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AS YOU EAT, SO YOUR BABY GROWS
A Guide to Nutrition in Pregnancy
by Nikki Goldbeck, CDN
Pregnancy News
Note from Nikki Goldbeck, author of As You Eat, So Your Baby
Grows/A Guide to Nutrition in Pregnancy:
The following information comes directly from the U.S. Food and Drug
Administration (FDA) and represents their current advice on fish
consumption for pregnant women in regard to mercury contamination.
This message does not address other issues of fish safety, including
other toxic metals and pollutants. Comprehensive information on fish
safety recommendations for all groups, not just pregnant women, can
be found at the sources at the end of this document.
CONSUMER ADVISORY from the U.S. Food and Drug Administration,
Center for Food Safety and Applied Nutrition
AN IMPORTANT MESSAGE FOR PREGNANT WOMEN AND WOMEN OF CHILDBEARING
AGE WHO MAY BECOME PREGNANT ABOUT THE RISKS OF MERCURY IN FISH
Seafood can be an important part of a balanced diet for pregnant
women. It is a good source of high quality protein and other
nutrients and is low in fat.
However, some fish contain high levels of a form of mercury called
methylmercury that can harm an unborn child’s developing nervous
system if eaten regularly. By being informed about methylmercury and
knowing the kinds of fish that are safe to eat, you can prevent any
harm to your unborn child and still enjoy the health benefits of
eating seafood.
HOW DOES MERCURY GET INTO FISH?
Mercury occurs naturally in the environment and it can also be
released into the air through industrial pollution. Mercury falls
from the air and can get into surface water, accumulating in streams
and oceans. Bacteria in the water cause chemical changes that
transform mercury into methylmercury that can be toxic. Fish absorb
methylmercury from water as they feed on aquatic organisms.
HOW CAN I AVOID LEVELS OF MERCURY THAT COULD HARM MY UNBORN CHILD?
Nearly all fish contain trace amounts of methylmercury, which are not
harmful to humans. However, long-lived, larger fish that feed on
other fish accumulate the highest levels of methylmercury and pose
the greatest risk to people who eat them regularly. You can protect
your unborn child by not eating these large fish that can contain
high levels of methylmercury:
Shark
Swordfish
King mackerel
Tilefish
While it is true that the primary danger from methylmercury in fish
is to the developing nervous system of the unborn child, it is
prudent for nursing mothers and young children not to eat these fish
as well.
IS IT ALL RIGHT TO EAT OTHER FISH?
Yes. As long as you select a variety of other kinds of fish while you
are pregnant or may become pregnant, you can safely enjoy eating them
as part of a healthful diet. You can safely eat 12 ounces per week of
cooked fish. A typical serving size of fish is from 3 to 6 ounces. Of
course, if your serving sizes are smaller, you can eat fish more
frequently. You can choose shellfish, canned fish, smaller ocean fish
or farm-raised fish – just pick a variety of different species.
WHAT IF I EAT MORE THAN 12 OUNCES OF FISH A WEEK?
There is no harm in eating more than 12 ounces of fish in one week as
long as you don’t do it on a regular basis. One week’s
consumption does not change the level of methylmercury in the body
much at all. If you eat a lot of fish one week, you can cut back the
next week or two and be just fine. Just make sure you average 12
ounces of fish a week.
Some kinds of fish are known to have much lower than average levels
of methylmercury and can be eaten safely more frequently and in
larger amounts. Contact your federal, state, or local health
department or other appropriate food safety authority for specific
consumption recommendations about fish caught or sold in your local area.
WHAT ABOUT THE FISH CAUGHT BY MY FAMILY OR FRIENDS IN FRESH WATER
LAKES AND STREAMS? ARE THEY SAFE TO EAT?
There can be a risk of contamination from mercury in fresh waters
from either natural or industrial causes that would make the fish
unsafe for you or your family to eat. The Environmental Protection
Agency provides current advice on fish consumption from fresh water
lakes and streams. Also check with your state or local health
department to see if there are special advisories on fish caught from
waters in your local area.
