Q&A: Am I putting my baby at risk as a vegetarian during pregnancy?

I am 10 weeks pregnant, and have been a vegetarian for about four years. I get a lot of protein from eating vegetables, beans, nuts, and soy. Occasionally I'll eat fish, although the nausea isn't helping on that front. Am I putting my baby at risk because I won't eat meat? Should I take more than the regular prenatal pills?

I am confused about what sort of vegetarian you are. Most "vegetarians" who eat fish also eat eggs and dairy products, which provide easy sources of protein. But you are describing a vegan diet with fish, if I understand correctly. And you are right, it can be difficult to get enough protein as a vegan. On the other hand, most vegans eat lots of vegetables, fruits, and whole grains, and come closer to the ideal diet than the average American does. The problem is, as you say, protein, which can be found in beans, legumes and nuts, and also some essential fatty acids. Unfortunately, vitamin pills don't supply protein, so that won't be the answer to your good question. DHA supplements with your vitamins may be helpful to give you the fatty acids that your baby's brain needs.

Fish in general is very good for moms-to-be, and hopefully you won't be nauseated forever. Low-mercury fish like catfish and wild salmon, and any small fish like sardines, are good sources of protein and essential fatty acids in pregnancy. Larger fish like swordfish, some farm-raised salmon, tilefish, albacore "white" tuna, and mackerel are high in mercury and should be avoided. The website www.fda.gov or the smartphone app Seafood Watch (look under health notes) both provide a full list of fish with their mercury levels.

I usually recommend that my vegan patients talk to a nutritionist so they can be sure to get everything they need during pregnancy. If you don't eat dairy or eggs and don't think you will be eating fish, a nutritional consult with a registered dietitian is probably a good idea.

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