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Foods to Avoid Foods To Avoid During Pregnancy Food Safety Listeriosis: Listeria monocytogenes in a pathogenic bacterium which causes a group of diseases collectively known as Listeriosis. Listeriosis in pregnancy is characterised by diarrhoea, headache, fever, muscle pain, meningitis, septicaemia, as well as spontaneous abortion. Listeria monocytogene can grow at refrigeration termperatures but os killed by cooking and pasteurisation. Therefore, unpasteurised milk and unpasteurised dairy products are not recommended during pregnancy. Some refrigerated foods with a long shelf life (greater than 5 days) which are consumed without further cooking also have a high risk of contamination since L. monocytogenes can grow at refrigeration temperatures. Such foods include soft cheese (even those made with pasteurised milk), paté, smoked salmon, deli meats (e.g. luncheon meats), and pre-prepared salads (e.g. coleslaw). Toxoplasmosis: Toxoplasmosis is caused by the bacterium Toxoplasma gondii and infection is caused by ingestion of Toxoplasma oocytes excreted in cat faeces, or by eating raw or undercooked meat with visible cysts from infected food animals. Infection with this bacterium during pregnancy can result in the transfer of the bacterium to the foetus and result in spontanoeus abortion or serious handicap in the newborn. Raw or undercooked meats, poorly fermented or cured meats, and unwashed fruit and vegetables are potential sources of this bacterium and should be avoided during pregnancy. Meat should be well cooked (no pink meat) and served piping hot to prevent Toxoplasma gondii infection. Hand washing (especially after handling raw meat and unwashed vegetables) and other hygiene practices are of utmost importance as well as wearing gloves when gardening or changing cat litter. Salmonella While Salmonella infection is unlikely to cause any problems with a pregnancy or with fetal development, it’s very unpleasant to suffer the effects during pregnancy. Pregnant women are advised to take steps to minimise the risk of infection: cooking eggs till the yolk and white are solid and avoiding products that may contain raw egg, such as homemade mayonnaise (shop bought mayonnaise is acceptable due to it not containing raw egg). Campylobacter Campylobacter and Salmonella are both relatively common contaminants of meat. Like Salmonella, Campylobacter causes the usual symptoms of food poisoning (diarrhoea, vomiting, Phoca PDF Foods to Avoid Foods To Avoid During Pregnancy stomach pains and cramps and fever) that can be particularly hard to cope with during pregnancy. There is no particular risk to the infant or to the pregnancy from Campylobacter infection. Foods to avoid With so many conflicting stories in the media about risks during pregnancy, often from dubious, unscientific sources, many pregnant women feel vulnerable and confused about what advice to trust for the welfare of their unborn child. Healthcare professionals can provide valuable and reliable information and advice to such women, who should be urged to take care during their pregnancy but not to the point of inappropriate anxiety. The following article looks at risks to the health of both the mother and her unborn infant that some foods may pose during pregnancy and offers sensible guidelines to minimise potential problems. Foods, drinks and supplements that should be avoided in pregnancy Vitamins and other supplements, including fish liver oil supplements, which contain vitamin A (or retinol) Liver and liver products Milk that has not been pasteurised or ultra-heat treated Dairy products made with unpasteurised milk including all soft cheese and mould-ripened cheese (even those made with pasteurised milk), e.g. Brie, Camembert, Goat's cheese, and blue cheese, e.g. Danish Blue, Stilton, Roquefort. Pâté of any sort Uncooked and undercooked ready-prepared meals Raw and partially cooked eggs and food that may contain them Raw meat products and partially cooked meat Uncooked cured or smoked meats Smoked salmon and gravid lax fish Unwashed fruit and vegetables, including ready-prepared salads Raw shellfish Shark, swordfish and marlin Limit tuna to one fresh tuna steak (150g) per week or two 240g tins of tuna per week. Avoid alcohol completely during pregnancy. Food Preparation and Hygiene: Always wash hands before handling food Wash fruit and vegetables thoroughly before eating Keep raw and cooked meats separate when cooking and in the fridge and wash hands and chopping boards thoroughly after contact with uncooked meats. Use different kitchen utensils and chopping boards when cooking raw and cooked meats to avoid cross contamination Clean kitchen surfaces with disinfectant after preparing uncooked meat Phoca PDF Foods to Avoid Foods To Avoid During Pregnancy Cook all foods thoroughly especially meat and fish and serve hot Ensure the temperature of the fridge is <5°C Avoid eating foods past their 'use by' date Water from a contaminated supply should not be consumed. Check with your local authority that your tap water is safe for consumption. Drink bottled water only when abroad. Always wash hands: before preparing