Doctor's Note

For more on vitamin B12, check out these videos:
Vitamin B12 Necessary for Arterial Health
Daily Source of Vitamin B12
Safest Source of B12
New Vitamin B12 Test

Also check out my blog post, Vegan B12 Deficiency: Putting It into Perspective, for more context on this terrible tragedy.

My video, American Vegans Placing Babies At Risk, addresses how commonly vegans in the United States place their infants at risk by failing to supplement their diet with vitamin B12, based on studies published recently in the Journal of Pediatrics and the Journal of the AMA.

If you haven’t yet, you can subscribe to my videos for free by clicking here.

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  • Michael Greger M.D.

    Check out my blog post Vegan B12 Deficiency: Putting It into Perspective to put this terrible tragedy into context. Tomorrow‘s video-of-the-day will address how commonly vegans in the United States place their infants at risk by failing to supplement their diet with vitamin B12 based on studies published recently in the Journal of Pediatrics and the Journal of the AMA.

  • Dear Dr. Greger, I sincerely appreciate this website! That said, I have one constructive comment.

    Let’s not say that a vegan diet killed the baby, please; rather, let’s put into the headline that a vitamin (vital amine) deficient diet killed the baby. There are plenty of vegans who know the inherent risk of lacking such vital amines in their diet, and, as you state in another post, there are plenty of vegan-congruent ways to attain plenty of these essential nutrients. Rather than scare well intentioned people away from a vegan diet, let’s proffer the true information.

    Sincerely, Damian Rowe (vegan-inspired, non-vegan)

    • Michael Greger M.D.

      I appreciate your comment. Sadly, the true information is that most vegans apparently aren’t supplementing (I’ll cover this in my video on Saturday). It’s not enough that “plenty” of vegans know about the importance of B12; all vegans need to know. Please help me spread the word!

      • Dear Dr. Gregor. If the parents were supplementing with B12, would the child have died?

  • MsAdventuress

    A vitamin deficient diet absolutely has consequences for all involved.

    Dr. Gabriel Cousens wrote an interesting article about the vegan/meat-eater diet deficiencies.

    I wonder how many parents (male and female) are tested for vitamin/mineral deficiencies before they conceive, regardless of their diet. I can’t help but think we’re dealing with possible preventable issues, at every level of development, due to this, but we don’t yet know the full spectrum of it.

    I was severely deficient in B12 (and other vits/mins) while still eating an animal-based diet (due to undiagnosed celiac and other autoimmune issues). But I didn’t know it. I shudder to think what would have happened, had I had children.

    • Veguyan

      Dr. Cousens recommends D3. Is that a vegan supplement?

      Gabriel also recommends Spirulina and Chlorella for plant protein. Now Dr. Greger tells us these things are hepatotoxic, etc. What’s one to do?

      • MsAdventuress

        I was just noting the article because of the interesting comparison of deficiencies on both sides (I didn’t know Dr. Greger already had a video on it).

        I try to stay away from supplements (except B12). I get my vits/mins from eating whole food. I get my Vitamin D from sunshine.

        • MsAdventuress

          Well, I’m “trying” to get my Vit D from sunshine. My levels are being monitored, so we’ll see.

      • MsAdventuress

        Oh my goodness, I just watched Dr. Greger’s spirulina videos. I wondered about it, but I assumed if you purchased what you assumed to be a high quality product (Spirulina Manna), there wouldn’t be risk. Wow. I can’t say I want to test that theory out (anymore).

        This site is great.

      • Michael Greger M.D.

        There are lots of wonderful sources of protein (legumes) that don’t have such toxins. Dr. Cousens just may not be aware of the latest research--I certainly wasn’t!

      • Cyclo

        Hey Veguyan!