For information about the risks of Mercury in Seafood call toll-free 1-888-SAFEFOOD
U.S. Food and Drug Administration, Center for Food Safety and Applied
Nutrition, Food Information Line, 24 hours a day or visit FDA’s
Food Safety Website www.cfsan.fda.gov
Further information is also available from Environmental Protection
Agency www.epa.gov/ost/fish
or state or local health departments. (A list of contacts is
available at www.epa.gov/ost/fish.
Click on Federal, State and Tribal Contacts for fish advisories.)
CONSUMER ADVISORY from the U.S. Food and Drug Administration,
Center for Food Safety and Applied Nutrition
AVOIDING LISTERIOSIS, A FOODBORNE ILLNESS
Listeria monocytogenes is a bacterium that can cause a
serious infection in humans called listeriosis, and causes an
estimated 2,500 serious illnesses and 500 deaths each year. Foodborne
illness caused by L. monocytogenes in pregnant women can
result in miscarriage, fetal death, and severe illness or death of a
newborn infant. Others at risk for severe illness or death are older
adults and those with weakened immune systems.
Because L. monocytogenes can grow at refrigerator
temperatures and is found in ready-to-eat foods, the Food and Drug
Administration (FDA) is advising all consumers to reduce the risk of
illness by:
-
Using perishable items that are precooked or ready-to-eat as soon as possible;
-
Cleaning their refrigerators regularly; and
-
Using a refrigerator thermometer to make sure that the refrigerator
always stays at 40 degrees F. or below.
Since pregnant women, older adults and people with weakened immune
systems are at higher risk for listeriosis, FDA provides the
following advice to those at-risk consumers of foods that have a
greater likelihood of containing L. monocytogenes:
-
Do not eat hot dogs and luncheon meats unless they are heated until
steaming hot.
-
Do not eat soft cheeses such as feta, Brie and Camembert, blue-veined
cheeses and Mexican-style cheeses such as “queso blanco fresco.”
Cheeses that may be eaten include hard cheeses; semi-soft cheeses
such as mozzarella; cream cheese; and cottage cheese.
-
Do not eat refrigerated pâtés or meat spreads. Canned or
shelf-stable pâtés and meat spreads may be eaten.
-
Do not eat refrigerated smoked seafood unless it is contained in a
cooked dish, such as a casserole. Refrigerated smoked seafood, such
as salmon, trout, whitefish, cod, tuna, or mackerel, is most often
labeled as “nova-style,” ”lox,”
“kippered,” “smoked,” or “jerky.” This
fish is found in the refrigerated section or sold at deli counters of
grocery stores and delicatessens. Canned or shelf-stable smoked
seafood may be eaten.
-
Do not drink raw (unpasteurized) milk or eat foods that contain
unpasteurized milk.
To keep foods safe from harmful bacteria, follow these four simple steps:
-
Clean: Wash hands and surfaces often
-
Separate: Don’t cross-contaminate
-
Cook: Cook to proper temperatures
-
Chill: Refrigerated promptly.
For more information on handling foods safely call toll-free 1-888-SAFEFOOD
U.S. Food and Drug Administration, Center for Food Safety and Applied
Nutrition, Food Information Line, 24 hours a day or visit FDA’s
Food Safety Website www.cfsan.fda.gov
Protect Your Unborn Baby: Important Food Safety Information for
Pregnant Women
Safe Plates: Healthy Eating for Pregnant Moms
Eating nutritious foods is important during pregnancy. But some foods
can carry harmful bacteria and parasites that can make you and your
baby sick. It is easy to take steps to protect yourself from food
poisoning while nourishing yourself and your baby.
Listeria monocytogenes (Listeria)
Listeria is a bacterium most often found in soft cheeses,
unpasteurized milk products, and ready-to-eat or undercooked meat,
poultry, or seafood. Listeria can grow even in refrigerated foods.
Listeriosis causes mild to severe flu-like symptoms in pregnant
women, who can pass the illness to their unborn child. Infection of
the fetus can result in miscarriage, premature birth, blood
poisoning, and birth defects. Listeriosis can be treated with antibiotics.
