Dietary practices of pregnant and breastfeeding women following a vegan diet, and underlying determinants: a qualitative study

Abstract Background Dietary choices during pregnancy and lactation can have a profound impact on maternal and child health. However, the determinants influencing the maintenance of a vegan diet during these life stages remain insufficiently understood. This study aimed to explore dietary practices and identify the determinants influencing dietary decisions among women following a vegan diet during pregnancy and lactation. Methods A cross-sectional qualitative study was conducted in the Netherlands using online semi-structured interviews. Women who followed a vegan diet during their current pregnancy or a pregnancy within the past four years were recruited through social media and a newsletter. Data were analysed thematically using a hybrid inductive–deductive approach, guided by the Theory of Planned Behaviour and Self-Determination Theory. Results Between May and July 2023, 29 interviews were conducted. Participants were aged 29–45 years and were all highly educated. They had followed a vegan diet for a median of five years (range 2–23), primarily for ethical reasons, and all had breastfed or intended to breastfeed. Participants demonstrated a high level of nutritional knowledge and actively monitored their dietary intake. Despite limited perceived support from healthcare providers, they felt confident maintaining their diet and relied on informal networks for practical and emotional support. Intrinsic motivation and moral identity appeared to protect participants from social pressure and criticism. Their confidence was reinforced by positive pregnancy experiences and the perceived healthiness of their diet. Conclusions Women following a vegan diet during pregnancy and lactation were motivated and well-informed but experienced limited professional support. These findings highlight the importance of health literacy, social support, and identity-driven motivation as determinants of dietary adherence, and the need for inclusive, evidence-based nutrition counselling within antenatal and postnatal care.