Can You Have a Healthy Vegetarian or Vegan Pregnancy?

Jun 30, 2017 · 76 comments
Patrick (Hawai'i)
I see that this article does not make the distinction between the synthetic "folic acid" and the real stuff that the body wants "folate". Humans with the https://ghr.nlm.nih.gov/gene/MTHFR gene understand the distinction.
Penelope Miller (United States)
Great share! Those days are well behind me now, but I will share this with my friends! Also, https://www.whattoexpect.com/pregnancy/ can help you guys solve all your pregnancy related questions. tHANKS.
CF (California)
A vegetarian diet can still be rich in animal products. Eggs and dairy products bring a wealth of nutrition to a pregnant woman who isn't eating meat itself.
YD (nyc)
Very sorry, but I find this to be a completely ignorant question. Not sure if it's even real. A vegetarian diet is the norm in many parts of the world, including America, where I presume there are millions of vegetarians by virtue of religion, lifestyle or pure choice. You take a prenatal vitamin and call it a day.
Rocky Road (Armonk)
Would someone please tell my why everyone is obsessed with INDIA and their vegetarian culture? The article doesn't say a single thing about them.
Anita Bansal (Mumbai, india)
majority of Indian population is vegetarian and have been having healthy babies for millineums.
In addition, it is still rare for majority of indian babies and infants to have food related allergies.This is all crazy paranoia populated by meat industries in the western world that a plant based diet cannot support a healthy pregnancy.
All pregnancies require that expectant mom pays attention to proper nutrition not just pregnant woman following a plant based diet.
CF (California)
Those populations don't eat meat but they eat a lot of eggs and dairy, which means they get the B12, choline and other benefits of animal products.

It isn't a "plant based diet" when the main protein sources are diary and eggs. It includes plants, OF COURSE. But really, it's a balanced diet.
RLH (Bellingham, WA)
The ALSPAC study of more than 11,000 UK mother-child pairs found that avoiding seafood in pregnancy tended to cause neurodevelopmental problems rather than prevent them, and that mothers who consumed the most fish during pregnancy had children with the best outcomes. "For each outcome measure, the lower the intake of seafood during pregnancy, the higher the risk of suboptimum developmental outcome." The science was compelling enough that more than 100 scientists petitioned the FDA to revise its advice to pregnant and nursing mothers to consume more seafood. Due to political resistance implementation was slow in coming and ultimately subtle, but eventually changed to include a minimum--from "eat up to 12 ounces of fish lower in mercury per week" to "eat at least eight ounces and up to 12 ounces weekly.

https://www.fda.gov/ForConsumers/ConsumerUpdates/ucm397443.htm

http://www.thelancet.com/journals/lancet/article/PIIS0140673607602773/ab...
NorCal Girl (Northern CA)
I know someone who has had osteoporosis since her 30s owing to vegan pregnancies.
dan s (blacksburg va)
Definitely not healthy to be vegan or vegetarian during pregnancy, or during nursing.

This statement is wrong: "Vitamin B12 is not found in plants, but it’s in tofu, soy milk, some cereals and nutritional yeast, "

True B12 is only found in animal foods. End of story.

B12 and iron are just two of many nutrients deficient in veg diets. Other missing nutrients include:

taurine (veg eats are very deficient, and this impairs brain development)
carnitine
zinc
beta alanine
vitamin A (retinol)
iodine
collagen and connective tissue building nutrients
choline
lecithin
EPA/DHA omega 3s

And likely others. Veg eaters will need to supplement far more than just B12 and iron!

Humans require animal foods, as a result of millions of years of evolution. It is possible to supplement the nutrients missing from a veg diet, but this requires substantial knowledge of nutrition.
Camille (NY)
B12 is actually made by bacteria, not animals - no animal makes B12, not even cows. The reason B12 is in beef is because of the bacteria in the cow's body, not because it's "true" B12. B12 in soy products is just as natural as from any other source.

