Parents: vegetarianism - Bean feast

Good nutrition in the early years is essential for growth and development and careful attention is needed to ensure the correct balance of nutrients is obtained. Like wheat-free, egg-free or nut-free diets, vegetarianism can be considered a type of special diet and should be planned with care.

There are degrees of vegetarianism, ranging from the exclusion of red meat, to the exclusion of all meat and fish or all animal products. The latter is a vegan diet. When a child registers with a setting and specifies a vegetarian diet, it is important to question the parent or carer to establish which foods are to be avoided.

Balancing nutrients

A survey of 2,000 UK parents found that 6 per cent of under-threes were vegetarian. It is estimated that less than 1 per cent follow a vegan diet. Vegan diets are not recommended for babies, as it can be hard to meet their very high-energy and nutrient needs. Practitioners should encourage parents to seek advice from a dietitian about vegan diets.

Studies have found vegetarian diets are healthier than those that include meat. Vegetarians usually eat more fruit and vegetables, more fibre and less saturated fat. The long-term health implications of such a diet are good and there is no evidence that a carefully planned vegetarian diet compromises child health or development.

A child's nutritional status is only at risk if alternatives are not given for omitted food groups. The four main food groups are:

- breads, cereals, potatoes and other starchy foods

- fruits and vegetables

- meat, fish and alternatives

- milk and dairy foods.

It is group three, and possibly four, that may need to be substituted. Meat and fish are the best sources of iron in the diet. Without enough iron, children's growth, mental performance and behaviour can be affected. Iron deficiency anaemia may result. Signs to look out for are palor, tiredness and frequent illness.

Vegetarian alternatives to meat and fish include tofu, Quorn, pulses (beans, peas and lentils), houmous, dried fruit, fortified breakfast cereals, dark green leafy vegetables, eggs and ground nuts or smooth nut butters (but be aware of nut allergy). Oily types of fish, such as salmon, sardines and fresh tuna are good sources of iron and essential fats. Many of these foods are also good calcium-rich alternatives to dairy foods for the vegan child.

Careful planning

A good meat alternative must be included in a menu at least once a day. For example, with chicken and mushroom risotto, simply excluding the chicken for the vegetarian child is not acceptable. Quorn, tofu or chick peas could be added instead.

Iron-rich snacks include: houmous and pitta fingers, baked beans on toast, lentil puree with breadsticks and carrot fingers, or egg mayonnaise and cucumber sandwiches. When using tinned pulses choose those with reduced salt or sugar.

Iron from plant sources is more easily absorbed in the presence of vitamin C, so it would be good practice to include a glass of pure, diluted fruit juice or fruit for dessert. Never give young children tea or coffee, as they interfere with iron absorption.

Plant-based diets are often bulky, which can be a problem for young children with high energy needs, but small stomach capacity. Ensuring these children have small frequent meals and do not fill up on fluids between and during meals is very important.

Cow's milk is a poor source of iron and children should be encouraged to eat before drinking. Over-consumption of fluids, especially from a bottle, fills children up and could contribute to iron deficiency. Practitioners should encourage the use of cups, especially after one year. There may be a problem if parents give inconsistent messages about using bottles or cups and practitioners should talk to families individually about practices in the home.

Children should never feel isolated or excluded and practitioners should not draw attention to a vegetarian child as being 'different'. To encourage eating well, the mealtime setting must be encouraging, stress-free and sociable. It is good practice for practitioners to eat with the children and be positive role models. Give plenty of praise to encourage good eating behaviour so that they enjoy the eating experience and, with your support, grow up to be the healthiest they can be.

Further information

- Eating well for under-fives in childcare: www.cwt.org.uk

- The Vegetarian Society: www.vegsoc.org (0161 925 2000)

- The Vegan Society: www.vegansociety. com (0121 523 1730).