Infants from families adhering to vegan diets exhibit growth patterns that closely resemble those from omnivorous households, according to a comprehensive national cohort study. The research, involving nearly 1.2 million children, suggests that early differences in growth are minimal and tend to vanish by age two.
The study, published in JAMA Network Open, provides significant evidence regarding plant-based diets during early life and pregnancy. It highlights that while vegan dietary patterns in families can support normal infant growth, further research is necessary to understand how diet quality and nutritional counseling during pregnancy and infancy contribute to optimal development.
Key Findings from the Study
The retrospective analysis tracked the growth of nearly 1.2 million singleton infants born in Israel from 2014 to 2023. It utilized data from public family child health centers, focusing on measurements such as length, weight, and head circumference. Researchers compared these metrics among infants from vegan, vegetarian, and omnivorous households, adjusting for various perinatal, maternal, and sociodemographic factors.
Most infants in the cohort came from omnivorous households, with smaller percentages from vegetarian and vegan families. Initially, infants from vegan households were slightly lighter and shorter than their omnivorous counterparts, with mean differences of approximately 100 grams in weight and less than half a centimeter in length. These differences translated to WHO z-score differences of less than 0.3, which are not considered clinically significant.
“These findings suggest that family vegan dietary patterns may support appropriate infant growth, but further work is needed to clarify how vegan diet quality and nutritional counselling during pregnancy and infancy support optimal infant development,” the researchers wrote.
Implications of Early Growth Patterns
During early infancy, differences were most noticeable at the extremes of growth. While stunting prevalence was similar across dietary groups at around 7%, infants from vegan households had higher odds of being classified as underweight compared to those from omnivorous households. However, the absolute prevalence remained low, and overweight was uncommon across all groups.
Longitudinal modeling of repeated measurements demonstrated that growth trajectories for length, weight, and head circumference in vegan and vegetarian infants closely matched those of omnivorous peers over the first two years of life. Adjustments for birth weight, maternal age, parity, mode of delivery, breastfeeding duration, and socioeconomic factors further reduced or eliminated most between-group differences.
By around 24 months of age, stunting prevalence had fallen to below 4% in all groups, and there were no significant differences in underweight or overweight by household dietary pattern.
Factors Influencing Infant Growth
Birth weight played a crucial role in early differences. Infants from vegan households had lower mean birth weights and lower birth-weight-for-gestational-age centiles, along with a higher prevalence of low birth weight and small-for-gestational-age status. Adjusting for birth weight significantly reduced observed differences in postnatal growth, indicating that prenatal factors might account for much of the early signal.
Breastfeeding patterns also varied by household diet. Mothers in vegan and vegetarian households were more likely to breastfeed and to do so for longer durations. Prolonged breastfeeding was associated with slightly higher odds of stunting but lower odds of overweight, a pattern consistent with previous research.
Study Limitations and Recommendations
The authors noted that the study relied on a single caregiver-reported household dietary classification and lacked detailed data on maternal nutrient intake, supplementation, and diet quality. This limitation restricts insights into specific nutritional drivers. Nevertheless, the scale of the dataset, standardized anthropometric measurements, and consistent findings across multiple analyses bolster confidence in the results.
For clinicians and public health practitioners, the study offers reassurance that in high-income settings with access to preventive care, vegan family dietary patterns can support normal infant growth. However, the slight increase in early underweight underscores the need for careful nutritional counseling during pregnancy and infancy, particularly concerning nutrients that may be limited in vegan diets. Routine growth monitoring is essential to identify and address issues early.
“Recent literature has indicated that well-planned vegan diets may meet children’s nutritional needs and support healthy growth with appropriate supplementation (e.g., vitamin B12) and nutrient monitoring,” the researchers wrote.
The study emphasizes the importance of nutritional counseling and pediatric follow-up for infants and children from vegan households, as well as for pregnant and breastfeeding mothers. While vegan diets generally have favorable nutrient profiles, the adequacy varies widely among families. Future research should focus on assessing actual intake, supplementation, and biomarkers to better characterize diet quality in children from vegan households.
