VEGAN BABIES:

the dangers of extreme diets

It was the middle of the night when the small, limp baby girl was brought into the emergency department of Geelong Hospital.

She had blood in her nappy and was cool to the touch. The nurse noted she had open wounds and grazes, which her father insisted were nappy rash. Sarah Michelle Adams* had just turned one, but when the nurse put her on the scale she weighed 6.04kg, about the same as an average four-monthold. “Wow, she lost 3kg. When did that happen?” her father said. He told the nurse she had been vomiting and had diarrhoea, but she had been eating and drinking normally.

Normal was not an accurate description of Sarah’s diet. Court documents show that two days earlier, on August 5, 2018, Sarah’s father had sought advice from a US-based “herbal health club” that claims to specialise in “regenerative detoxification” because Sarah had bruising around her abdomen, “wacky green poo” and was “vomiting up the same stuff”.

“Sarah’s going through heavy detoxification,” John Francis Adams said in an email to herbal health club employee Shannon Brese, which was tendered in court. “Is there a way we can slow the detox down without prolonging it? We really don’t want to take her to the doctors or hospital because they just don’t understand, but we also don’t want her to get so sick that we have no choice.”

The court found that, after consulting Shannon, John had been feeding his one-year-old a “stomach tea” because she had been refusing food, but after hearing how Sarah responded to the tea, Shannon said to take her to hospital.

When Sarah arrived at emergency, she was anaemic, hypoglycaemic and had sepsis associated with organ dysfunction. The doctors urgently transferred her to the Royal Children’s Hospital in Melbourne, where she was put on life support to keep her little lungs working. She was diagnosed with kwashiorkor, which is a form of severe malnutrition.

As court documents note, kwashiorkor is “very rarely seen in first world countries but has been well recognised in countries experiencing famine”.

Prosecutors said Sarah’s condition was “a direct result of a diet that was severely deficient in protein”.

What John hadn’t told the nurse in Geelong was that Sarah had been surviving on a plant-based diet for most of her life. From the age of three months, her parents had been feeding her a home-made baby formula of coconut water, banana, dates and a superfood powder. They later added Irish Moss as she progressed to solids including quinoa, porridge and mashed vegetables. Sarah remained in hospital for almost three months and her parents were charged and convicted of negligence.

Cases like this surface from time to time. A child is admitted to a hospital suffering malnourishment, and the doctors find an extreme diet is to blame. In several recent high-profile cases the media focused on a vegan diet, but Dieticians Australia spokesperson and accredited dietician Kate Di Prima says the problem is an obsessive attitude towards food.

“All eating habits can be unhealthy if they’re not balanced,” she says. “It’s like anything people become obsessed with – religion, finance. People become passionate about something and don’t see beyond the end of their own nose.”

Unfortunately, people working in the eating disorder space are seeing a normalisation of extreme and unhealthy attitudes towards food. Spokespeople from the Butterfly Foundation and BodyMatters Australasia say there is an alarming number of unqualified people promoting “disordered eating” as a lifestyle. “Disordered eating” is a term used to describe extreme and unhealthy eating patterns that involve some of the symptoms of eating disorders, such as anorexia nervosa, bulimia nervosa, binge-eating disorder and so on. “It is fed really intensely by all of these social media platforms where people can just put out whatever they think, and they have enough of a following and that’s enough for people to think they’re credible,” Butterfly Foundation spokesperson Danni Rowlands says.

The potential danger of extreme food fads for youngsters was in the spotlight not so long ago when a book of paleo recipes for babies and toddlers by chef Pete Evans and others was pulled from the production line and investigated by the health department. “There appear to be recommendations not to use either breast milk or an approved infant formula, but to provide other foods to infants under six months of age and that really is a big health risk,” Professor Heather Yeatman from the Public Health Association told the ABC. “There’s been discussion about a beef broth with mashed up liver as part of a recipe. Now, something like that might be appropriate for an older child, but under six months of age, really the best option [is] breast milk.” Even after Pete adjusted his now infamous bone broth recipe, dieticians lined up to warn against it or any other restrictive diet for babies.

Cases as severe as Sarah’s are mercifully rare and individual parents must be held responsible. But they don’t exist in a vacuum, and they show the harm that can be caused when unqualified people push so-called “health” advice that has no basis in fact.

Dangerous diet

John Francis Adams struggled with obesity as a child and was bullied all through school because of his weight. After Year 12 he did a baker’s apprenticeship and in his early twenties adopted a vegan diet and lifestyle. According to Victoria’s director of public prosecutions, he “held strong views about maintaining a rigid plant-based diet”. Around this time, he met Bronwyn Elise Hill, who became vegan too. They were married in 2015 and built a life together on Victoria’s Bellarine Peninsula. Sarah was their first baby, arriving a few weeks early in the winter of 2017. She was a healthy 3.57kg at birth.

