Food Safety Issues for Pregnant Women

While you're pregnant, you are in a high-risk group for food-borne illness. This means there are foods you'll have to give up or cut down on during pregnancy, because they could harm your baby.

Some Cheeses and Dairy Products

• Cheeses with a white, mouldy rind, such as brie and camembert, blue-veined cheeses and unpasteurised soft cheeses, such as those made from sheep and goat's milk should all be avoided. All these cheeses could contain listeria bacteria. Listeria can cause an infection called listeriosis that may harm your baby. Listeria is unusual because unlike other foodborne bacteria, it can grow at refrigerator temperatures, where most other foodborne bacteria do not.
• Unpasteurised milk and dairy products made with unpasteurised milk (such as some cheeses, ice creams and yoghurts) aren't safe during pregnancy either. They are more likely to contain bacteria that could give you food poisoning. You're more vulnerable to food poisoning while you're pregnant.

Eggs

• Raw or undercooked eggs can contain salmonella bacteria. Cook eggs until the yolk and white are firm. Don't eat mousse, ice cream and fresh mayonnaise from delis or restaurants as these may contain raw egg. However, salad dressings that you buy in supermarkets, such as mayonnaise, are usually made using pasteurised egg, so are safe to eat. Ensure that you check the label before eating.

Meat

• Liver isn't safe to eat during pregnancy because it contains high levels of a type of vitamin A called retinol. You don’t need this vitamin every day and high levels of it can harm your unborn baby. However, all other fresh meats are fine. Just make sure you cook meat thoroughly until there are no pink bits in the centre and the juices run clear. Be extra careful when cooking meat on a barbeque, or as part of a microwavable ready meal.
• It's best not to eat cured meats, such as parma ham and salami. These also carry a risk of listeriosis and toxoplasmosis. Toxoplasmosis is caused by infection with the common parasite Toxoplasma gondii (T. gondii) and is passed from a pregnant woman to her unborn baby. It can cause serious health problems in babies born with the infection and can sometimes be fatal. All pâté, whether made from meat, fish or vegetables, may contain listeria bacteria, which can harm your baby, so avoid these too.

Fish

• Oily fish is good for you and your baby, but it can contain environmental pollutants, so it's best to eat no more than two portions of oily fish a week.
• Don't eat any shark, swordfish and marlin. These fish may contain unsafe levels of naturally occurring mercury. Tuna contains some mercury too, so don't eat more than four medium-sized cans, or two fresh tuna steaks per week.
• Raw shellfish isn't safe when you're pregnant, because it can cause food poisoning.

Drinks

• Try not to have more than 200mg of caffeine a day. That’s two cups of instant coffee, two mugs of tea or five cans of cola a day. Drinking lots of caffeine during pregnancy has been linked to miscarriage and low birth weight. You could switch to decaffeinated drinks instead.
• Government advice is that you stop drinking alcohol during pregnancy. If you want to drink during your pregnancy, don’t drink more than one or two units of alcohol, once or twice a week, and don't get drunk.

Immunisations During Pregnancy

Certain types of vaccines are safe for pregnant women, but ensure that you talk to your doctor before being immunised. As a general rule, safe vaccines are those made from dead (’inactivated’) viruses, toxoids (proteins from bacteria) and certain genetically-engineered viruses.

Vaccines to Consider During Pregnancy

• Flu vaccination. You should only get the flu vaccine by injection. Do not receive the "LAIV" (inhaled flu vaccine), which contains live attenuated influenza vaccine.
• Tetanus vaccination. If you get a dirty or deep wound, check with your doctor immediately to see if you need a tetanus shot, especially if you haven't had one within the last 10 years.
• Hepatitis A: If you are planning to visit a developing country, ask your doctor about the vaccine.
• Polio: You've probably already received a polio vaccine. However, if you plan to visit India, Southeast Asia, or Africa, you may need a polio booster shot (a small additional dose).
• Pneumococcus: If you have a lung condition, such as asthma, your doctor may recommend the genetically-engineered pneumococcal vaccine, which prevents some forms of pneumonia.