Some other glaring errors in your comment include the comment about vitamin A, famously found in carrots and other vegetables, as well as collagen and lecithin, which the body makes itself.

If you enjoy eating meat that's up to you, but don't malign objectively healthy and more eco-friendly diets with false information about nutrition.
The Pooch (Wendell, MA)
@Camille:
Yep, the cow gets its B12 from bacteria, because the cow has an enormous digestive system adapted to absorb the products of bacterial fermentation. Lacking the cow's digestive adaptations, we are adapted to get B12 from animal foods. Supplements would also do the trick. No unsupplemented plant food has B12.

Carrots and other vegetables have _beta-carotene_ which is a pre-cursor to vitamin A proper (retinol). The conversion of beta-carotene to retinol is accomplished with low and variable efficiency, so multiply those servings of carrots and squash by ten to get sufficient vitamin A.

How/where has veganism ever been established to be "objectively healthy"? And compared to what other diet(s)?
Daniel Wagle (Decatur, GA)
The ongoing Adventist studies do exactly that. Seventh Day Adventists who are Vegan have some of the highest life expectancies.
Cheryl (Yorktown)
Every traditional society has developed a cuisine which makes use of what they have, based on is most easily acquired, produced and preserved. I prefer not to get moralistic about food choices.

The article did address a serious question some women have, and provided guidance for assuring vegetarians and vegans that they can, with care, have a very heathy pregnancy.
It is not a snap to get enough iron and B12 when eliminating meat, poultry and fish (given a personal hx of anemia), but otherwise, think that a predominantly vegetable based diet is a superior choice. Many of the problems with meat etc, are mitigated by treating it as a side dish, almost a condiment, rather than a centerpiece in a meal. Which, of course, is exactly the way most tasty peasant cuisines have always treated it. ( With exceptions, of course).
SCA (NH)
If humans were meant to be vegan, women wouldn't produce breast milk.

Consuming milk from other mammals isn't so particularly peculiar. Sure, the composition differs somewhat. Human maternal breast milk changes in its composition per the needs of the nursing child. It*s all in the same ballpart.

We were designed evolutionarily to be omnivores.

Vegetarianism in India didn't grow out of some higher spiritual aesthetic. Scriptural justifications always follow social needs and pressures.

Western women can afford the financial costs of healthy vegetarianism and veganism. But it*s hardly the *natural* choice.
Gabriella (Los Angeles)
If you don't know: Cows are vegan and they still produce milk for their babies. You are contradicting yourself.
Amanda (Boston)
"designed evolutionarily" is an oxymoron, no?
The Pooch (Wendell, MA)
@Gabriella:
Do you think cows and humans might have some different adaptations?
BMD (USA)
Of course. It is done all the time. Even in the US, researchers could easily collect data from vegan/vegetarian moms. It is doubtful that their children are more ill, and likely they are more healthy and probably more likely to be of normal weight and height.
Raj (Chennai, India)
Like the article states, Vegan or Vegetarian is good only if you aware of it's limitations and don't take a cavalier approach. In India Mal nourishment rate is much higher among Vegetarian kids (Mostly Hindu) than Meat eating kids (Muslim for example) of equal or even lesser wealth.
SCA (NH)
I've got news for you. Most women and children in India are malnourished. Stunting is common.

States with large Christian populations, especially in seacoast areas where plenty of fish is consumed, have healthier women and children.

We have a long history in this country of seeing India as a font of ineffable wisdom. It's not. It's a country like any other. A hysterical veneration of cows has led to a population of wandering bovines as malnourished as the people who don't eat them. At least vegetarian Indians consume plenty of dairy products, compensating for the lack of meat.

In this country, vegetarian and vegan women tend to be upper-income, with abundant access to alternative sources of protein (nuts are expensive) and good medical care.

