Comment by danShumway | Hacker News Reader

Comment by danShumway | Hacker News Reader

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That's certainly an interpretation of that study. Here's another one.

> Almost half of parents (45.2%) claim that their pediatrician was unable to provide sufficient information and adequate indications regarding unconventional weaning and 77.4% of parents reported the pediatrician’s resistance towards alternative weaning methods.

> Our results show that alternative weaning methods are followed by a significant number of families; in half of the cases, the family pediatrician was not perceived as an appropriate guide in this delicate process.

In other words, nearly half of parents who try vegetarian weaning report that their pediatricians stop helping them or are unable to give them adequate/informed nutritional advice, and unsurprisingly, parents who no longer have adequate access to health resources and information struggle to raise healthy kids.

This isn't an argument against vegetarian weaning, it's an argument for educating pediatricians so they're not shrugging their shoulders when people ask them how to keep their kids healthy.

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It's also really important here to distinguish between vegan and vegetarian weaning. You're lumping them together when the paper doesn't. Its take is:

> Vegetarian weaning with appropriate guidance from family pediatricians or nutritional experts is possible and it should not be opposed.

> Vegan weaning should be discouraged because serious damages (slow growth, rickets, irreversible cognitive deficits, cerebral atrophy, and also death) have been demonstrated.

This is something that kind of annoys me when it comes up in these conversations. The health risks of veganism and vegetarianism are very different. Being vegan requires paying attention to your food intake, it requires doing some research, because the United States food system is not built around that concept. The risks aren't common knowledge and fewer foods are fortified to deal with problems that vegans face. But being vegetarian is comparatively much, much easier to do, and you're much less likely to make a mistake and end up with a deficiency if you go down that route. They really shouldn't be talked about as if they have the same levels of risk.

>> In other words, nearly half of parents who try vegetarian weaning report that their pediatricians stop helping them or are unable to give them adequate/informed nutritional advice, and unsurprisingly, parents who no longer have adequate access to health resources and information struggle to raise healthy kids.

I think your "other words" are deviating very significantly from the letter of the article and you're adding your own interpretation to what's actually written. As actually written, the article says that "the family pediatrician was not perceived as an appropriate guide" by the families Note the "perceived". This may be because the families have different ideas about a healthy diet than the pediatrician, for example "77.4% of parents reported the pediatrician's resistance towards alterantive weaning methods". Since those "alternative weaning methods" may include anything from a vegan weaning to feeding one's child beneficial moon rays (while simultaneously protecting her from the evil dark rays of death), I am inclined to believe that the problem is not that pediatricians are not adequately informed, but that parents are adhering to information from inadequate sources.

There are plenty of articles in the mainstream press by doctors who lament the fact that their patients will trust charlatans who sell them energy therapies and other such snake oil treatments, instead of the doctors themselves. Those doctors are usually specialists (for example, oncologists) but their patients still think the charlatans know best.

You have to be pretty selective in this article to look at one word, "perceived", and conclude that the issue here is that people aren't trusting their pediatricians. If the paper meant to say that that vegetarian weaning was a snake oil treatment, it would have said that a lot more directly.

Instead, it literally says: "Vegetarian weaning with appropriate guidance from family pediatricians or nutritional experts is possible and it should not be opposed."

If the paper meant to say that pediatricians were fully up-to-date on how to give advice, and the problem was that nobody was listening to them, then it would have said that a lot more directly. Instead, it literally says: "Efforts should be made to enhance nutritional understanding among pediatricians as an unsupervised vegetarian or vegan diet can cause severe nutritional deficiencies with possible detrimental long-term effects."

I don't think a full reading of the entire paper supports the conclusion that pediatricians are perfectly informed and that vegetarian weaning is a snake oil con. It supports the conclusion that research is underdeveloped and that many pediatricians are not qualified to guide parents through that process. It does discourage vegan weaning because it's difficult to do correctly, because it can go very wrong if not done correctly, because we're still getting research about the best ways to handle those diets, and because, again, pediatricians and health experts have not studied these diets enough to be confident giving advice about them. This is not necessarily the same thing as saying that vegan weaning is impossible to do well -- it's acknowledging that we live in a world where it hasn't been scientifically studied enough to know the potential downsides, and where guiding resources are extremely scarce.