and eating foods before and after handling raw meat after contact with animals after going to the toilet or changing a baby's nappy after gardening Liver, liver products and supplements containing vitamin A Liver and liver products contain high levels of vitamin A (retinol). Vitamin A is a fat soluble vitamin and plays an important role in many biological processes. It is required for vision, embryonic development, and for cell proliferation and differentiation. If vitamin A intakes are high, however, it can build up in the body, and high levels have been shown to have harmful effects on the developing fetus2. Consequently, pregnant women are advised to avoid liver and liver products1. The Irish recommended daily allowance (RDA) for vitamin A during pregnancy is 700?g/day retinol activity equivalent (RAE)3, with a tolerable upper level of 3,000?g/day RAE (Institute of Medicine, 2006). As some vitamin supplements contain high levels of vitamin A, pregnant women need to be careful about which type of supplement they take. A woman who wants to take a multi-nutrient supplement should be directed towards those specially formulated for pregnancy. Fish liver oils also contain high levels of vitamin A and should be avoided during pregnancy1 . FSAI 2012 Guidance on Vitamin A Intake During pregnancy1 Alcohol Phoca PDF Foods to Avoid Foods To Avoid During Pregnancy There is no known safe alcohol intake in pregnancy therefore the Department of Health and Children (2008) and the Food Safety Authority of Ireland (2012)1 recommend that pregnant women avoid alcohol completely. Alcohol is a teratogen (a substance which is harmful to the developing fetus), and can easily pass through the placenta to the developing foetus. Alcohol consumption during pregnancy can lead to the development of Foetal Alcohol Syndrome which is characterised by behavioural problems, mental retardation, aggressiveness, nervousness, short attention span, growth retardation, and birth defects4. The negative effects of maternal alcohol consumption on a developing baby seem to occur at widely varying alcohol intakes. This makes it hard to justify a ‘safe’ alcohol intake during pregnancy1. FSAI 2012 Guidance on Alcohol During Pregnancy1 Raw shellfish Raw shellfish are another common source of viruses and bacteria that can cause food poisoning, so the advice is to steer clear of these during pregnancy.1 Shark, swordfish and marlin Concerns about high levels of mercury have led to a recommendation to avoid eating shark, swordfish and marlin during pregnancy. Mercury at high levels can damage the developing nervous system1. Tuna Due the mercury content of tuna, pregnant women should limit their intake of tuna to one fresh tuna steak (150g) per week or two 240g tins of tuna per week1. Allergenic Foods In the past, it was recommended that mothers of infants at high risk of developing atopic disease (infants with at least 1 first degree relative with an allergy) should avoid potentially high allergenic foods during pregnancy including eggs, cow's milk, fish, peanuts, and tree nuts. However, the most recent guidelines by the Food Safety Authority of Ireland (2012) state that unless the mother is allergic to the food herself, there is no evidence to recommend the elimination of these foods from her diet1. FSAI 2012 Guidance On Potential Allergenic Foods During Pregnancy1 Phoca PDF Foods to Avoid Foods To Avoid During Pregnancy Caffeine Excess caffeine intake has been associated with adverse health outcome in pregnancy such as: Miscarriage5 Sudden infant death syndrome (SIDS)6 Low birth weight7-8 Caffeine is absorbed freely across the placenta but cannot be broken down by either the placenta or the foetus. In some cases, women go off coffee during pregnancy, and this natural aversion may have some protective basis. As well as coffee, other foods such as tea, chocolate and energy drinks also contain caffeine. The Food Safety Authority of Ireland (2012) recommend that pregnant women should not have more than 200mg/day of coffee1 (approximately 2 cups of brewed coffee per day). FSAI 2012 Guidance on Caffeine Consumption During Pregnancy1 References: 1. Food Safety Authority of Ireland (2012). Scientific Recommendations for a National Infant Feeding Policy, 2nd Edition. 2. Miller RK et al. (1998). Periconceptional vitamin a use: How much is teratogenic? Reproductive Toxicology. 12(1): 75–88. 3. Food Safety Authority of Ireland (1999). Recommended dietary allowances for Ireland. 4. March of Dimes Birth Defect Foundation. (1997). Public health education information sheet: Drinking alcohol during pregnancy. 5. Fenster et al. (1991). Caffeine consumption during pregnancy and fetal growth. Am J Public Health. 81(4): 458–461. 6. Ford RPK et al. (1998). Heavy caffeine intake in pregnancy and sudden infant death syndrome. Arch Dis Child. 78: 9-13. 7. Bracken MB et al. ( 2003). Association of Maternal Caffeine Consumption with Decrements in Fetal Growth. Am J Epidemiol.157:456–466. 8. Care. (2008). Maternal caffeine intake during pregnancy and risk of foetal growth restriction: a large prospective observational study. BMJ. 337: a2332 . Phoca PDF Powered by TCPDF (www.tcpdf.org)