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What’s the big deal about deli meats and sushi while I’m pregnant?

8/15/2017

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“So, I just found out I am pregnant and went to the doctor for my first prenatal visit.  The first thing I was given was a long list of food restrictions.  All I am craving is a deli sandwich- is it really that dangerous?”  I get this question from my patients all the time.  So, lets break some of these food restrictions down and explore the real reason they exist.  

So the vast majority of food restrictions in pregnancy come from concerns about food contamination.  If you eat raw eggs or fish, you could be at risk of salmonella, e. coli, or campylobacter.  Is this any different if you are pregnant or not.  No.  These bacteria can make you sick and will probably cause you a lot of GI distress (fever, vomiting and diarrhea).  Given the changes in your immune system during pregnancy, though, any of these infections would also be more likely to make you ill than usual.  However, these bacteria are not likely going to cause an intrauterine infection that is specifically dangerous to your baby.  Also, pregnant women are typically advised to limit seafood intake to about 3 times per week due to concern about exposure to mercury (that's also why fish at the bottom of the food chain are preferable - lower mercury concentration).  

So what can affect my baby? Exposure toxoplasmosis or listeria while pregnant.

Lets talk about toxoplasmosis first.  Toxoplasmosis is a parasite that is most frequently associated with cat litter (it is the reason your doctor will tell you not to clean the litter box if you have cats because it puts you at risk of exposure).  You can also contract toxoplasmosis through raw meat and unwashed vegetables. If you are not pregnant, exposure to toxoplasmosis can cause some minor flu like symptoms or no symptoms at all.  However, if you are pregnant the fetus can become infected and this can cause your baby to have blindness, mental retardation and have seizures.  So how do you avoid exposure?  Avoid undercooked and raw meats and wash your fruits and vegetables well.  Also avoid dried or cured meats.  And, of course, do not handle kitty litter while pregnant. 

Now on to Listeria…listeria is harder to avoid and pregnant women are far more susceptible to this bacteria (about a third of cases every year occur in pregnant women).  If you are infected while pregnant, you are at increased risk of stillbirth, preterm birth, and infected newborns.  The source of listeria infections are not always easy to determine and everything from cantelope, sprouts, and celery have been linked to outbreaks of listeria. This is why it is harder to avoid than toxoplasmosis.  However, there are some consistent causes of listeria which while pregnant you should avoid.  They include the following: queso fresco, other raw milk cheeses (unpasteurized dairy products), and deli turkey.  

So in summary…
  • Wash your vegetables well and avoid rare/raw meat
  • Avoid queso fresco, other raw milk cheeses and deli turkey (this is why you are better off avoiding deli meats if you can)
  • Sushi and raw eggs puts you at risk of salmonella and campylobacter, which will cause a lot of GI distress but are less likely to affect the baby

That being said, you are pregnant, and some indulgences should be allowed (the baby made you crave it, after all ;)  Just to try to avoid likely sources of food-borne infection, and be sure to ask your doctor if you have any questions about what foods may make you sick.

​Dr. Pam
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