Spend some time in a village in Northern India and tell me about the great benefits of a vegan diet.
Gabriella (Los Angeles)
This article is not about "Can you have a healthy vegan, vegetarian pregnancy in India?"
Gabriella (Los Angeles)
A lot of poor people all over the world, meat eaters are mal nourished as well. You can't take India as a reference, it is a very poor country. Look Alicia Silverstone, Jessica Alba. Sorry to tell you but you need supplements even if you are not vegan. 80% of population lacks most of vitamins.
SirWired (Raleigh, NC)
80% lacks "most" vitamins? Really? Care to share a source for that startling statistic that isn't somebody associated with selling supplements?
KBP (Boston)
Over the last twelve years, I've spent 2.5 years living and working in India. One of the things I've noted is the flexibility/practicality of many Indians, including when it comes to vegetarianism. For instance, I know of Indian vegans and vegetarians in the US and in India who eat dairy and/or meat during pregnancy but not otherwise, or who give their children meat and then steer those children towards vegetarianism as they get older. We Americans tend to be very binary in our thinking; Indians see every shade of grey.
Gabriella (Los Angeles)
Vegan Diet can be very safe during pregnancy if you eat enough nutrients. If you can't get enough nutrients from food, you can always supplement. Even a meat eater that doesn't have enough iron, B12, Folic Acid and other important nutrients is at risk of having an unhealhty pregnancy. Anorexics and bulimics are a great example. There are several books that teach you how to have a healthy vegan pregnancy. If you are not vegan and eat a lot of junk food you will very likely to develop diabetes and all sorts of problems for you and your baby. Please, people read more and get better data. Trump Era has to end. Get your data before spilling your opinion out there.
Nina (Palo alto)
Millions of heathy children are born to women in India who are vegetarian. This article shows how uninformed the NYT appears to be on this topic.
Ebiker (St. Louis)
Clearly you must not have read the article, which endorsed the option of vegetarianism during pregnancy.
Ms Prision (New York, NY)
American provincialismism at its best. At least we no longer believe we have the best education, best economic system, best political system, and best medical and healthcare system in the world. At which point, perhaps we will wake up and start learning about other ways of being in the world, rather than imposing our very problematic ideology on other nations, usually at the end of a gun (something our nation does excel at).
SCA (NH)
"Vegan diets are perfectly healthy--as long as you take a pill to provide the nutrients it doesn't give you..."

You do hear the absurdity in that, right?

I appreciate the moral and ethical standards promoted here. But as noted by at least a couple of fellow commenters, the varying levels of malnutrition found in Indian vegans is not entirely due to the inability to afford enough food. The type of food matters, too. Vegetarians who consume eggs and milk products--and can afford to eat them in sufficient quantity--are able to get complete proteins. For example--dal and rice are healthy but incomplete proteins; add a hearty serving of yogurt-based chutney, have milky chai--and you will have a healthier baby than your vegan friend.

Indian vegans writing here to defend their lifestyle are likely people of high-enough economic status to afford higher-quality food--and nutritional supplements. The average woman in India is not.
Alex (USA)
That's false.

All you have to do is eat a varied diet during the day (and rice + legumes has a great amino acid profile):

"We conclude that it is not necessary to balance the amino acid profile at each meal, especially under conditions where intakes of total protein substantially exceed minimum physiological requirements."

"Consumption of complementary proteins at different meals over the course of the day should assure the achievement of an adequate state of nitrogen (protein) retention and utilization."

"Therefore, an undue emphasis on amino acid balance at each meal is inappropriate in the context of usual diets in healthy populations."

Source: http://ajcn.nutrition.org/content/59/5/1203S.full.pdf
SCA (NH)
Uh, Alex: I didn't say the various proteins must be consumed together, at the same meal.

But vegan diets for most of the world are inherently lacking. Rich vegans can afford a variety of vegetable proteins that take the place of meat.

Poor vegans cannot.