        Vitamin D3 is most often from animal origin.
        But there seems to be one product on the market that is true Vegan Vitamin D3 (even approved by the vegan society, yey!):

        I came across this site by following an discussion on Jack Norris RD page:

        Otherwise, you have Vitamin D2, which is the vegan version of Vitamin D. However, there seems to be very mixed opinions and scientific studies about it’s effectiveness compared to Vitamin D3.

        Vitamin D2 is a “synthetic” version of Vitamin D, and Vitamin D3 is identical to the Vitamin D that is produced in your body when you expose your skin to the sun.

        However, Vitamin D2 seems to be working just fine even though it’s not “natural”, after all, it has been used for treating Vitamin D deficiency for a very long time. :)

        • Michael Greger M.D.

          Taken daily at the doses I tend to recommend, D2 is equivalent to D3, so I’d suggest just getting whichever is cheaper. Given new findings (which I’ll profile soon in a new video), my new recommendation for those not getting enough from sun is 2000iu a day.

      • Robert

        When in doubt, go with Dr. G.

    • Michael Greger M.D.

      If you’re interested, I have a video similar to Dr. Cousen’s article: Omnivore vs. Vegan Nutrient Deficiencies.

      • MsAdventuress

        Love it, Dr, Greger, thank you! I’m adding these resources of yours to my plant-based wellness page. It helps so much to see it all laid out, side-by-side.

        And I was thinking…it would be something if the parents of FAS/drug babies were held as accountable as the parents who were B12 deficient. ♥

  • lbateman

    Critical prevention education, Dr. Greger: thank you.
    Perhaps we could make the handout easy to get to, and put together a pre,during,post-baby prevention diet guide for each type of diet being consumed out there.

    I am a Clinical Nurse Specialist, nicknamed Earth Mother, out to prevent so much tragedy and suffering going on unnecessarily.

    • Michael Greger M.D.

      A noble venture! For those who choose to eat vegan I would recommend Norris and Messina’s book Vegan for Life.

  • I find it hard to believe a woman could be B12 deficient enough to cause her breast-fed infant’s death, without suffering some symptoms significant to cause her to seek medical attention. The story just somehow doesn’t sit right.

    • Michael Greger M.D.

      Always good to be skeptical about everything! What you may not be taking into account in your thinking, though, is how good our liver is at storing the vitamin. So after this mother decided to cut animals from her diet she still had some stored up (adults typically keep about 2 or 3,000 on board). But her baby didn’t have the luxury of starting out with that much. Infants usually only get come out with about 25 mcg, just enough to last for a few weeks. Normally, colostrum (a mother’s first milk) is packed with B12, but in someone without much B12 to give, the infant is particularly susceptible with potentially devastating consequences. Does that make sense?

  • Well, yes, but if the mother was already vegan when the infant was born, you’d think her obstetrician would have caught this. Of course I don’t know the details of this particular case. Certainly a tragedy and something to be learned from. Thanks for the education, it’s very much appreciated.

    • Michael Greger M.D.

      When I speak at hospitals and medical schools it’s definitely something I cover. As plant-based diets continue to get more popular it’s important for the medical community to to educate itself (before they’re all put out of business by people eating healthy diets! :).

  • I’m so glad you covered this video, my vegan friends ignore the important of B12 and do not eat fortified foods and advise other people it is not necessary, in an attempt to show the superiority of the vegan diet and avoid/ignore any considerations vegans need to make. Same with omega 3 etc, they are convinced natural is best, I’m sure, but let’s not waste the tremendous knowledge we have learnt and an opportunity to make the most of our vegan diets!

    The health benefits of the vegan diet are covered in abundance across your other articles, it is important for vegans to be aware of their own requirements in order to achieve optimal health, and stop the meat-eaters avoiding the vegan diet for the wrong reasons, or converts going back to meat when their doctors tell them they aren’t getting enough B12. The last thing we need is vegans ignoring their few ‘pitfalls’ and counteracting all the benefits of our superior diets :-)

    • Michael Greger M.D.