Vaccines to Avoid During Pregnancy

As a rule, you should not receive live virus vaccines while you are pregnant. This includes the measles, mumps and rubella vaccines.

Medications During Pregnancy

Women who are pregnant (or who plan to breastfeed) and have short-term or long-term health problems may need to take medications during their pregnancy. Your doctor can guide you about the safety of any medication you might be taking, and whether a safe alternative might be available.

Talk to your doctor if you:

• have taken – or need to take – a medication
• have a chronic medical condition such as asthma, epilepsy (seizures), high blood pressure, thyroid complications, depression, and others
• are considering a herbal or dietary supplement. Often, these are not regulated and could cause side effects or other problems
• are considering vitamin supplements. Some necessary vitamins, such as Vitamin A, can be harmful if taking in too large a dose.

Supplements specifically designed for pregnancy can be useful in ensuring you are receiving what you and your baby needs. You can discuss this with your GP or midwife.

Pet Issues During Pregnancy

Pets such as lizards, snakes, iguanas, turtles, and other reptiles can carry the salmonella bacteria in their faeces and therefore pose a risk to pregnant women. Pet rodents such as hamsters, gerbils, and guinea pigs can transmit the virus lymphocytic choriomeningitis virus (LCMV), which can cause miscarriage and birth defects. Pregnant women should not change or handle cat litter. This can put them at risk of toxoplasmosis, an infection caused by a parasite that can cause serious problems for an unborn baby. Ideally, someone else should clean the cat litter tray, but if you’re pregnant and have to do it, wear disposable gloves and wash your hands thoroughly afterwards.

Allergens Issues During Pregnancy

Pregnancy hormones have a huge influence on the immune system and as a consequence cause or have an effect on any allergies which you may suffer from. Effects can be variable. They can have a ‘dampening’ effect on allergies and alleviate symptoms, or increase the allergy triggering potential of the immune system, and heighten allergic symptoms during pregnancy. Asthma, for example, may become worse with frequent attacks and it may even occur for the first time in pregnancy. But paradoxically it may become less severe and easier to control during pregnancy.

Nasal allergies often occur for the first time in pregnancy and allergy-like rashes are also common.

Getting Help for Allergies

Ideally, you want to stay as comfortable as possible during your pregnancy. If your allergy symptoms are not bearable, are getting worse or are interfering with your daily activities, contact your doctor to discuss possible remedies and solutions that are safe during your pregnancy.

In addition, contact your doctor right away if:

• you have hives (raised, red, itchy rash) or if other signs and symptoms are severe, such as pain, difficulty sleeping or wheezing
• your wheezing or shortness of breath rapidly worsens, or if you are short of breath after minimal activity, which could indicate asthma.

Click here for more advice on helping reduce allergens in your home and making it a healthy environment for you and your family.

Preventing Infections During Pregnancy

In addition to personal health habits, there are some important steps you can take to ensure that your home environment is a healthy one, too. During your pregnancy, you'll want to take special care to prevent the spread of germs at home, so that you stay healthy before the baby arrives.

These 10 tips can help you prevent infections that could harm your unborn baby.

1. Wash your hands often with soap and water, especially

Before:

• preparing food or eating
• caring for and playing with children
• being around people who are sick
• dressing wounds, and giving or applying medications.

After:

• using the bathroom
• touching raw meat, raw eggs, or unwashed vegetables
• preparing food and eating
• gardening or touching dirt or soil
• handling pets
• being around people who are sick
• getting saliva (spit) on your hands
• changing nappies.

If soap and running water are not available, you should use a hand sanitiser instead.

2. Do not share forks, cups, or food with young children.

Wash your hands often when around children. Their saliva and urine may contain a virus called cytomegalovirus (CMV) that is likely to be harmless to them, but it could be dangerous for you and your unborn baby. Most healthy children and adults with CMV have no symptoms and may not even know that they have been infected.

3. Cook your meat until it's well done.

The juices should run clear and there should be no pink inside. Do not eat hot dogs, luncheon meats, or deli meats, unless they are reheated until steaming hot. These undercooked meats and processed meats might contain harmful bacteria.

