Reducing Foodborne Risks During Pregnancy
What you eat during your pregnancy has a direct effect on the growth and development of your baby. It is important to eat a well-balanced diet that includes lean meats or meat alternatives, whole grains, low-fat dairy products, and plenty of fruits and vegetables. In addition to increasing your consumption of healthful foods, there are certain foods you need to limit or avoid. Some foods contain substances that can affect your baby’s development, while others put you at risk of developing an infection that can be passed to your baby.
Research has shown that only about a third of healthcare professionals provide food safety information for their pregnant clients. In addition, most pregnant women express concern about eating healthy during pregnancy but are unaware that certain foods are potentially harmful to the baby.
Fish and Shellfish
Mercury is a metal that is naturally found in the environment and that is released by industrial pollution. When mercury settles into water, it is converted into methylmercury, a more dangerous form. Methylmercury can accumulate in the fatty tissue of fish. Most fish contain trace amounts of methylmercury, which is unlikely to cause harm, but large predatory fish can contain high levels of methylmercury.
In March 2004, the United States Food and Drug Administration (FDA) and the Environmental Protection Agency (EPA) recommended that pregnant women, women who could become pregnant, nursing mothers, and young children avoid eating fish that contain high levels of mercury, including swordfish, shark, king mackerel, and tile fish.
The FDA/EPA recommendation indicated that pregnant women can safely eat up to 12 ounces of fish containing low levels of mercury per week. This will allow you to reap the health benefits of fish, while avoiding putting your baby at risk. Fish containing low levels of mercury include shrimp, canned light tuna, salmon, pollock, and catfish. Because white tuna and tuna steak contain higher levels of mercury, women are advised to eat no more than six ounces of these fish per week.
Pregnant women should also avoid raw and undercooked fish, especially shellfish (eg, oysters, clams) because they can contain disease-causing organisms. Cook fish until it is opaque and flakes easily with a fork.
Soft Cheeses and Ready-to-Eat Meats
Unpasteurized soft cheeses and ready-to-eat meats should be avoided during pregnancy because they may contain bacteria that causes listeriosis, a form of food poisoning that is especially harmful to unborn babies. Listeriosis is associated with ]]>miscarriage]]> , premature delivery or stillbirth, and serious illnesses in newborn babies. A study in the May/June 2004 issue of the Journal of Nutrition Education and Behavior found that most pregnant women were not taking precautions to prevent listeriosis.
To avoid listeriosis, the FDA advises pregnant women to do the following:
- Avoid eating hot dogs or luncheon meats that have not been reheated until steaming hot.
- Do not eat soft cheeses (eg, feta, brie, Camembert, Roquefort, Mexican soft cheeses) unless they are made with pasteurized milk.
- Avoid refrigerated pâtés or meat spreads.
- Avoid refrigerated smoked seafood unless it has been cooked.
- Do not consume unpasteurized milk or foods made from it (eg, eggnog, Hollandaise sauce).
Undercooked Meat and Eggs
Undercooked meat, including poultry and eggs, should be avoided during pregnancy because these foods can increase your risk of a number of foodborn illnesses, including listeriosis, ]]>E. coli]]> , Campylobacter infections, ]]>salmonellosis]]> , and toxoplasmosis.
To ensure your meat is well-cooked, use a meat thermometer. Pork should be cooked to 160ºF, red meat should be cooked to 145ºF, and poultry should be cooked to 180ºF. And cook eggs until both the white and yolk are firm.
Pregnant women should also avoid eating raw vegetable sprouts (eg, alfalfa, clover, radish) and unpasteurized fruit or vegetable juices, since they can carry disease-causing bacteria.
In addition, pregnant women should limit their consumption of liver, since it contains high levels of vitamin A, which could potentially cause harm to a developing baby.
Food Preparation Tips
When preparing and handling foods, the March of Dimes recommends you take the following precautions to avoid foodborn illnesses:
- Wash your hands with hot soapy water before and after handling food.
- Wash cutting boards, work surfaces, and utensils after they have been in contact with raw meat, poultry, or fish.
- Keep raw meat, poultry, and fish separate from cooked or ready-to-eat foods.
- Rinse fruits and vegetables under running water before eating, removing surface dirt with a clean brush.
- Remove the outermost leaves from lettuce and cabbage.
- Refrigerate leftovers promptly and avoid eating cooked food that has been out of the refrigerator for more than two hours
- Keep your refrigerator temperature below 40ºF and your freezer 0ºF or below; buy a thermometer to check the temperature.
American Dietetic Association
March of Dimes
United States Food and Drug Administration
The Society of Obstetricians and Gynaecologists of Canada
Women's Health Matters
Athearn PN, Kendall PA, Hillers VV, et al. Awareness and acceptance of current food safety recommendations during pregnancy. Matern Child Health J. 2004;8:149-162.
Cates SC, Cater-Young HL, Conley S, et al. Pregnant women and listeriosis: preferred educational messages and delivery mechanisms. J Nutr Educ Behav. 2004;36:121-127.
Foodborn risks in pregnancy. March of Dimes website. Available at: http://www.marchofdimes.com/professionals/681_1152.asp . Accessed September 12, 2005.
Food safety. March of Dimes website. Available at: http://www.marchofdimes.com/pnhec/159_826.asp . Accessed September 12, 2005.
How to safely handle refrigerated and ready-to-eat foods and avoid listeriosis. Food and Drug Administration website. Available at: http://www.cfsan.fda.gov/~dms/adlister.html . Accessed September 12, 2005.
Morales S, Kendall PA, Medeiros LC, et al. Healthcare providers’ attitudes toward current food safety recommendations for pregnant women. Appl Nurs Res. 2004;17:178-186.
What you need to know about mercury in fish and shellfish. United States Food and Drug Administration website. Available at: http://www.cfsan.fda.gov/~dms/admehg3.html . Accessed September 12, 2005.
Last reviewed June 2009 by ]]>Ganson Purcell Jr., MD, FACOG, FACPE]]>
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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