Food Safety and Foods to Avoid during Pregnancy

While the focus of this book is mainly on the positive changes you can
make to your diet to improve the overall health and well-being of your
growing baby, it is also important to discuss some of the key food safety
issues. Pregnancy affects your immune system, increasing your and
your baby’s susceptibility to different bacteria, viruses, and parasites that
may cause foodborne illnesses. So it’s that much more important to
focus on safe food handling, preparation, and consumption when you’re
pregnant. To decrease your risk of infection and prevent any potential
harm to your baby, there are a few foods that you should avoid. Some of
this may sound familiar when these food groups were discussed. However, when it comes to the safety of you and your baby, it is worth repeating. Note that not all potentially dangerous foods carry the same degree of risk, so I have categorized the foods here as either “Don’t eat” or “Be careful” based on their risk.

Don’t Eat

The following foods should not be eaten while pregnant as they may
pose high risks to you and your baby.

Unpasteurized Milk and Cheeses

You may have heard that all soft cheeses are no-limits during pregnancy. However, it’s the pasteurization that matters. You can indulge in any soft cheese, as long as it’s made from pasteurized milk (be sure to check the label; if it doesn’t say pasteurized, do not eat it). All unpasteurized milk and milk products such as cheese, fresh or frozen yogurt, pudding, and ice cream should be avoided during these nine months. Fortunately, most milk products in the grocery store are pasteurized.

Why the big fuss about pasteurization? Because of a nasty little bug called Listeria. While it may only give you a bad case of diarrhea if you’re not pregnant and in good health (although it can be lethal, especially in those with weakened immune systems such as newborns and the elderly, and causes of death have been recorded), getting listeriosis during pregnancy can have detrimental effects on your baby. Listeriosis is pretty rare in the general population, but it is ten times more common in women who are pregnant, and 16 to 27 percent of all infections with Listeria occur in pregnant women. Although the symptoms of listeriosis may be mild for the mother (unlike symptoms, including fever, backache, headache, vomiting and diarrhea, muscle pains, and sore throat, or even no symptoms at all), it can potentially be lethal to the baby, with 29 percent of all Listeria infections during pregnancy ending in miscarriage, stillbirth, or neonatal deaths.

In addition to Listeria, unpasteurized milk can contain other dangerous bacteria such as E. coli, Campylobacter, and Salmonella. Listeria infections are the third most deadly foodborne illness (salmonellosis and toxoplasmosis are first and second, respectively). Due to these health concerns, you should steer clear of raw milk, unpasteurized feta, unpasteurized blue cheeses, unpasteurized Brie, unpasteurized Camembert, unpasteurized queso Blanco, unpasteurized queso fresco, unpasteurized panela, other unpasteurized soft cheeses, and any other unpasteurized milk products. If you’re unsure whether or not it’s pasteurized because nothing is stated on the package or you never saw the package because the cheese was part of a dish served at a restaurant or a party, avoid it and go for something else instead.

Raw or Undercooked Fish and Seafood

Listeria can also contaminate sushi and other raw sh or seafood. Thus the Centers for Disease Control recommends that all pregnant women avoid consuming sushi and cook all sh to at least 145°F. Because cooking sh or other animal products to optimal temperatures can decrease your risk, it may be helpful to invest in a food thermometer to use during cooking, if you don’t have one yet. Similarly, avoid eating raw shellfish, as it can contain Vibrio bacteria.

Raw Eggs

Cookie dough ice cream may be on your list of pregnancy food cravings, but watch out. Due to the salmonella that can be present in uncooked eggs, batter, or raw cookie dough, make sure not to lick your fingers or the spoon before baking these, no matter how tempting. Be sure the yolks in cooked eggs are rm (never runny!) and that any foods containing eggs (such as casseroles) are cooked to at least 160°F. And that tempting cookie dough ice cream? Good news! Most store-bought brands don’t use raw eggs.

Fish High in Mercury

While the recommendation throughout pregnancy is to consume 12 ounces of sh per week (approximately two meals), you should avoid certain sh because they are high in mercury and may be high in other contaminants as well. Examples of sh with high methylmercury levels are swordfish, tilefish (golden or white snapper), shark, marlin, king mackerel, largemouth bass, larger species of tuna, northern pike, and orange roughy.

Additionally, limit your consumption of albacore tuna to 6 ounces per week (a typical can is 5 ounces). The U.S. Environmental Protection Agency (EPA) periodically releases guidelines about sh that may contain various environmental contaminants, and you can check www.epa.gov/mercury/advisories.htm for the latest updates. Also, the Natural Resources Defense Council provides reports and lists of sh to avoid and those you can safely consume, based on research regarding the amount of contaminants found. You can access the most recently updated information at www.nrdc.org/health/eects/mercury/guide.asp.

It may also be a good idea to have a snapshot of this list on your smartphone so you can access it while in a restaurant to make sure that you order the types of sh that is healthy for you and your baby. Five of the most commonly eaten sh that are low in mercury (and therefore good choices) are salmon, shrimp, canned light tuna, catfish, and pollock.

Raw or Undercooked Sprouts

Sprouts—including alfalfa, radish, mung bean, and clover sprouts—may
contain E. coli or salmonella, so be sure to cook them to at least 145°F
instead of eating them raw.

Liver Products and Supplements Containing Vitamin A

While vitamin A is beneficial and essential throughout pregnancy, too much of it can do more harm than good. Animal liver products can contain very high vitamin A levels, so it is best to avoid them. Also, you should not take any vitamin A supplements, as this vitamin is naturally contained in a variety of foods, and deficiencies in the developed world are very rare.

Be Careful

Your intake of the following foods should be limited while you’re
pregnant to avoid risks to you and your baby.

Some Types of Meat, Fish, and Poultry

Similar to unpasteurized milk and milk products, certain types of meat (deli meats, luncheon meats, cold cuts, fermented or dry sausages, and hot dogs) can harbor Listeria. Unless they are heated to 165°F or served steaming hot, it is best to avoid them. Also try to avoid getting the uid from inside hot dog and lunch meat packages onto other foods and surfaces, so that if Listeria is present they don’t contaminate your other food or kitchen. Listeria can also contaminate other processed meats and seafood, like pâtés or meat spreads and refrigerated smoked seafood.

Therefore, try to avoid refrigerated pâté or meat spreads from a meat counter or deli, as well as from the refrigerated section of a store. Canned or shelf-stable pâtés and meat spreads that do not require refrigeration are safe to eat—just remember to refrigerate them after opening. Refrigerated smoked seafood, such as cod, mackerel, salmon, trout, tuna, or whitish, are also potential Listeria reservoirs that you might encounter at your local deli or bagel shop. Watch out for labels such as “jerky,” “kippered,” “lox,” “nova-style,” or “smoked.” Not all processed seafood products are o-limits, however; canned and shelf-stable sh (such as salmon, tuna, and others) and sh products, as well as cooked, smoked sh dishes such as casseroles, are all safe and perfectly me to eat.

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