It should be manifestly clear that humans, whose first nourishment is, uh, breast milk, were not designed to thrive on a vegan diet.
Raindrop (<br/>)
One problem is that drinking tea or eating dairy with the meal inhibits the absorption of iron in the food. So lentils with tomato or peppers is better than meals eaten with tea or milk. In many places, tea is the most common beverage. In the US, this is not the case, but avoiding dairy with greens and lentils being sought for iron would be prudent.
Dennis Knicely (Los Angeles)
As Editor of the web's "Healing News Network" I have been researching diet and nutrition for over 40 years, starting in the early b1970s with 2 bio chemistry PhDs. Our research included testing milk of mothers, with local midwives delivering hundreds of babies to pure vegan women without serious health issues.. Those eating vegan had the least toxicity in their milk. The lacto vegetarian mothers had the 2nd. least toxicity in the milk, and those eating the Standard American Diet including meat always had the most toxicity in their breast milk. This alone verifies that vegan mothers can have the healthiest babies.
SirWired (Raleigh, NC)
I wasn't aware that "toxicity" was some sort of standard measurement.
Cheryl (Yorktown)
It shows they can have healthy babies, not "the healthiest."
dan s (blacksburg va)
Toxicity is just one factor. Vegetarians have higher rates of deficiency of many nutrients critical for baby development, like taurine, iodine, choline, EPA/DHA, lecithin, etc.
Sara (Portland OR)
At 38, I carried spontaneous boy/girl twins to full term on a vegetarian diet- my 10th year as a vegetarian. They were very healthy - 7 lbs. 13 oz. and 6 lbs. 2 oz. Both breast-fed immediately. My milk came in the next day. They were exclusively breast-fed until we put them on food at 7 months. (Not one drop of formula. I was even able to donate some milk.) They are now 22 1/2 months old, still breast-feeding, eating healthy and both vegetarian. They've been between the 50th and 85th percentile for height and weight after my daughter caught up from her birth weight.

As a vegetarian I carried 14 pounds of babies with perfect Apgar scores at birth. I had an excellent OB Doctor who kept track of my health. I only had to take additional iron supplementation towards the end of the pregnancy. The doctors and nurses at the hospital were so blown away that I basically carried two full-term singletons.

Like the doctor mentioned in this article, I had extreme nausea the first trimester and the entire pregnancy couldn't stand broccoli which was previously one of my favorite foods. However i found different things that worked for me and I managed to not take any medications- not even antacids- just by modifying diet during the pregnancy and listening to my body. This is not something that Americans are used to doing. We wish to have pills for everything and a quick answer. If you listen to your body will tell you what you need. You do not need meat to make a baby.
Dr. Maria (Astoria, NY)
I have seen women who eat vegan diets develop gestational diabetes (diabetes in pregnancy). They have to work hard at increasing protein and reducing carbohydrates within the restrictions of their diet. Some eventually add/increase eggs & dairy, and some will add fish/animal proteins.
Jaque (Champaign, Illinois)
In these days of interconnected world, how can NYT and BJOG be so ignorant of the millions of healthy children born In India of vegetarian moms? And many of them who have migrated to different parts of world, still remain vegetarians.
Barry Gillespie (King of Prussia)
I have been vegan since 1980, before the term existed I believe. I was "crazy" then, but at 70 and healthy, "cool" now. My belief today is that everyone has to find her/his own way in the dietary world. Everyone has a different vibration and sees the world differently. For example, it may be better to eat animal food if you have great fear for the health of your vegan fetus for nine months.
Renee Hoewing (Illinois)
Seriously? There are billions of vegetarians (fewer vegans, I'm sure) in the world, half of which are women and many of which get pregnant at some point. People are willing to condemn this way of life for many Hindus and Buddhists because of concerns when pregnant? I'm aghast at the cultural ignorance of Americans. Any diet can be a bad one but to think that vegetarianism is automatically unsustainable during pregnancy is ignorant. Only people who late in life adopt such a diet would not understand this.
Post motherhood (Hill Country, Texas)
My vegetarian daughter, her choice since four years of age (and correlated with her viewing the classic "Bambi" as a child reared in a community with abundant neighborhood deer - and enthusiastic hunters), recently delivered a very healthy baby in her northwest US community in which health care providers are supportive of her dietary choice. I regret I failed to do the best job to meet her nutritional needs as a child in a household where the male head was "meat and potatoes" to the core. She became well versed in how to mix food items to gain the needed nutrients and she was complimented by her prenatal medical caregiver on the appropriate blood levels for fetal development. She is still nursing that beautiful "baby" as she was herself nursed past two years of age. And that "baby" is a vegetarian eating a well-balanced diet. That "baby" will make its own choice to eat meat someday. Grandmother will not advocate.
demetroula (Cornwall, UK)
I've been a dairy-and-fish-eating vegetarian for over 40 years, since age 18. Almost 31 years ago I gave birth to my healthy son, my vegetarianism posing absolutely no problems for me or my baby. I did increase my intake of dark leafy greens and fish, just to be sure I was getting enough basic nutrients and protein. (My only cravings began in my sixth month, for Ben & Jerry's chocolate fudge brownie ice cream -- after years of avoiding white sugar!)

