• Reducing Foodborne Risks During Pregnancy

    PD Fitness and Wellbeing 67101 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 healthy 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.

    Fish and Shellfish

    Mercury is naturally found in the environment and is also 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.
    The United States Food and Drug Administration (FDA) and the Environmental Protection Agency (EPA) provide these recommendations for women who may become pregnant, are pregnant, or are nursing:
    • Avoid eating fish that contain high levels of mercury, including swordfish, shark, king mackerel, and tilefish.
    • Eat up to 12 ounces (340 grams) of fish containing low levels of mercury per week. 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.
    • If you usually eat locally caught fish, check advisories about the safety of the fish. If there are no advisories, limit your intake to 6 ounces (170 grams) 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.

    Ready-to-Eat Meats and Soft Cheeses

    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.
    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. These foods can increase your risk of a number of foodborne illnesses, including listeriosis, E. coli , Campylobacter infections, salmonellosis , and toxoplasmosis .
    To ensure your meat is well-cooked, use a meat thermometer. Follow these temperature guidelines when cooking food:
    Type of Food Proper Cooking Temperature
    Chicken 165°F-180°F (74°C-82°C)
    Egg dishes 160°F (71°C)
    Ground meat 160°F-165°F (71°C-74°C)
    Beef (medium well) 160°F (71°C)
    Beef (well done) 170°F (76.7°C)
    Pork 160°F-170°F (71°C-76.7°C)
    Ham (raw) 160°F (71°C)
    Ham (precooked) 140°F (60°C)

    Other Foods

    Pregnant women should also avoid eating raw vegetable sprouts (eg, alfalfa, clover, radish) and unpasteurized fruit or vegetable juices. These 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 foodborne illnesses:
    • Before and after handling food, wash your hands with soap and hot water.
    • Wash any item or area that comes in contract with raw meat, poultry, or fish.
    • Separate ready-to-eat food from raw meat, poultry, or fish.
    • Before eating raw fruits and veggies, rinse them and use a scrub brush to remove dirt.
    • Take the outermost leaves off of lettuce and cabbage.
    • Refrigerate leftovers right away. Also, avoid eating cooked food that has been out of the refrigerator for more than two hours.
    • Keep your refrigerator temperature below 40ºF (4ºC) and your freezer at 0ºF (-18ºC) or below. Buy a thermometer to check the temperature.

    RESOURCES

    American Dietetic Association http://www.eatright.org/

    March of Dimes http://www.marchofdimes.org/

    United States Food and Drug Administration http://www.fda.gov/

    CANADIAN RESOURCES

    The Society of Obstetricians and Gynaecologists of Canada http://www.sogc.org/index%5Fe.asp

    Women's Health Matters http://www.womenshealthmatters.ca/

    References

    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/nutrition%5Frisks.html . Updated May 2008. Accessed June 15, 2011.

    Food safety. March of Dimes website. Available at: http://www.marchofdimes.com/pnhec/159%5F826.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.

    Listeria and pregnancy. American Pregnancy Association website. Available at: http://www.americanpregnancy.org/pregnancycomplications/listeria.html .

    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. US Food and Drug Administration website. Available at: http://www.fda.gov/food/foodsafety/product-specificinformation/seafood/foodbornepathogenscontaminants/methylmercury/ucm115662.htm . Published March 2004. Accessed June 14, 2011.

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