growth, body composition, and cardiovascular and nutritional risk of 5- to 10-y-old children consuming vegetarian, vegan, or omnivore diets. Am J Clin Nutr. 2021;113(6):1565-1577. doi:10.1093/ajcn/nqaa445
  7. Watling CZ, Schmidt JA, Dunneram Y, et al. Risk of cancer in regular and low meat-eaters, fish-eaters, and vegetarians: a prospective analysis of UK Biobank participants. BMC Med. 2022;20(1):73. doi:10.1186/s12916-022-02256-w
  8. Sabaté J, Wien M. Vegetarian diets and childhood obesity prevention. Am J Clin Nutr. 2010;91(5):1525S-1529S. doi:10.3945/ajcn.2010.28701F
  9. Olfert MD, Wattick RA. Vegetarian diets and the risk of diabetes. Curr Diab Rep. 2018;18(11):101. doi:10.1007/s11892-018-1070-9
  10. Lee H, Sim N, Fotouhi A, Daveluy S. Vegan diet in dermatology: a review. J Clin Med. 2023;12(18):5800. doi:10.3390/jcm12185800
  11. Hovinen T, Korkalo L, Freese R, et al. Vegan diet in young children remodels metabolism and challenges the statuses of essential nutrients. EMBO Mol Med. 2021;13(2):e13492. doi:10.15252/emmm.202013492
  12. Mennella JA, Jagnow CP, Beauchamp GK. Prenatal and postnatal flavor learning by human infants. Pediatrics. 2001;107(6):E88. doi:10.1542/peds.107.6.e88
  13. Miyake Y, Sasaki S, Tanaka K, Hirota Y. Consumption of vegetables, fruit, and antioxidants during pregnancy and wheeze and eczema in infants. Allergy. 2010;65(6):758-765. doi:10.1111/j.1398-9995.2009.02267.x
  14. Su Y, Xie J, Jan R, Hsieh C. Association between a maternal vegetarian diet during pregnancy and the occurrence of atopic dermatitis in children. Pediatr Allergy Immunol. 2023;34(12):e14052. doi:10.1111/pai.14052
  15. Kunio M, Sayaka H, Ryoji S, et al. Maternal dietary fiber intake during pregnancy and child development: the Japan Environment and Children's Study. Front Nutr. 2023;10. doi:10.3389/fnut.2023.1203669
  16. U.S. Department of Agriculture. Dietary Guidelines for Americans, 2020–2025. Accessed April 26, 2024. https://www.dietaryguidelines.gov/sites/default/files/2021-03/Dietary_Guidelines_for_Americans-2020-2025.pdf
  17. Murphy MM, Higgins KA, Bi X, Barraj LM. Adequacy and sources of protein intake among pregnant women in the United States, NHANES 2003-2012. Nutrients. 2021;13(3):795. doi:10.3390/nu13030795
  18. Committee to Review Dietary Reference Intakes for vitamin D and calcium, food and nutrition board, institute of medicine. dietary reference intakes for calcium and vitamin D. Washington, DC: National Academy Press; 2011.
  19. Institute of Medicine, Food and Nutrition Board. Dietary reference intakes for thiamin, riboflavin, niacin, vitamin b(6), folate, vitamin b(12), pantothenic acid, biotin, and choline. Washington, DC: National Academies Press; 1998.
  20. Institute of Medicine (US) Panel on Micronutrients. Dietary reference intakes for vitamin a, vitamin K, arsenic, boron, chromium, copper, iodine, iron, manganese, molybdenum, nickel, silicon, vanadium, and zinc. Washington (DC): National Academies Press (US); 2001. Accessed April 26, 2024. https://nap.nationalacademies.org/catalog/10026/dietary-reference-intakes-for-vitamin-a-vitamin-k-arsenic-boron-chromium-copper-iodine-iron-manganese-molybdenum-nickel-silicon-vanadium-and-zinc    
  21. Anderson BM, Ma DW. Are all n-3 polyunsaturated fatty acids created equal? Lipids Health Dis. 2009;8:33. doi:10.1186/1476-511X-8-33
  22. Food and Nutrition Board, Institute of Medicine. Dietary reference intakes for energy, carbohydrate, fiber, fat, fatty acids, cholesterol, protein, and amino acids (macronutrients). Washington, DC: National Academy Press; 2005.