I think you're projecting a conclusion onto this that the authors explicitly reject. A paper that was trying to warn about the troubling trend of parents rejecting their pediatricians' advice would not look like this. It would be talking about things like combating disinformation, it wouldn't be spending half the paper talking about the best B12/iron/etc vegetarian food sources.

But it never goes to topics like misinformation. Instead, it lays out nutritional advice, warns against unsupervised weaning and the risk of naively eliminating meat, and then ends by reinforcing again the need for proper professional guidance: "alternative weaning as a self-decision should be generally discouraged. Pediatricians should guide families strongly willing to follow a vegetarian/vegan regimen, providing all nutritional requirements."

That doesn't line up with the narrative you have about this paper. Nowhere does it say, "pediatricians should figure out how to convince families strongly willing to follow a vegetarian/vegan regimen that they're being scammed/deluded."

> There are plenty of articles in the mainstream press by doctors who lament the fact that their patients will trust charlatans who sell them energy therapies and other such snake oil treatments, instead of the doctors themselves.

I'm sure there are. It's just, this paper isn't one of them and shouldn't be lumped into that category. If you're writing about energy therapies, you don't spend half the paper describing how to do energy therapy well and how we need more resources to guide parents through energy therapy, because it's not a real thing that can be done well.

>> That doesn't line up with the narrative you have about this paper. Nowhere does it say, "pediatricians should figure out how to convince families strongly willing to follow a vegetarian/vegan regimen that they're being scammed/deluded."

I'm sorry, I don't follow. Who said that?

> I am inclined to believe that the problem is not that pediatricians are not adequately informed, but that parents are adhering to information from inadequate sources.

I don't think the paper supports that conclusion. The paper doesn't suggest that vegetarian weaning is itself a problem or a scam, it suggests that we don't have the educational resources available to support people who are doing it.

I still don't understand: who said that "vegetarian weaning is itself a problem or a scam"?

Maybe I don't understand your argument. If vegetarian weaning isn't a problem, then what do you mean by:

> I am inclined to believe that the problem is not that pediatricians are not adequately informed, but that parents are adhering to information from inadequate sources.

The way I heard that was, "the problem is that parents aren't listening to pediatricians when they tell them less-common weaning methods are a bad idea." Did you mean something else?

I'm thinking about that in conjunction with your original statement, which to me sounds more directly like it's making that argument:

> Yes, the problem is not dairy vs. non-dairy, it is with feeding kids who have been weaned a vegetarian or vegan diet in general.

Is that statement not saying that vegetarian weaning is a problem?

But if we're arguing past each other, I apologize. I guess I'm not sure what your claim is. Do you mean that pediatricians are informed, and they are giving adequate advice about how to do successful vegetarian weaning, and they aren't hostile to the practice, but that parents are just ignoring it anyway and trying to do weaning on their own? But this paper still spends zero time trying to talk about how to convince the public to trust their pediatricians, so that also doesn't seem like it's the conclusion that the author is going for.

Again, apologies for misinterpreting you, but if that's not what you're trying to say then I'm missing what you are trying to say.

> This isn't an argument against vegetarian weaning, it's an argument for educating pediatricians so they're not shrugging their shoulders when people ask them how to keep their kids healthy.

No, it’s an argument that people should probably listen more to their pediatrician.

This study does not conclude that a vegetarian diet is unhealthy for weaned children -- in fact, it concludes the opposite, that vegetarian diets are fine for weaning if parents are properly guided through the process.

If pediatricians are not properly equipped to guide through that process, then yes, it is a problem with educating pediatricians.

Health professionals need to be educated about what a healthy vegetarian diet looks like for children, because they are going to meet vegetarians who (very reasonably) are not going to accept an answer of "this is totally possible to do well, but I don't personally know how to do it, so nobody should do it." I think it's reasonable for the public to expect that those people learn how to address the health issues that the people under their care are facing.

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