WHAT NOT TO EAT WHEN YOU ARE EXPECTING
(Food Safety in Pregnancy)
Gloria Glidewell, CNM, MS
The CDC estimates that there are up to 76 million cases of food-borne illnesses in the United States each year. Food-borne illnesses are a big concern and lead to over 325,000 hospitalizations and 5,000 or more deaths yearly. In pregnancy, avoiding food related illnesses and food contaminants takes on a whole new dimension. The hormonal changes in pregnancy decrease the immune response in pregnant women giving them and their unborn offspring an increased susceptibility from exposure to pathogens or contaminants. An unborn baby in the early stages of development may suffer from life long illness or injuries from exposures that present with mild or even no symptoms in adults.
Women know that they should avoid smoking, alcohol and many drugs in pregnancy. Food presents a special challenge. Everyone must eat! Following is an overview of which foods to avoid and which practices to adopt to keep you and your baby safe throughout pregnancy. The best time to adopt these practices is before conception!
General Guidelines
1. Clean, Clean, Clean!
• Wash hands thoroughly and often with warm water and soap and always before and after handling food, changing diapers, using the bathroom or handling pets.
• Wash cutting boards, dishes, utensils and countertops with hot water and soap before and after food preparation.
• Rinse raw fruits and vegetables thoroughly under running water.
• Avoid sharing forks, cups, or food with other people and in particular, young children who might carry viruses or bacteria that could harm unborn babies.
2. Separate and store foods properly.
• Store raw meat, poultry, and seafood separately from ready-to-eat foods. Store raw meat in leak-proof containers to avoid contamination from the possible dripping of meat juices onto other foods in the refrigerator.
• Use a designated non-wood cutting board for meat and a different one for fresh fruits and veggies.
• Place cooked food on clean plates. Wash plates, cutting boards or utensils used to prepare raw foods before reusing.
• The Danger Zone for bacterial growth is between 40 degrees (F) and 140 degrees (F).
• Toss foods left out at room temperature (or above as in a hot car) for two hours or more.
• Store all perishables such as eggs, cheese, leftovers, and other perishables in the refrigerator. Eat perishables as quickly as possible and reheat leftovers to at least 165 degrees before eating.
• Do not eat raw or undercooked eggs, or foods such as home made eggnog, smoothies or hollandaise sauce that might contain raw or undercooked eggs.
3. Cook thoroughly.
• Use a food thermometer to check that foods are heated to the proper temperature for the appropriate amount of time according to cooking directions (check FoodSafety.gov’sSafe Minimum for further info).
4. Cool correctly.
• Check your refrigerator with an appliance thermometer to be sure the refrigerator registers at 40 degrees (F ) or below and the freezer is at 0 degrees (F).
Pathogen Awareness
Listerosis: Listeria monocytogenes is a bacteria found in nature, soil, ground water, plants and animals. It can grow at refrigerator temperatures where most other food-borne bacteria do not. Listeria can travel to any part of the body but shows an affinity for the central nervous system and the placenta.
How to Avoid:
• Do not eat hot dogs, lunch meats or deli meats unless they have been heated to steaming hot. Also be sure that the juices from the packages of these items do not contaminate other foods or surfaces where foods are prepared.
• Do not eat soft cheeses such as Feta, Brie, Camembert, queso blanco, queso fresco and Penela, or blue-veined cheeses, unless they are labeled as made with pasteurized milk. Read labels!
• Do not eat refrigerated smoked seafood unless it is cooked – as in a casserole. These food products are usually found in the refrigerated seafood area of the grocery store, and include smoked salmon, trout, whitefish, cod, tuna or mackerel.
• Do not drink raw milk or eat foods that contain unpasteurized milk.
• Do not eat foods that have a long shelf life such as potato salad or coleslaw, deli salads or meat pate’s unless you are certain they are freshly made with fresh ingredients.
• Do not drink unpasteurized juice or eat raw sprouts
Toxoplasmosis: Found in raw or undercooked meat (particularly pork, lamb, venison), and fruits and vegetables, and in animal and human feces. Toxoplasma gondii is a parasite that can lead to blindness or brain damage if infants are exposed in the womb.
How to Avoid:
Use a meat thermometer to be sure that meat and poultry are thoroughly cooked.
Recommended temperatures are as follows:
• Pork roasts and chops: cook to at least 145 degrees (F).
• Beef, veal and lamb roasts and steaks to 145 degrees (F).
• Ground beef, veal, lamb and port to 160 degrees (F).
• Ground poultry to 165 degrees (F).
• Chicken breasts to 170 degrees (F).
• Whole poultry to 180 degrees (F).
(And avoid cleaning kitty litter)
Methylmercury: Although mercury is a naturally occurring element in the environment, when it is released into the air through industrial pollution it accumulates in rivers, lakes, streams, and the oceans. Bacteria transform the mercury into methylmercury which is a toxin. Methylmercury can cause irreversible damage to the developing brain, the nervous system and possibly the heart of unborn babies. Exposure to methylmercury may also affect children’s behavior and learning capacity. Very high levels of exposure may result in symptoms similar to cerebral palsy.
Polychlorinated Biphenyls (PCB’s) are a mixture of chemicals that are no longer produced in the United States, but are still found in the environment. PCB’s are known to cause cancer in animals and may produce other health effects ranging from acne-like skin conditions to immune system dysfunction, as well as thyroid, reproductive, stomach, liver, kidney and neurobehavioral effects in children. Unborn babies and children are particularly susceptible to these chemicals.
How to avoid:
Fish offer many nutritional advantages to a healthy diet and it is safe to include fish as part of your diet in pregnancy. However, since all fish now contain at least trace amounts of mercury, pregnant women should limit fish consumption to 12 ounces per week of types that are low in mercury. These include shrimp, salmon, Pollock, catfish and canned light tuna. Eat no more than six ounces of albacore (white)tuna which is higher in mercury.
What’s all the Hype about Omega 3 Fatty Acids?
Recent studies show that omega 3 fatty acids may aid in fetal brain development and are healthy choices for pregnant women. Omega 3 rich fish that are low in mercury include salmon, herring, anchovies, sardines and trout. Large, predatory, long-lived fish should be avoided and these include shark, tilefish, king mackerel, and swordfish.
• Eat smaller, younger fish which generally contain lower mercury levels
• Remove skin, dark muscle tissue and visible fat from fish before cooking. Broil, grill or bake fish and allow fat to drip away from the meat to reduce exposure.
• Eat fish from a variety of water bodies to avoid exposure to any one chemical contaminant or group of contaminants.
• Internal organs of fish may contain high levels of contaminants and should be avoided.
• Raw is risky! Avoid sushi, sashimi, and raw oysters, clams or muscles. Raw fish are more likely to contain parasites or bacteria than cooked fish.
• Before eating game fish (fish caught for sport), check with the guidelines for specific water bodies listed at: http://www.tdh.stte.tx.us/bfds/ssd or call the Seafood Safety Division at 312 719-0215.
In reading through all of this information, it might seem like too much to manage or remember. However, most people will have already adopted many of these practices and/or do not eat all or many of the risky items. Also, keep in mind that with most exposures to contaminants or toxins, it is prolonged and repeated exposures that pose the most risk. Generally, a one-time mistake or accidental exposure will mean minimal or no effects to you or your unborn little one. Choosing a variety of healthy foods to include in your daily diet and adopting these safe-handling practices will be your best bet for a nutritious pregnancy diet that will help you to grow a vigorous, robust and healthy child.
Bon Appetit!
UNT Nurse-Midwives