Strangely, the only aversion I had during pregnancy was for asparagus, one of my favourite vegetables.
Valerie (Blue Nation)
A vegetarian eats a plant based diet that might include dairy and eggs. A vegetarian does not eat any meat including fish.

If you eat fish but forgo all other meats, you are a pescatarian.
Camille (NY)
As Valerie notes, please do not call yourself a vegetarian when you are a pescatarian - as I'm sure you can imagine, it is very frustrating to have to explain to people time and again what a vegetarian is. Vegetarian means no animals, and fish are animals.
Savita Sriram (Thailand)
I'm indian and was raised on a vegetarian diet. This article makes no sense to me. Why do you need a study? At least 30% of Indians have never and will never eat meat. Even eggs are unthinkable.
B (PA)
Vegan and vegetarian diets are safe for all stages of life. There is nothing missing from a vegan diet so why wouldn't it be healthy? B12 is made by bacteria and is more easily absorbed from fortified foods or a sublingual supplement. I was vegan for 5 years when I got pregnant with my son. We were healthy throughout my pregnancy and my son was born a it healthy weight, good Apgars etc. He's now 21 months and very healthy. Folate and many of the other nutrients needed for a healthy pregnancy and baby are found in a abundance in a vegan diet.
Nancy (Sacramento)
My husband is from from India. Both he and his brother are now in their 70s and healthy as could be. Like most Hindus, their mother never tasted meat, seafood or poultry (and cringed at the very thought).

Some people in the USA can't conceive of a vegetarian diet. They'll say to my (still vegetarian) husband, "But wouldn't such a diet stunt growth?" And he'll point to his own 6'4" body and say, "Apparently not."
CF (California)
But she ate animal products like eggs and dairy, and got the nutritional benefits of animal products that way.
James DeAlto (Raleigh, NC)
Appreciate the article, but it's maddening how often you end these pieces on a note that will inevitably scare non-vegans. There is a thriving community of vegan mothers. Search for vegan parenting groups on FB and you'll get lots of information based on first-hand experience. Humans have zero biological need to eat the flesh of consume the secretions of exploited animals.
Andrea (Maryland)
The women I know who've been vegan during their pregnancies all now have remarkably healthy children. It's easy to take a vitamin B12 pill and eat enough iron by eating a variety of foods. I'm more concerned about my omnivorous friends who eat fish, beef, and other animal products that are high in toxins like mercury and dioxin during their pregnancies and nursing months. These toxins can be extremely harmful to the baby.
The Pooch (Wendell, MA)
@Andrea:
The nutrition and health benefits of eating fish far outweigh the risks.
HT (Ohio)
Oh come on, Pooch.

