Pregnancy Food Myths

If you are pregnant or you are close to someone who is pregnant, you have probably heard the laundry list of rules with regards to what you can and cannot consume while pregnant. Unfortunately, few of these rules are based in real data or take legitimate risk into consideration. Talk to your provider to decide which foods are specifically right for you, but here is a summary of the available data.

The Five Concerning Pathogens

              The five pathogens that contribute to these food rules are Listeria, Toxoplasmosis, E. coli, Campylobacter and Salmonella. Of these five, only 2 of them can cause harm to your baby if you contract them. When you are pregnant, your immune system is slightly weaker than it is while not pregnant so your immune system does not attack your growing baby. For this reason, you are at greater risk for foodborne illness; however, it is your choice whether or not you want to take extreme cautions.

              If you have Salmonella, E. Coli or Campylobacter poisoning while pregnant, it is not connected to negative pregnancy outcomes. If you become extremely ill, you may need to be hospitalized to maintain hydration, but this is true regardless of pregnancy status. On the other hand, if you become ill with Listeria or Toxoplasmosis, it can cause serious harm to your baby. Luckily, Listeriosis is extremely rare and Toxoplasmosis is quite easy to avoid. Let’s get into which foods can harbor these pathogens and what kinds of risks they carry.

Food Sources of Pathogens

              This list was taken from Expecting Better by Emily Oster. I highly recommend reading this book, it is a quick read, full of easily digestible information and made me laugh out loud a few times.

-          Raw eggs (salmonella)

-          Raw fish (salmonella, campylobacter)

-          Raw shellfish (salmonella, campylobacter, toxoplasmosis)

-          Unwashed produce (toxoplasmosis and E. coli)

-          Raw/rare meat and poultry (salmonella, toxoplasmosis, campylobacter, E. coli)

-          Smoked fish (listeria)

-          Pate (listeria)

-          Raw/unpasteurized milk (listeria, campylobacter)

-          Raw milk soft cheese (listeria)

-          Deli meats (listeria)

If you look at the above list, there are probably some foods that you wouldn’t eat either way—most people wash their produce and do not eat raw poultry. In the United States, the vast majority of milk is pasteurized, making most dairy products safe for consumption in pregnancy. Other risks can be decreased by improving the source of your food—eggs that come from your local farmer, laid by healthy chickens are less likely to be contaminated with Salmonella than eggs sitting at the gas station. Additionally, sushi that comes from high quality sources is far more likely to be safe (although certain fish are important to avoid due to their mercury content).

Listeria

              Unfortunately, Listeria makes quite a few appearances on the above list, but luckily, it is extremely rare. According to the CDC, about 1,600 people become ill with Listeriosis in the United States per year. This may sound like a large number, but if you consider the population of the US (332 million people), that means only .00048% of the population becomes infected per year. I like those odds. You can also check the CDC to see the most recent sources of outbreaks. Yes, deli meats and soft cheeses are listed, but so are other random foods such as ice cream, Dole packaged salads, fully cooked chicken and Enoki mushrooms. I would argue that it is impossible to fully avoid every single food that could have Listeria, especially because it is somewhat random. The most commonly and consistent food sources of Listeria are deli turkey and queso fresco that is made with unpasteurized milk. You get to decide what is right for you, but shortening your food avoidance list based on the above data may be pretty appealing.

              If you do start to feel ill, it is important to call your doctor right away. Treatment can greatly decrease the risk of harm to your baby. The most common symptoms of Listeriosis are nausea, vomiting, diarrhea, fever, chills and body aches.

Toxoplasmosis

              Toxoplasmosis is a parasite caused by Toxoplasma gondii that is largely present in poop and soil (that is why pregnant women are often advised to wear gloves while gardening and avoid cleaning the cat litter box. This is good advice). The most common symptoms of infection are flu-like symptoms, but many people are asymptomatic. The main risk is congenital toxoplasmosis which affects about 1 in 1,500 babies and can have serious complications including brain damage, blindness and epilepsy. Infection earlier in pregnancy is more likely to cause issues than later. With this information, it is important to do your best to avoid infection (which luckily is pretty easy).

              Washing your produce well with water, avoiding raw/undercooked meat and poultry, wearing gloves while gardening and washing your hands well after finishing gardening will vastly reduce your risk of exposure. I love a medium-rare steak as much as many people, but pregnancy is the time to have your steak well done.

The Bottom Line

              Talk to your doctor of individualized advice about which foods to avoid during pregnancy. The above information is meant for education purposes only. Understanding the nuances of the recommendations can help you make informed decisions about which foods are best for you to consume.

About the Author

Alli Erdahl is a Naturopathic Doctor practicing in Chaska, Minnesota.