RD, LDN, CBS
Certified in Maternal and Infant Nutrition from Cornell, Angela’s mission is to help people reach their wellness goals. She also helps run a program that teaches pregnant women about how a healthy lifestyle optimizes prenatal and postnatal care.
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Pregnant women are more susceptible to foodborne illnesses and some infectious diseases due to the unique immunological condition created by pregnancy. While this condition protects your body from attacking the baby growing inside, it also lowers your own immune system’s defenses. It’s important to be aware of certain foods that can put you and your baby at risk, due to processing (or lack thereof), contamination, bioaccumulation, or chemicals naturally occurring in the food itself.
Such foods and ingredients that are best avoided include:
Methylmercury is found in foods that certain fish eat and remains in the fish’s body after it is eaten. When a pregnant woman then eats these fish, some of the methylmercury passes to them, can cross the placental barrier, and can cause harm to the baby’s developing nervous system.
Fish is an important source of a number of high quality nutrients, from protein to fatty acids, so don’t avoid all fish, but do avoid fish recognized as having high amounts of methylmercury, like shark, tuna, swordfish and king mackerel. Instead, aim to eat 12 ounces each week of these lower mercury fish: wild salmon, canned light tuna, shrimp, tilapia and sardines.
The American College of Obstetricians and Gynecologists (ACOG) recommends limiting your caffeine intake to no more than 200 milligrams per day, which means you should take note of all sources of caffeine in your daily diet.
In addition to coffee (both regular and decaf), caffeine is also present in non-herbal teas (like green, matcha, yerba maté, chai, black and oolong), medications (like certain headache and migraine medications), chocolate, soda, certain herbal products and supplements (that contain guarana/paullinea cupana and kola nut/cola nitida) and certain energy drinks.
A word on green tea – not only does green tea contain some caffeine, but it can also limit your body’s absorption of folic acid, a critical nutrient that promotes the proper development of an unborn baby’s neural tube, which later becomes the brain and spinal cord. Although the strength of the connection between green tea and folic acid is unclear, to be safe, limit your green tea consumption to 1-2 cups per day.
In general, it is best to avoid all artificial sweeteners such as Splenda™/sucralose, Stevia™, Nutrasweet™/aspartame, and Acesulfame-K, saccharin (Sweet-n-low) as there are no long-term evidence on their safety during pregnancy.
When a pregnant woman drinks alcohol, so does her baby. There is no known safe amount of alcohol use during pregnancy, and all types of alcohol – liquor, wine, beer and sake – can be equally harmful. Drinking alcohol during pregnancy can increase the risk of birth defects.
Note that Kombucha tea also contains alcohol (and caffeine). Due to the lack of research on the safety, benefits and potential risks associated with Kombucha, it is best to avoid it while pregnant.
Herbal teas and products
Avoid any teas labeled as medicinal or herbal supplements as they are intended to serve up high concentrations of herbs and further, can contain unknown ingredients. Also avoid any teas containing goldenseal, black and blue cohosh, ephedra, dong quay, feverfew, juniper, pennyroyal, St John’s wort, rosemary or thuja.
Readily available herbal teas such as peppermint, ginger, chamomile, zinger blends, and other varieties are safe to drink in moderation (up to 4 eight-ounce cups per day of any one type).
Unpasteurized, undercooked, and raw foods
It’s best to avoid unpasteurized dairy products, like milk, cheese and yogurt. With cheese, always check the label, but generally, hard cheeses are safer because they tend to be made from pasteurized milk or are cooked at high temperatures. Soft cheeses sold in the U.S. are increasingly made with pasteurized milk, but do double check the label. Cheeses made from raw milk should be avoided. Any cheese that’s heated until it’s melted and bubbly is safe to eat.
Scrutinize store-bought juices and ciders to be sure they’re pasteurized before drinking. Fresh juice made at home with well-washed fruits and vegetables should be safe if you drink them immediately.
Other foods that, while otherwise healthy, may pose a risk to you and your growing baby due to their preparation, include undercooked meat, poultry, fish, eggs and deli meat. Read the What to Do section for a complete list of these potentially high-risk foods.
Minimize risky foods
Avoid raw or undercooked eggs, poultry, meat and seafood (like carpaccio, tartare, ceviche, raw sushi and sashimi and anything cooked to ‘rare’ or ‘medium rare’); anything unpasteurized; unwashed fruits and vegetables; processed meats (like deli meats, charcuterie and hot dogs, unless served steaming hot); high mercury seafood (like tuna, shark, king mackerel and swordfish); pâté, meat spreads, smoked seafood and mayonnaise-based salads made in a store (like egg salad, tuna salad, chicken salad or seafood salad); soft-serve ice cream and frozen yogurt (while the dairy used in these frozen desserts is usually pasteurized, the dispensers can be breeding grounds for harmful bacteria, like Listeria, if improperly or infrequently cleaned); raw sprouts (like alfalfa, clover, radish and mung bean); artificial sweeteners; alcohol; excess caffeine from all sources (more than 200 milligrams per day, roughly the amount in 2 small cups of coffee); and excess green tea (more than 2 cups per day).
Eat freshly made foods
If previously cooked or refrigerated food has been sitting out for over two hours at room temperature (like behind the case at a deli or in a buffet) or over one hour at 90*F or above (like at a pool party or BBQ), skip it. Toss any food that by date, smell or appearance is questionable. When in doubt, throw it out!
Practice good food safety techniques
Always wash your food thoroughly. Rinse all raw produce under running tap water before eating, cutting or cooking. Cook all meats to proper internal temperatures and refrigerate leftovers promptly.
Keep a clean kitchen; wash your hands, knives and other utensils, disinfect your countertops and cutting boards after use, use different cutting boards for raw meat/fish/poultry and for produce, regularly change out dishtowels, and microwave your sponges (For more information see Food Safety in Pregnancy).
Properly reheat leftovers
Refrigerated leftovers or previously cooked foods should be fully reheated until steaming hot before eating.
Ask questions when dining out
Don’t be afraid to ask your server about specific ingredients and cooking techniques. Order meat, fish and poultry to medium or well-done and check to make sure it has in fact been fully cooked before eating. Inquire whether raw eggs are hiding in salad dressings (like homemade Caesar), sauces (like aioli, Hollandaise or Bearnaise) and desserts (like mousse, ice cream, custard, tiramisu or meringue).
It’s better to be safe than sorry – there’s no shame in sending something back if you’re unsure whether or not it’s safe to eat.
Contact your health care provider if you are concerned about symptoms
If you develop signs of a foodborne illness such as nausea, vomiting, diarrhea or fever after consuming questionable foods or believe you have eaten a food that appears on a recall list or which has made someone else sick, contact your healthcare provider as soon as possible.
“Food Safety for Pregnant Women”. U.S. Department of Health and Human Services. Date accessed 24 July 2018. “Moderate Caffeine Consumption During Pregnancy”. American College of Obstetricians and Gynecologists. Date accessed 24 July 2018.
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