Andrea wrote that she is concerned about friends who are eating meat products that are "high in in toxins like mercury and dioxin." You can't deny that this is an issue with fish. The FDA lists 7 species of fish (including tuna) that pregnant women should avoid completely because the mercury levels are high, and another 19 whose consumption should be limited. Bioaccumulation of toxins like dioxin and PCBs is a well known phenomenon, and pregnant women should be careful what species of fish they eat, and, if they eat locally caught fish or seafood, to be aware of any state advisories.

https://www.fda.gov/food/foodborneillnesscontaminants/metals/ucm393070.htm

https://fishadvisoryonline.epa.gov/General.aspx

It's one thing to advocate an "omnivorous diet," it's another thing to pretend that mercury poisoning and bioaccumulation of fat-soluble toxins like dioxins and PCBs doesn't occur.
The Pooch (Wendell, MA)
@HT:
Andrea and many other vegans have this idea that _all_ meat and dairy products are full of toxins. Mercury is only a problem with the few particular species of fish listed in your links. For the large majority of fish and shellfish species, the nutritional benefits of eating seafood far outweigh the risks. _Especially_ during pregnancy.
Raj (Chennai, India)
Yes, there are parts of the world. I come from one (India) where there we have large population of vegetarians. However that doesn't necessarily mean that it's good or even ok. India has an astonishing percentage of Mal nourished kids (higher than Somalia even) partly due to restricted or a non existent meat diet during pregnancy and also after child birth. So it's good to question everything...even if it's prevalent in many parts of the world.
Atul (NYC)
NO IT IS NOT due to lack of meat. it is due to lack of food.
Anthony (New York, NY)
The long answer is also yes. There's so much poison in meat and dairy that you're insane to raise them otherwise.
The Pooch (Wendell, MA)
@Anthony:
Which poisons, specifically? Are plant foods free of "poisons"? Humans (in general) are adapted to be an omnivorous species.
Post motherhood (Hill Country, Texas)
I differ with your blanket judgment regarding dairy and meat products. Excellent organic products are available. The mere act of breathing air and consuming water exposes one to the "poisons" you mention. Surely breathing and hydrating remain necessities of life. As the mother of pregnant and nursing women and the grandmother of preschoolers, I am familiar with the expense of "going organic" for the sake of the next generation. A Texas grocery chain (with its origins in my town) has a line of remarkably reasonably priced organic products targeting children. I'm thankful for grocery chains sensitive to families trying to reduce vulnerable children's exposure to the chemicals in our environment. But blanket judgmental statements don't help.
Dan Stackhouse (NYC)
Might have been a good idea too to point out that once the baby is born, if anyone tries to feed it a vegan diet, the baby will probably get malnutrition and die. Vegan is very ethically pure and smug and all, but humans are not evolved to live on nothing but granola, and every time people try to raise a baby on wheat germ and such, the baby suffers terribly.
Facts matter (Utah, USA)
That is simply untrue. Please check your facts before saying things like that. Have there been babies of vegans who died? Yes, because their parents made incredibly uninformed mistakes. Anecdotes do not make fact. The same thing has happened to children of omnivores. Please see here: https://www.reddit.com/r/vegan/wiki/dieteticorgs
This is a link to statements from dietetic and governmental nutrition organizations across the world which day that vegan diets are good for people of all ages.
vegmom (VA)
Really Dan? Every time? Do you have any data to support that claim? I raised my baby 100% vegan and she is now 28 years old and thriving. She never had meat, poultry, fish, eggs or dairy in her life. She was rarely sick and her B-12 level is fine, thanks to supplementation. We were fortunate to find a renown pediatrician in VA (Dr. Russell Libby) who was himself vegetarian, and who supported us every step of the way. Although it wasn't in vogue to be vegan in 1989, I read the research and even then, there was a 1:1 correlation between diet and health. I have no regrets about raising a compassionate young woman who values the life of all sentient beings.
Jennie (WA)
Pretty sure even vegans have no problem with breastmilk, and there are soy-based formula options for those who can't breastfeed.