      Could not have said it better myself–I hope you come back and contribute often!

  • Ouch! Humans have not evolved to ignore animal protein 100%. They have been called “hunter gatherers” for a reason. Cyanocobalamin. I remember seeing this stuff in its pure form. I’m still reducing my meat consumption though!

  • Michael Greger M.D.

    Also be sure to check out my associated blog post Vegan B12 deficiency: putting it into perspective!

  • becky

    Ok… so let’s suppose I have a tooth against taking ‘medicated’ food AND I’m a vegan. mostly raw. what DO I eat? Yeast? What kind of yeast? Where do I get it?
    I know lots and lots of people who lived in the countryside, never or almost never had animal products and lived a happy healthy long life. Not to mention hundreds of monks that live on almost nothing… again, happy, healthy long lives.
    Is there something that doctors or biochemists don’t know? Or something they do know, but keep away, to sell ‘supplements’, now that more and more people refuse medication? I mean.. if these were isolated cases, I would’ve said it’s ok. But hundreds and thousands of people doing that.. is not just an exception, is it?
    Thanks for your time!
    I really, really appreciate this website. Makes more sense than others.

  • Aubrianne

    how to speak to my doctor about no vaccination to my baby or me

  • Kristen

    I am a breastfeeding mama. How much B12 should I be taking to make sure I get enough for me and baby?

    • Joseph Gonzales R.D.

      Lactating moms need 2.8 micrograms per day. Infants need 0.4 micrograms per day of B12. Please check with your pediatrician to assure proper B12 needs are met.

  • Slavica Mazak Beslic

    Aren`t B1,B6, B12, B17 and many other vits and supstances at nuts,almonds, seeds of apricots and at aple seeds and at many/all other seeds ? I believe herbivore animals have not B vits deficiency, so raw vegans have it not too ( if eat 80%fruits,15% vegetables, 5% seeds ) . I do not know what was causa mortis by that baby at the article , maybe mother was guilty if did not feed baby , but I think vegan diet of mother was not guilty. I know many mothers who eat like an omnivores but had bad quallity / poor milk so must add baby feeding with artefitial baby food because baby eat their poor milk and stay hungry and cry..Sorry for my english.

  • Carol D.

    Dear Dr. Greger,
    I’m expecting a chid and I’m wondering what’s your point of view on raising a child on a vegan diet. Do you think that as long as the child has it’s B-12 vitamins it’s fine, or if I should provide a more complete diet for the first few years of life (maybe vegetarian) just to be on the safe side,

    • Joseph Gonzales R.D.

      Hi Carol D. Thanks for reposting. A vegan diet can be healthful in every stage of life, but like any diet it must contain the right nutrients. The Academy of Nutrition and Dietetics has a position paper on vegan and vegetarian diets, which would be a great read for a mother thinking about feeding her baby a vegan diet. Some of the best literature is perhaps by the author of this paper, Dr. Mangels. She is a great resource and trustworthy doctor and dietitian. Check out her website about feeding children. Breastfeeding is crucial regardless of what diet mom follows. When your baby gets older I love this kid’s brochure by PCRM. They also provide thousands of recipes, here. Dr. Greger’s Optimal Nutrition Recommendations may also help. Ellyn Satter’s division of responsibility in feeding is a great resource, as well once kiddo starts eating food. See if any of these links help answer your questions? Let me know what you decide and please let your pediatrician know and consider seeing a RD if possible to help with planning. Good luck I hope to stay in touch!


    • bobble

      when my aunt had my baby cousin he wasn’t getting enough to eat because my aunt never produced enough breast milk. at a month old he fit into premature baby clothing. My mom has worked in pediatrics for as long as i can remember and she helped my aunt and cousin. Its okay to give your child Formula. and if your a vegan that doesn’t mean your child has to be. at least until the are a couple year old. Formula will give your child all the vitamins and nutrients it needs to grow to be strong and healthy. my cousin is now three and grew out of the premature baby clothes once he was getting enough to eat :) consider the formula.
      good luck.

