Eating vegan while pregnant or breastfeeding: what to ask your doctor

“Can I eat vegan while pregnant?” is asked constantly online, and most of the answers are far more confident than the person writing them has any right to be. This article does not answer it. The person who can answer it is your own obstetrician, because the answer depends on blood results, history, stage of pregnancy and any medication — none of which anybody can guess for you.

What this article does is different, and genuinely useful: it lists the questions worth asking. An appointment is often fifteen minutes, and it is very easy to leave having never raised the subject of food at all.

Why pregnancy is a different matter

On an ordinary vegan diet, small imbalances can be corrected gradually. Pregnancy differs in three ways:

• Requirements rise, but not evenly. Some nutrients rise far more than others, so “eating a bit more” does not automatically cover it.
• The window is narrow. There are stages of pregnancy where particular nutrients matter far more than at others. Catching up late is not the same as having it on time.
• Two people, one supply. Where something is short, the mother's body usually gives way first, so she may feel tired before anything else shows.

This is why it does not belong in the “read it online and apply it” category, even if you have eaten vegan for years and know your own diet well.

Six questions to ask

1. “I eat vegan in this particular way — should I have any tests first?”

The important part is saying which way: vegetarian with eggs and dairy, vegetarian full-time, or fully vegan. Those three differ enormously nutritionally, and many people say only “I'm vegetarian” and are understood to mean something else.

2. “How should I be taking B12?”

B12 is virtually absent from plants as they grow. It is the nutrient most often raised in connection with pregnancy and a fully vegan diet. Leave the dose and the form to your doctor — do not buy a high dose on your own.

3. “Where is my iron?”

Plant iron is absorbed more slowly than animal iron, and iron requirements rise in pregnancy. Ask for the actual figure from your blood test, and ask whether you need a supplement and when in the day to take it.

4. “What about calcium and vitamin D?”

Anyone not using dairy should know where their calcium is coming from, and vitamin D is what makes calcium absorbable. Plenty of people in a sunny country are still short of vitamin D, so do not assume.

5. “Where should omega-3 come from?”

The omega-3 most discussed in pregnancy (DHA) usually comes from fish. Vegans get it from algae. Ask whether you need a supplement and which form suits.

6. “Is there anything I should avoid entirely?”

Not only a vegan-or-not question. Some food groups are advised against in pregnancy for food-safety reasons, and some vegan dishes fall within them. Ask specifically rather than guessing.

Preparing before the appointment

Doctors answer more precisely with data. Three things to do beforehand, about ten minutes' work:

• Write down the last three days of eating. Honestly, including snacks and drinks. This is far more useful than any general description such as “I eat fairly varied.”
• Photograph the labels of any supplements you take. If you take a multivitamin or a fortified nut milk, bring the ingredients panel.
• Put the six questions in your phone. It sounds trivial, but this is the thing most often forgotten once you are in the room.

On eating out while pregnant

For anyone pregnant, what matters most when eating out is freshness and how the food has been kept, not whether it is vegan. A few practical points:

• Eat soon after buying rather than hours later — particularly anything with fresh salad and sauce.
• Choose a place that makes in batches and sells out daily over one that makes everything in the morning.
• If you are carrying it, ask for the salad and pickles separately and add them on arrival.

At Banh Mi XANH the five shops are open 24 hours and bread is baked in batches, never sitting on the shelf more than four hours — so at any hour there is fresh bread rather than something that has stood. The menu is entirely vegan: Thập Cẩm at 59,000d, Chả Lát Chay at 53,000d, Đậu Hũ Cay at 56,000d, Bơ Đường at 28,000d, Thượng Hạng Premium at 75,000d.

Many pregnant customers ask for Đậu Hũ Cay to be made milder or choose another loaf, since reflux and heartburn are very common in pregnancy.

The five shops: 38 Lê Thị Riêng, 15B Nguyễn Thị Minh Khai, 2B Trần Hưng Đạo and 148B Đề Thám in District 1, and 210 Bùi Văn Ba in District 7. For delivery call 0923.183.183; orders from 500,000d within 5km are delivered free.

This is general information to help you prepare questions. It is not medical advice and does not replace your doctor's instructions. Decisions about diet and supplements in pregnancy should come from the doctor following your pregnancy.

Quick questions

Can I eat vegan while pregnant?

Only the doctor following your pregnancy can answer that, because it depends on blood results, history and stage. This article does not answer it — it helps you ask the right questions at the appointment.

How should I describe my diet to a doctor?

Say which kind: vegetarian with eggs and dairy, vegetarian full-time, or fully vegan. The three differ greatly, and “I'm vegetarian” is very easily understood as something else.

Should I start supplements before the appointment?

Do not decide a dose yourself, particularly a high one. Bring the label of whatever you are taking and let the doctor adjust it.

What should I prepare beforehand?

An honest record of the last three days of eating, photographs of any supplement labels, and the questions written in your phone. Ten minutes of preparation buys a far more useful appointment.

What matters most when eating out while pregnant?

Freshness and storage, not whether the food is vegan. Eat soon after buying, choose a place that makes in batches, and if carrying it ask for salad and pickles separately.

Is spicy food all right during pregnancy?

It varies by person and stage, and is worth asking your doctor about. In practice many pregnant people avoid it, because reflux and heartburn are very common.