When Sarah was a newborn

Bronwyn breastfed her, but after a few months Sarah began to lose weight. Bronwyn wasn’t producing enough breast milk so their maternal child health nurse, Angela, suggested she supplement Sarah’s feeds with formula. John would not allow his daughter to be fed formula. He “was adamant that Sarah would not have artificial formula and told [Angela] he would find a natural alternative”, court documents say. Angela patiently explained that there were no suitable alternatives for a baby ➝

as young as Sarah, and referred John and Bronwyn to a GP to rule out any health issues. When Angela saw Sarah the following week, she had lost another 80 grams and appeared flushed. John said they were looking into artificial formula options, but they “would not do cow’s milk”. Angela said they should talk to their GP about their diet, and that Bronwyn should have her iron levels checked. There was a risk Sarah could have a vitamin B12 deficiency, she said.

The doctor found Sarah to be in good health, but nonetheless recommended her parents give her formula at least once a day, while continuing to breastfeed. A pharmacist would be able to help find a suitable formula, the doctor said.

Bronwyn started researching soy or rice-based baby formulas, but when she couldn’t find anything suitable she started using an organic cow’s milk formula she found at a local health food shop. The packaging was in another language so she told her husband the formula was plant-based.

The following week, John had a phone consultation with Angela. He told her Sarah was fine, apart from a nappy rash caused by “toxins” from her body. He also said he’d found a coconut-milk based formula and had a meeting with a naturopath. The next time they spoke, John told Angela that Sarah had gained weight and was drinking a coconut formula made from coconut water, dates and superfood powder that had been obtained from a naturopath. Angela told them she was trying to be “respectful of their wishes in regards to their lifestyle choices, but … coconut mixture is definitely not recommended as a suitable supplement for an infant”.

She said she was worried about Sarah, concerned that she hadn’t had her blood or urine tested by a GP. Frustrated, Angela sought some advice from a paediatric dietician at the

Royal Children’s Hospital, and she forwarded it to John and Bronwyn. It stated: “Coconut mixture is definitely not appropriate as this is not nutritionally adequate for an infant.” The RCH paediatrician said if the mother’s breastmilk supply was inadequate, the baby should be fed approved infant formula, and that soy would be an option but only if the baby was over six months old.

Angela didn’t hear from John or Bronwyn, so a few days later, on Friday, November 17, she called them and left a voice message saying that if she hadn’t heard from them by the following Monday she’d have to take the matter further. They emailed her that evening saying her behaviour was “threatening”.

“We believe your actions are uncalled for and are based in unfounded prejudice,” they wrote. They then insisted on seeing another nurse, and said they were looking into filing a complaint.

Angela called John three days later to acknowledge she’d received the email. He told her the baby was “great, doing amazingly well, almost crawling, rolling, happy and talking”. Angela said she was concerned about the nutrition adequacy of the mixture they were using. John said the couple was “talking to some people in America” and had moved on to a different recipe.

Missed appointments

Bronwyn was to return to work on November 27, so on November 22 she and John took Sarah to a GP who noted, “they have decided to make their own formula with peat moss, banana, dates, water”. The GP also noted Sarah had “taken it really well and gained all the weight back again”. She said she was “thriving, interactive” and reaching her developmental milestones. The GP was unaware that Bronwyn was still supplementing Sarah’s feeds with the organic cow’s milk formula. When she returned to full-time work, John became Sarah’s primary carer.

Around this time Angela called the couple’s GP to say she was worried about Sarah. The GP called the couple and booked them in for a consultation in December, but they didn’t show up, and they didn’t see any other GP after this date.

For the next nine months, Bronwyn and John fed Sarah a diet of fruit juice, smoothies made from coconut water and plant-based solids, like mashed vegetables. They added superfood powders to her smoothies and once a week emptied the contents of a vitamin B12 capsule into her drinks. John looked into adding Irish Moss to Sarah’s diet and relied on natural health and vegan-living websites for advice.

They saw a new maternal child health nurse at the end of December 2017. She observed that Sarah was “robust” and “engaging”, but did note that Sarah hadn’t been immunised. John said his sister was “researching homeopathic immunisation”.

Sarah was next due to be seen by the maternal child health service in March, but records show her parents didn’t take her to the appointment.

In July, Sarah’s feet became swollen and she developed a weeping rash on her legs, which her parents attributed to a change in the type of nappies they were using. “It didn’t worry us … we weren’t worried at the time,” Bronwyn later said.

Around this time, the media began reporting on a mother and father from Sydney’s eastern suburbs who had been charged with child neglect after feeding their 20-month-old daughter a strict vegan diet. The child had suffered a seizure in March and was admitted to the Sydney Children’s Hospital, where doctors discovered she was severely malnourished and suffering from rickets. Police arrested the parents in April 2018.

