Table 5.

Practical recommendations for infant feeding during the first year of life according to vegetarian or vegan regimens (sources: Lemale et al. [8] and Mangels et al. [11]).

	Vegetarian Diet			Vegan Diet
BF (Lactating Woman)	FF	CF	BF (Lactating Woman)	FF	CF
Vitamin B12: is likely to be lacking. Vitamin B12 fortified foods (cereals, alternative milk, meat analogs, and nutritional yeast) or vitamin B12 supplementation (50 μg/day) are recommended. If the mother refuses either, the baby should be supplemented with vitamin B12.   Vitamin D: vitamin D supplementation of 1000–1200 IU/day is recommended in all breastfed infants. Currently, the only commercial infant vitamin D drop is derived from sheep’s wool (lanolin), thus suitable for vegetarians but not for vegans.   Proteins: Varied consumption of vegetables and cereals.   Calcium: 500–1000 mg/day depending on other sources.   Iron: Iron-rich plants with vitamin C-rich fruit. Specific preparation methods (grinding, soaking, germination). Supplementation of 2–3 mg/kg of iron depending on serum ferritin.   Zinc: Plants rich in zinc (Brassicaceae); Specific preparation methods (grinding, soaking, germination). If deficiency: 1 mg/kg/day of zinc gluconate.   Iodine: 6.5 g/day of iodized salt.   DHA and ALA: Vegetarian lactating women should consume DHA fortified foods and ALA rich foods (flaxseeds, chia seeds, walnuts, etc.). 100–200 mg of micro-algae/day source of DHA suitable also for vegans.	Cow’s milk-based formula provides good amounts of Vitamin B12, proteins, calcium, iron, zinc, iodine, and DHA (if DHA enriched).   Vitamin D: 1000–1200 IU/day (or 600–800 IU/day if formula is vitamin D enriched).   DHA: if formula not DHA enriched, 100 mg of micro-algae/day	In formula-fed infants, there are no specific concerns. Conversely, breastfed infants may lack iron and zinc, therefore iron- and zinc-fortified infant cereal or firm tofu should be advised.   Iodine: No addition of iodized salt up to 12 months of life.	Vitamin B12: same considerations as for vegetarian diet.   Vitamin D: if the family declines to supplement the baby with lanolin-derived vitamin D3, the mother should receive a high-dose vitamin D2 (derived from fungi) supplementation of 2000 IU/day or 60,000 IU/month for three months to ensure good concentrations of vitamin D in breast milk.   DHA and ALA: same considerations as for vegetarian diet.	Soy protein-based formulas (even though they are supplemented with lanolin-derived vitamin D3).   Commercial soy drinks or other plant-based beverages, homemade formulas from grains or nuts, vegetable juice, and unmodified cow’s milk should be avoided.   Vitamin D: 1000–1200 IU/day (or 600–800 IU/day if formula is vitamin D enriched)   DHA: if formula not DHA-enriched, 100 mg of micro-algae/day	Same considerations as for vegetarian diet.

BF: breastfeeding; FF: formula feeding; CF: complementary food; DHA: Docosahexaenoic acid; ALA: α-linolenic acid.