Toxoplasma gondii (T. gondii)
T. gondii, a parasite carried by cats, can also contaminate
food. Most often, toxoplasmosis results from eating undercooked meat
and poultry or unwashed fruits and vegetables, from cleaning a litter
box, or from handling contaminated soil.
Toxoplasmosis usually causes no symptoms or only mild flu-like
conditions in pregnant women, but can be passed to a developing baby,
resulting in miscarriage, disability, and retardation. The severity
of effects in the fetus can sometimes be reduced with antibiotic treatment.
The Path to Safe Eating During Pregnancy
The following steps can help protect you and your developing baby
from listeriosis, toxoplasmosis, and other foodborne hazards.
Pregnant women are susceptible to all food poisoning, but Listeria and
T. gondii pose a particular threat to fetuses.
-
Wash your hands before preparing food, before meals, after
handling raw meats, and after using the bathroom. · Use hot,
soapy water and scrub well.
-
Avoid cross-contamination. · Separate raw meat from other
food. · With soap and hot water, immediately wash all knives,
cutting boards, and dishes that contact raw meat, poultry, and
seafood. · Always put cooked foods onto clean plates and use
clean utensils. · Double wrap raw meat and poultry in your
refrigerator to prevent juices from dripping onto other foods.
-
Cook raw meat and poultry until well-done. · Cook
hamburgers and pork to an internal temperature of 160°F, cook
steaks to 170°F, and cook chicken to 180°F. · Do not
sample meat while cooking.
-
Reheat leftovers and ready-to-eat foods like hot dogs and deli
meats until they are steaming. · Reheat these foods to at
least 165°F. · Do not eat these foods if they cannot be reheated.
-
Wash fruits and vegetables thoroughly under running water.
-
Do not eat fresh refrigerated pâtés or meat spreads.
-
Do not eat products made from unpasteurized milk. · Avoid
soft cheeses such as Mexican-style (queso blanco), blue-veined, feta,
Brie, and Camembert. You can eat hard cheeses, mozzarella, yogurt,
YoChee, cottage cheese, and cream cheese. · Avoid dishes
containing raw eggs and drink only pasteurized juices.
-
Store and maintain food properly. · Refrigerate leftovers
within two hours. If food is left sitting out, throw it away. ·
Cover stored food to keep out all insects, rats, and pets. ·
Discard foods past their expiration dates; discard leftovers after a
few days.
Further Safety Measures
· Avoid cleaning cat litter boxes.
If you do clean the litter box, wear gloves and wash your hands afterwards.
· Wear gloves when gardening and for activities that involve
dirt, and wash your hands afterwards.
· Talk to your doctor about Listeria, T. gondii,
and other food safety matters.
If your doctor suspects an infection, he or she can perform a blood
antibody test for Listeria or T. gondii.
If you may have eaten hazardous foods, own cats, or have been
gardening, you are at greater risk for infection.
Hazardous Foods for Pregnant Moms and Young Children
To assure a safe pregnancy, it is important to avoid these foods,
unless they have been thoroughly heated.
-
Unpasteurized Milk and Milk products
-
Soft Cheeses (Mexican-style, feta, Brie, Camembert, and blue-veined)
-
Raw Shellfish
-
Rare Meat and Poultry
-
Pâtés
-
Cold Ready-to-Eat Meats (hot dogs, sausage, ham, bologna, etc.)
-
Cold Ready-to-Eat Seafood Products (smoked salmon, etc.)
-
Cold Leftovers
-
Unwashed Fruits and Vegetables
-
Raw Eggs and Raw Egg Products (homemade ice-cream, mayonnaise,
eggnog, Caesar salad dressing, raw cookie dough, and raw cake mix)
-
Unpasteurized Fruit Juices and Ciders
For more information on T. gondii, Listeria or other
bacterial risks to pregnancy:
Organization of Teratology Information Services (OTIS);
Pregnancy Riskline
1-888-285-3410
http://orpheus-1.ucsd.edu/otis/
United States Department of Agriculture
Food Safety and Inspection Service
(202) 720-7943
http://www.fsis.usda.gov
U.S. Food and Drug Administration
Center for Food Safety and Applied Nutrition
1-888-SAFEFOOD
http://www.cfsan.fda.gov
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