Bronwyn saw the coverage and in July 2018, she emailed John an article titled Why Families Are Raising their Kids Vegan that mentioned it, writing, “LOL, the media, have a look”.

The little girl in the Sydney case was so malnourished by the time she was 19 months old she didn’t have any teeth and looked as if she was just three months old, according to The Sydney Morning Herald.

“IT’S IRONIC HER HIGH-NEEDS STATUS IS A CONSEQUENCE OF YOUR ACTIONS.”

As John and Bronwyn were not taking Sarah to see a doctor, there are no records of her health at this time, but on August 1, John sent his first email to Dr Morse’s Herbal Health Club seeking medical advice.

“My one-year-old has stopped wanting to drink/eat and when she does it’s not staying down,” he wrote. “She is on a fruit diet. Please help ASAP.”

The court heard that, at this point, Shannon Brese suggested a “stomach tea”. The next day John wrote to Bronwyn, who was away from home in NSW, to say he was “getting tea into her”. He said Sarah “through up [sic] a lot of brown lymph. It was gross !!!!

But she is getting better, no more screaming in pain”.

Text messages between John and Bronwyn give some insight into Sarah’s condition. In one exchange from early August, Bronwyn wrote, “Make sure to keep her hydrated, if you have to force her to drink the coconut water using the syringe then do so. Rather than her just sucking on the teat and not actually drinking.”

They referred to bruising and John said he would ask the Herbal Health Club about it. Bronwyn responded: “also mention the weight loss and floppiness of her body”.

On August 5, 2018, John sent Shannon the message about Sarah “going through heavy detoxification” and not wanting to take her to the hospital. Text messages show that while he was waiting to hear back he gave Sarah apple juice and honey tea. He and Bronwyn described her as “very weak” and “so floppy”. That’s when Shannon told him to take her to hospital.

Sarah spent a month in intensive care at the Royal Children’s Hospital. She was transferred to the general ward on September 7 and stayed there for two months before Child Protection placed her with her maternal grandparents.

John and Bronwyn were arrested in 2019 and charged with negligently causing serious injury. In a medical report tendered in court, the Director of the Victorian Forensic Paediatric Medical Service, Jennifer Anne Smith, said that her extreme medical and physical neglect had resulted in a severe and permanent brain injury. Sarah now

has cerebral palsy that affects her motor function, feeding, learning and communication.

In sentencing John and Bronwyn to negligently causing serious injury, Judge Claire Quin said both parents deserved to be criminally punished for the gross breach of their duty of care to their daughter. However, she noted there were exceptional circumstances in this case. Sarah required a high level of support and care, and since her hospitalisation both parents had undertaken parental training courses and were devoting themselves to her care.

“It is ironic that her high-needs status is partly as a consequence of your actions,” Judge Quin told Bronwyn. “I would have had no hesitation in imposing a term of imprisonment on you had Sarah not been so dependent on you.” Sarah’s struggles would be a daily reminder to Bronwyn and John of the consequences of their conduct, and a punishment in itself, Judge Quin said.

Malicious misinformation

Disease is a fallacy. Denying yourself sugar causes cancer. Eating raw food will clean your lymphatic system. These are the teachings of the fringe website John Adams used for advice when his daughter started showing signs of malnutrition. While Judge Quin did not accept anyone was to blame for Sarah’s condition but John and Bronwyn, when John asked for help on the internet, he was told to feed his daughter tea.

“At the moment, everybody can be a health expert. Everybody can claim they know things,” says psychologist and BodyMatters Australasia director Sarah McMahon. “Quite often the criteria is just someone looking good or looking happy, which is easy to manufacture on social media. If someone looks good and healthy we consider they’re a health expert regardless of what they’ve studied.”

Danni Rowlands adds: “Unfortunately, in these platforms, people are put on pedestals because of the way they eat and the way it makes their body look … Very vulnerable people, or all young people, accessing that information and applying it to themselves without the evidence can be dangerous.”

Groups like the Butterfly Foundation and BodyMatters are concerned there are unqualified people who celebrate a disordered relationship with food as a lifestyle. “Your [under-informed celebrity influencers] of the world are what drive a lot of this, and the conspiracy theorists playing into people’s vulnerabilities,” Danni says. “There’s a lot of money to be made. There are endorsements, supplements, all sorts of things people are being paid to push out. People’s health and well-being isn’t in the best interests of the people sharing this information.”

And the real tragedy is when innocent children are harmed.

*The names of family members are pseudonyms allocated by the Victorian County Court to protect the victim’s identity. If you need help or support for an eating disorder, call Butterfly Foundation’s National Helpline on 1800 334 673 or email support@butterfly.org.au