  • Roy
    • Thea

      Roy: Given the information provided, these examples have nothing to do with the diet being vegan and everything to do with a diet inappropriate for the age level. One example was a 3 month old baby on a vegan diet. 3 months! At that age, the baby should be breast feeding or on an appropriate formula. Another example was of a 6 month old given nothing both soy milk and apple juice. Again, everyone should know that soy milk is not the same thing as formula. Soy milk is not breast milk from any species.

      FYI: A position paper from the ADA states: “It is the position of the American Dietetic Association that appropriately planned vegetarian diets, including total vegetarian or vegan diets, are healthful, nutritionally adequate, and may provide health benefits in the prevention and treatment of certain diseases. Well-planned vegetarian diets are appropriate for individuals during all stages of the life cycle, including pregnancy, lactation, infancy, childhood, and adolescence, and for athletes.”

  • Ricardo Gaspar

    Hi, what are the guidelines to raise a vegan baby/child? Besides
    breastfeeding, it’s safe and healthy? And is possible without
    supplements? Usually, non-vegan don’t eat any (or low amounts of)
    supplements while growing up. I’m a vegan myself, but I became vegan only
    in my adult life.

    • NFModeratorKatie

      Hi Ricardo – Our friends at PCRM have some wonderful resources addressing questions on plant-based diets for kids. Vegetarian Diets for Children: Right from the Start

    • Thea

      Ricardo Gaspar: You already got a great reply from Moderator Katie. PCRM is one of my go-to resources also. I thought you might also appreciate my standard reply to questions like this:
      Note the following quote from a position paper from the ADA: “It is the position of the American Dietetic Association that appropriately planned vegetarian diets, including total vegetarian or vegan diets, are healthful, nutritionally adequate, and may provide health benefits in the prevention and treatment of certain diseases. Well-planned vegetarian diets are appropriate for individuals during all stages of the life cycle, including pregnancy, lactation, infancy, childhood, and adolescence, and for athletes.”
      Also note this quote from Dr. Greger’s book, How Not To Die, page 411-412: “Vitamin B12-fortified plant-based diets can offer health benefits for all stages of the life cycle. [When] Dr. Benjamin Spock, the most esteemed pediatrician of all time,…died at ninety-four, he advocated children be raised on a plant-based diet with no exposure to meat or dairy products. … ‘Children who grow up getting their nutrition from plant foods have a tremendous health advantage and are much less likely to develop health problems as the years go by.’ ”
      But having said that, there are some ‘gotchas’ when it comes to young children and whole plant food diets (just like there are gotchas with children and any diet). So, it really is worth spending some time reviewing accurate, evidence-based information on the topic. Here’s some ideas for specifics:
      PCRM is the Physician’s Committee For Responsible Medicine, headed up by Dr. Barnard. Dr. Greger has mentioned Dr. Barnard and PCRM favorably in posts and his book. Here are two articles from PCRM that I think contains the type of information you are looking for:
      I’ll also refer you to a site called the Vegetarian Resource Group, VRG. Their articles are usually very well researched and Dr. Greger has mentioned VRG favorably at least once. VRG has a whole section on kids on their website.
      Here’s the main page. Scroll down to the Nutrition section:
      This is one of my favorite articles on that page. which starts with babies and goes on up:
      Finally, I highly recommend getting a book called, Becoming Vegan, Express Edition. That book is a great over-all reference book for the whole family. It also has an entire chapter on children and what to feed. The authors of that book have been guest bloggers here on NutritionFacts. They are very well respected and extremely knowledgeable about nutrition science and how it applies to all ages.
      I really hope this helps you to get your mother-in-law on board. It’s not just respecting the decisions you make as a parent. Consuming animal products and junk food puts your daughter at risk. That’s just not OK.
      Does this help?