Pregnancy Nutrition Concerns

Food Safety

When you think of food-borne illness, do you think of the major outbreaks reported in the media? These outbreaks receive most of our national food safety attention, but according to the CDC these represent only 5% of the food-borne illness cases that occur every year. The CDC estimates 1 in 6 Americans get sick from a food-borne illness each year, and most of those illness are not part of an outbreak.

It is possible for bacteria and viruses to live on or in your food or water. Because these microorganisms cannot be seen, detection is not always possible. While pregnant, these bacteria and viruses will be a bigger risk to your health than before you became pregnant.

One of the changes your body experiences during pregnancy is a change in immune function. This is due to the increased progesterone and helps prevent your body from rejecting the baby. The downside of this immune change is an increased risk to contract some types of infections when pregnant.

Some of these food-borne illnesses are not a problem normally, but pregnant women who come into contact with the organisms are more likely to become infected. These illnesses include listeria, toxoplasmosis, Hepatitis E and Coxiella burnetii.

Normally, only 0.7 people in 100,000 get listeria, but among pregnant women 12 in 100,000 will contract listeria. This may not be a large number, but it demonstrates the increased risk of contracting listeria if a pregnant woman contacts the bacteria. In fact, pregnant women make up 27% of all cases of listeria. This is a very large number for a small piece of the population.

Some food-borne infections are no more likely to affect a pregnant woman than a non-pregnant woman, but when a pregnant woman becomes infected it puts her baby at great risk. These infections include cholera, giardia, e. Coli, campylobacter and salmonella.

While public policy helps to regulate agricultural, food processing and food service industries to reduce the risk, there are important things you can do at home to help reduce your risk further. A recent study found mothers tend to underestimate the importance of their food handling practices at reducing their family’s risk. Other studies have found midwives focus on the foods to avoid and do not provide safe food handling information to pregnant women. The best way to prevent a food borne illness is to follow standard safety guidelines while handling and preparing food.

Select your food carefully

Selecting your food carefully can help prevent bringing food bacteria and viruses into your home. Don't buy food in damaged containers that leak, bulge or are severely dented or whose lids are cracked or bulging. Purchase only as much produce as you will use in one week. Avoid precut greens that look slimy. Select pasteurized milk products.

Store your food properly

Storing your food properly can prevent the growth and spread of most bacteria or viruses that may be present in your food supply. When purchasing, select frozen and refrigerated foods last. Ensure meat is wrapped in a way that prevents leaking juices on other food items. Do not store your groceries in a warm car. Promptly refrigerate foods after purchase. Be sure your refrigerator is 40 degrees or less. Use refrigerated meats within one or two days, frozen meats within 3 to 4 months. When in doubt, throw it out.

Prepare your food smartly

Using proper food preparation techniques helps to prevent the spread of bacteria to other foods that may not be cooked to kill the bacteria. Wash your hands with hot soapy water before and after handling food. Keep counters, cutting boards, dishes and other cooking equipment clean. Thaw your food in the refrigerator, under cold running water or in the microwave. Cook foods promptly after thawing. Use the refrigerator to marinate. Wash fruits and vegetables under running water. Completely remove parts of food that have mold, or discard the entire piece of food.

Cook your food thoroughly

Cooking your food thoroughly is the most reliable way to kill any viruses or bacteria that may be present. A good rule of thumb is to eat no raw animal products. Meats should be cooked to a specific temperature to ensure doneness. Eggs should be prepared so the yolk and white are both fully cooked. Do not use unpasteurized dairy products in non-cooked foods such as ice cream or mayonnaise.

One food-borne bacteria called listeria, can live and grow at refrigerator temperatures. It is the cause of listeriosis, which can result in miscarriage, fetal death or severe illness or death of a newborn. It may be found in perishable ready-to-eat foods. To reduce your risk for this bacteria, be sure to store perishable pre-cooked items at 40 degrees or less and clean your refrigerator regularly.

Foods with the greatest risk of listeriosis should be thoroughly cooked or avoided. These foods include hot dogs and lunch meats, soft-chesses made with unpasteurized milk, refrigerated pates and spreads, refrigerated smoked sea-food, unpasteurized milk.

To reduce your risk of listeria try some of these strategies:

Cook lunch meats and use them to make a hot sandwich such as a grinder or a grilled ham and cheese.

Eat hot dogs promptly after cooking.

Unpasteurized milk can be cooked into puddings or custards, or heated to use in hot cocoa or coffee drinks.

Soft cheeses can be cooked to serve with pasta or used as a spread.

References

Bondarianzadeh, D., Yeatman, H., and Condon-Paoloni, D. (2011). A qualitative study of the Australian midwives' approaches to Listeria education as a food-related risk during pregnancy. Midwifery, 27:221-228.

Morales, S., Kendall, P.A., Medeiros, L.C., Hillers, V. and Schroeder, M. (2004). Health care providers' attitudes toward current food safety recommendations for pregnant women. Applied Nursing Research, 17(3):178-186.

Pezdirc, K.B., Hure, A.J., Blumfield, M.L., and Collins, C.E. (2011). Listeria monocytogenes and diet during pregnancy; balancing nutrient intake adequacy v. adverse pregnancy outcomes. Public Health Nutrition, 15(12):2202-2209.

Trepka, M.J., Murunga, V., Cherry, S., Huffman, F.G, and Dixon, Z. (2006). Food safety beliefs and barriers to safe food handling among WIC program clients, Miami, Florida. Journal of Nutrition Education and Behavior, 38:371-377.