4. Avoid unpasteurised (raw) milk and foods made from it.

Do not eat soft cheeses such as feta, brie, and blue-veined cheese unless they have labels that say they are pasteurised. Unpasteurised products can contain harmful bacteria.

5. Do not touch or change dirty cat litter.

Have someone else do it. If you must change the litter yourself, wear disposable gloves and wash your hands afterwards. Dirty cat litter might contain a harmful parasite called toxoplasma, which can be harmful to your unborn baby.

6. Stay away from wild or pet rodents and their droppings.

Some rodents might carry a harmful virus. Have a pest control professional get rid of pests in or around your home. If you do have a pet rodent, like a hamster or guinea pig, have someone else care for it until after your baby arrives. In addition, reptiles can carry the salmonella bacteria in their faeces and therefore pose a risk.

7. Get tested for sexually transmitted diseases (STDs), such as HIV, hepatitis B and herpes, and protect yourself from them.

Some people who have HIV, hepatitis B, or an STD do not feel ill. Knowing whether you have one of these diseases is important as transmission of STDs from yourself to your foetus, newborn, or infant can occur before, during, or after birth. This can result in dangerous consequences for your baby. If you do have an STD, talk to your doctor about how you can reduce the chance that your baby will become affected.

8. Talk to your doctor about vaccinations.

Some are recommended before you become pregnant, during pregnancy, or right after delivery. Having the right vaccinations at the right time can help keep you healthy and help keep your baby from getting ill.

9. Avoid people who have an infection.

Stay away from people who you know have infections, such as chickenpox or rubella, if you have not yet had it yourself or did not have the vaccine before pregnancy.

10. Ask your doctor about group B strep.

Group B streptococcus, or GBS, also known as group B strep, is one of many different bacteria that normally live in our bodies. Approximately one third of us carry GBS in our intestines without knowing. About a quarter of women also have it in their vagina. Most don't know it's there, as it doesn't usually cause problems or symptoms. An easy swab test near the end of pregnancy will show if you have this type of bacteria. If you do have group B strep, talk to your doctor about how to protect your baby during labour, as in rare cases, GBS can cause serious illness and even death in newborn babies. Although these cases are unusual, GBS is the most common cause of severe infection in newborns, particularly in the first week after birth (known as an early onset infection).

Cold and Flu During Pregnancy

If you get the flu while pregnant, your symptoms can be more severe or can lead to pneumonia. If you do get the flu, get plenty of rest, drink lots of fluids, and stay in contact with your doctor. Despite the uncomfortable symptoms, a bout with the flu will not harm your baby.

Cold and Flu Prevention Tips for Pregnant Women

• If you are pregnant (or breastfeeding), you should get vaccinated against seasonal flu, if available and recommended in your local area. This is because being pregnant can increase your risk of flu complications such as pneumonia. Speak to your doctor if you are planning to conceive to discuss the risks.
• Wash your hands thoroughly and often, especially after coming in contact with someone who may be ill. Use a hand sanitiser if water is not available.
• Clean and disinfect surfaces often to reduce cold and flu germs.
• Avoid coming in contact with someone who is ill.
• Avoid touching your eyes, nose or mouth and cover your cough or sneeze with your sleeve or tissue, and teach children to cover their own coughs and sneezes.
• Drink plenty of fluids and eat a well-balance diet to stay healthy.

If You Get a Cold or the Flu

Before taking any over-the-counter medication, it's always wise to check with your doctor or the pharmacist. In addition:

• get plenty of rest
• drink lots of fluids, such as water, juice, and caffeine-free tea
• try sugar or honey-based lozenges to relieve sore throats and cough.

When to Call Your Doctor

Contact your doctor straight away if your symptoms don't start to improve (or get worse) after three or four days, or if you have any of these symptoms:

• Difficulty breathing or shortness of breath.
• Turning blue.
• Bloody or coloured sputum (mucus when you cough).
• Pain or pressure in the chest or abdomen.
• Sudden dizziness, confusion.
• Severe or persistent vomiting.
• Decreased or no movement of your baby.
• High fever that is not responding to your traditional medicine.