Hemingway, vegan baby nutrition, plus everything that is wrong with our health care system and nutrition science

What is wrong with our health care system is basically this:

(1) It is a business: to the health care industry, a sick person is more profitable than a healthy person. (But this is not what this post is about.)

(2) Medical staff with no training in nutrition science (or any science) have to advise people about diet and lifestyle choices.

As Hemingway would say: "[...] there are, in life, always good and valid excuses for every failure [...]."

(3) But even the people who really should know better - scientists - often do not seem to know what giving science-based recommendations should really mean.

An example from today's "scientific" press (yes, "press" is an insult):

Writing about (or wanting to write about) vegan baby nutrition (complementary feeding), a magnificent handful of scientists from Italy wrote this:

"Almost half of parents (45.2%) claim that their pediatrician was unable to provide sufficient information [surprise!] and adequate indications regarding unconventional weaning and 77.4% of parents reported the pediatrician’s resistance towards alternative [including vegan] weaning methods." This confirms point (2) above.

"The vast majority of authors [scientists] agree on the fact that [..] vegan weaning may cause severe nutritional deficiencies [...]." This confirms point (3). The statement is not wrong but apparently these authors do not want to distinguish between a well-planned vegan diet and a very badly-planned vegan diet.

"To date, consistent findings to support both the safety and feasibility of alternative weaning [including vegan] methods are still lacking." Yes, evidence is lacking. And this very "meaningful" statement can be made about pretty much everything in the world. That is why at the end of almost every research article you can read "more studies are needed". There is some scientific evidence when it comes to vegan baby nutrition, however - see below.

Do not lose hope because now what they write is getting kind of good:
"Since the risk of nutritional deficiencies in the early stages of life is high, pediatricians have a pivotal role in guiding parents and advising them on the most appropriate and complete diet regimen during childhood." Problem is ... see point (1) above ... pediatricians generally "are still lacking" the most fundamental know-how when it comes to even general nutrition. How could they properly advise anyone about nutrition?

"Efforts should be made to enhance nutritional understanding among pediatricians [yes!] as an unsupervised [..] vegan diet can cause severe nutritional deficiencies [...]." And who could "enhance" pediatrician's knowledge in the field of nutrition? Well ... how about scientists? Scientists publish. Medical doctors read. It could work.
Well, how about these Italian scientist authors right here? After all, they did write a review article titled "Vegetarian and Vegan Weaning of the Infant".
Here is what they say: "Since a vegetarian diet has a smaller variety of foods than an omnivore one [true?] and a vegan diet is even more restrictive, neonates whose mothers are vegetarian/vegan and infants following alternative weaning methods are likely to suffer from clinical or sub-clinical nutritional deficiencies." No reference is given for this daring "low dietary variety leads to deficiencies hypothesis", and apparently the authors do not want to distinguish between a theoretically possible dietary variety and the actual dietary variety in vegans, vegetarians, and non-vegetarians. (Maybe they should talk to the intestinal microbiota scientists about this.) And nutrient deficiencies are not caused by a "low variety" of foods but by a lack of adequate nutrient sources.

They keep going: "Alternative weaning [including vegan] as a self-decision should be generally discouraged. Pediatricians should guide families strongly willing to follow a vegetarian/vegan regimen, providing all nutritional requirements." Yes, but how should they do this? It seems highly questionable that those who have no knowledge of how to plan a vegan diet well can or should guide anyone in this respect. Making any such recommendation is not just irrational but borderline-criminal. 
And ... whose fault is it when people do not trust medical doctors and scientists? I have my hypotheses about this.

The authors conclude: "Vegan weaning should be discouraged because serious damages (slow growth [caused by an insufficient intake of calories, and possibly of protein and a variety of nutrients], rickets [caused by vitamin D deficiency], irreversible cognitive deficits, cerebral atrophy [caused by severe vitamin B12 or iodine deficiency], and also death [caused by severe vitamin B12 deficiency]) have been demonstrated." This is true. This is information from case reports with very badly-planned vegan (or non-vegan) diets. A well-planned vegan diet will not cause any such deficiencies
But apparently, the authors do not want to distinguish between a well-planned vegan diet (which will address important nutrients, including vitamin B12, iodine, and vitamin D), and a badly-planned vegan diet.
Apparently, the authors do not want to distinguish either between case reports and much larger observational studies.
The following three are the main studies available on vegan child growth and development: the Italian authors here do not bother citing Weder et al. 2019, or O'Connell et al. 1989. They do cite Sanders 1988 somewhere as a side note, but they do not mention what Sanders found. He found: "Most [vegan] parents were aware of the need to supplement the diet with vitamin B-12. It is concluded that provided sufficient care is taken, a vegan diet can support normal growth and development." And this was in 1988.

With scientists writing articles like the above ... Even if you have a pediatrician who - despite their lack of time and lack of training in this area - is so motivated and science-loving that they will say "Hey, I will look this topic up on Pubmed!" ... so, this would be the crème de la crème of pediatricians ... they would still find review articles (!) like the one discussed here.

This however, is not the only problem vegan parents have to face. Many vegan organizations refuse to offer or refer to science-based vegan nutrition information, and some proactively lie about this issue. 

As a vegan nutrition scientist who thinks that all vegan parents have the human right to reliable information on vegan nutrition, and that all vegan babies have the human right to adequate nutrition (animal rights issues), ... I can only warn vegan parents about "anti-science" (or "bad science") scientists, "anti-science" doctors, and "anti-science" vegan organizations.

May the best, and most ethical science prevail. I mean, ONLY the best and most ethical science.