Once a child is old enough to eat solids, a vegan diet is perfectly healthy for it. The diet will have to be properly balanced and include supplemental B12.
jbi (new england)
Just wanted to add a clarification: B12 is not "found" naturally in tofu or soy milk or cereal. These foods may have added B12, but check to make sure. The Vegan Society has a no nonsense post on the importance of regular B12 supplements for all vegans, but especially women who might become pregnant!

www.vegansociety.com/resources/nutrition-and-health/nutrients/vitamin-b1...
SirWired (Raleigh, NC)
It bears mentioning that although the absolute requirement for artificial B12 supplementation in vegans has been known for decades, B12 deficiency (and ensuing pernicious anemia) amongst vegans is still depressingly common. This makes sense, since people (vegans included) are terrible about consistently taking a pill every day, and the foods fortified with B12 are not consumed by all vegans. (Indeed, vegans are more likely to be eating "all natural foods" (gardens, farmers markets, etc.) which, by definition, will not contain artificial fortitification.)
Cathy (MA)
Do people in this country not realize that there are entire swaths of continents where the vast majority of people are vegetarian? They are able to procreate without issue. Why is this not mentioned at the outset of every single article with some 'is it safe to be vegetarian?' headline?

For the record, I am a meat eater - but I know many people who have been vegetarian or vegan their entire adult lives, including women who have been happily and healthfully pregnant.
tweedledee (NYC)
While vegetarianism isnt the only reason, its certainly an important one, the percentage of malnourished people in India is very high. https://data.unicef.org/country/ind/
JK (Bowling Green)
Do you think maybe this malnutrition in India is more a result of poverty and lack of access to a full vegan diet, safe drinking water, sanitation and adequate physician care? It's proven that vegan diets are much healthier than SAD or other diets that contain animal products. Why the debate NYT?
GE (Bellingham, WA)
People commenting about malnourishment in India should realize this is because their is a very wide income distribution and poverty problem in India, not because people there are vegans and vegetarians. Anywhere where pregnant women cannot even get enough calories is going to be a problem regardless of diet. Same in the US. Same everywhere.
oneopinion (white plains)
Thank you for clarifying this point for people. Still there are many malnourished omnivores in the US who don't get challenged the way we vegetarians do. Still B12, iron, calcium,Omega 3 fatty acids are important issues, and ones that vegetarians often overlook. Folate is an issue for all pregnant women regardless of diet.
SirWired (Raleigh, NC)
"Vitamin B12 is not found in plants, but it’s in tofu, soy milk, some cereals and nutritional yeast,"

This MUST be clarified! It should state: "... but tofu, soy milk, cereals and nutritional yeast may have been fortified with the vitamin; check the label to verify this." If those foods have not been specifically fortified with B12, they WILL NOT contain it. (B12 is a byproduct of certain strains of bacteria, none of which are present in significant quantity in plant-based foods; B12 deficiency is widespread amongst vegans. Ironically, the more Natural/Organic/Farm-Raised foods they eat, the more likely the deficiency, since only processed foods will contain B12 fortification.)
H Robert Silverstein, MD, FACC (Hartford CT)
The safety of being vegan FAR OUTWEIGHS the risks of not being vegan. Wonderful book on pregnancy and the vegan diet by Michael Klaper, MD. HRS, MD, FACC
The Pooch (Wendell, MA)
@H Robert Silverstein:
What "safety"? And "safety" compared to what other diets? Humans are adapted to eat a whole foods omnivorous diet. A vegan diet requires special planning to get all essential nutrients, even more so during pregnancy, and even then some people will not thrive on a vegan diet. Because it is evolutionarily inappropriate to our species.
JK (Bowling Green)
Vegan diets don't need "special planning"...unless you count taking a B12 pill and maybe an iron pill. Humans do not need to eat animal products to thrive. On the contrary a vegan diet would go a long way to save uncounted lives and our very planet. The planet is being destroyed in the process of obtaining (fishery collapse) and growing (CAFOs, clear cutting rainforest for soy animal feed) animals. The whole business about creating complete proteins has been debunked. I know I will be asked for a link...this wikipedia article has dozens of links: https://en.wikipedia.org/wiki/Protein_combining
RB (Santa Cruz)
@Pooch - "Because it is evolutionarily inappropriate to our species."

Total hogwash!