Guide for a Healthy Pregnancy

FOOD SAFETY

How to Protect Yourself and Your Baby

What is a foodborne illness?

It’s a sickness that occurs when people eat or drink harmful microorganisms (bacteria, parasites, viruses) or chemical contaminants found in some foods or drinking water.

Symptoms vary, but in general can include: stomach cramps, vomiting, diarrhea, fever, headache, or body aches. Sometimes you may not feel sick, but whether you feel sick or not, you can still pass the illness to your unborn child without even knowing it.

Why are pregnant women at high risk?

You and your growing fetus are at high risk from some foodborne illnesses because during pregnancy your immune system is weakened, which makes it harder for your body to fight off harmful foodborne microorganisms.

Your unborn baby’s immune system is not developed enough to fight off harmful foodborne microorganisms.

For both mother and baby, foodborne illness can cause serious health problems – or even death.

Tips for a Lifetime

There are many bacteria that can cause foodborne illness, such as E. coli O157:H7 and Salmonella.

Here are 4 Simple Steps you should follow to keep yourself and your baby healthy during pregnancy and beyond!

CLEAN

Wash hands thoroughly with warm water and soap.
Wash hands before and after handling food, and after using the bathroom, changing diapers, or handling pets.
Wash cutting boards, dishes, utensils, and countertops with hot water and soap.
Rinse raw fruits and vegetables thoroughly under running water.

SEPARATE

Separate raw meat, poultry, and seafood from ready-to-eat foods.
If possible, use one cutting board for raw meat, poultry, and seafood and another one for fresh fruits and vegetables.
Place cooked food on a clean plate. If cooked food is placed on an unwashed plate that held raw meat, poultry, or seafood, bacteria from the raw food could contaminate the cooked food.

COOK

Cook foods thoroughly. Use a food thermometer to check the temperature
Keep foods out of the Danger Zone: The range of temperatures at which bacteria can grow – usually between 40° F and 140° F (4° C and 60°C).
2-Hour Rule: Discard foods left out at room temperature for more than two hours.

CHILL

Refrigerate or freeze perishables (foods that can spoil or become contaminated by bacteria if left unrefrigerated).
Use ready-to-eat, perishable foods (dairy, meat, poultry, seafood) as soon as possible.
Your refrigerator should register at 40°F (4° C) or below, and the freezer at 0° F (-18° C). Place an appliance thermometer in the refrigerator, and check the temperature periodically.

3 Foodborne Risks for Pregnant Women

As a mom-to-be, there are 3 specific foodborne risks you need to be aware of. These risks can cause serious illness or death to you and your unborn child. Follow these steps to help ensure a healthy pregnancy.

	What it is	Where it’s found	How to prevent illness
1. Listeria	A harmful bacterium that can grow at refrigerator temperatures where most other foodborne bacteria do not. It causes an illness called listeriosis.	Refrigerated, ready-to-eat foods and unpasteurized milk and milk products.	Follow the 4 Simple Steps listed above. Do not eat hot dogs and luncheon meats – unless they’re reheated and steaming hot. Do not eat soft cheese, such as Feta, Brie, Camembert, and Panela – unless they’re labeled as made with pasteurized milk. Check the label. Do not eat refrigerated pâté or meat spreads. Do not eat refrigerated smoked seafood – unless it’s 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.” These types of fish are found in the refrigerator section or sold at deli counters of grocery stores and delicatessens.) Do not drink raw (unpasteurized) milk or eat foods that contain unpasteurized milk.
2. Methylmercury	A metal that can be found in certain fish. At high levels, it can be harmful to an unborn baby’s or young child’s developing nervous system.	Large, long-lived fish, such as shark, tilefish, king mackerel, and swordfish.	Don’t eat shark, tilefish, king mackerel, and swordfish. These fish can contain high levels of methylmercury. It’s okay to eat other cooked fish/seafood, as long as a variety of other kinds are selected during pregnancy or while a woman is trying to become pregnant. She can eat up to 12 ounces (2 average meals) a week of a variety of fish and shellfish that are lower in mercury. Five of the most commonly eaten fish that are low in mercury are shrimp, canned light tuna, salmon, pollock, and catfish. Another commonly eaten fish, albacore (“white”) tuna has more mercury than canned light tuna. So, when choosing your two meals of fish and shellfish, you may eat up to 6 ounces (one average meal) of albacore tuna per week.
3. Toxoplasma	A harmful parasite. It causes an illness called toxoplasmosis, which can be difficult to detect.	Raw and undercooked meat; unwashed fruits and vegetables; soil; dirty cat-litter boxes; and outdoor places where cat feces can be found.	Follow the 4 Simple Steps listed above. If possible, have someone else change the litter box. If you have to clean it, wash your hands with soap and warm water afterwards. Wear gloves when gardening or handling sand from a sandbox. Don’t get a new cat while pregnant. Cook meat thoroughly.

For more information:

See your doctor or health-care provider if you have questions about foodborne illness.
FDA Food Information Line: 1-888-SAFE FOOD
FDA Center for Food Safety and Applied Nutrition: www.cfsan.fda.gov
Gateway to Government Food Safety Information: www.foodsafety.gov
U.S. Partnership for Food Safety Education: www.fightbac.org

This fact sheet is a condensed guide to food safety. For more in-depth information, be sure to check out:
Food Safety for Moms-to-Be at www.cfsan.fda.gov/pregnancy.html

More About Fish and Pregnancy

We know that fish can be very nutritious and are packed with great nutrients such as omega-3s, the B vitamins and lean protein. These are essential for growth and development. But unfortunately, fish can also have some unhealthy contaminants. The main concern with regard to eating fish during pregnancy has to do with the amount of methyl mercury contained in the fish.

Nearly all fish have some levels of mercury in them and some more than others. As a safety measure the FDA has set a limit for the amount of methyl mercury that is safe to consume as 1 ppm (part per million). This conservative limit is actually 10 times lower than the smallest level of mercury known to be harmful. For this reason most fish can be safely consumed in pregnancy because the amounts of mercury in them range from .01 to .5 ppm, a value that is 100% to 50% lower than the FDA limit. However, the FDA recommends that pregnant women NOT eat shark, swordfish, king mackerel or tilefish (e.g. golden bass or golden snapper) because these fish can contain higher levels of methyl mercury, near the FDA limit. In addition, certain species of very large tuna, typically sold as tuna steaks or sushi can have levels over the 1 ppm limit and should NOT be eaten.

Canned tuna is the most widely consumed type of seafood in the U.S. There are actually two types of canned tuna, light tuna and white (albacore) tuna. Light tuna contains less methyl mercury than white tuna. Women are advised to eat no more than six 6-oz servings of light tuna and no more than three 6-oz. servings of white tuna per month.

Seafood is an important part of a balanced diet for pregnant women. It is good to select a variety of other kinds of fish including shellfish, canned fish, and smaller ocean fish. It is considered safe to eat 12 ounces of cooked fish per week (A typical serving of fish is 3-6 oz.) as long as the above-mentioned fish are avoided.

It is not recommended to eat non-commercial fish (fish caught by family and friends) as well as not to eat raw fish of any kind. If eating lobster, do not eat the tomalley (the green substance found in the middle of the lobster).

Salmon is a high packed omega-3 fish that does not have any methyl mercury level concerns; however, there are concerns about elevated levels of polychlorinated biphenyls (PCBs) in farm-raised salmon. For this reason it is advised to eat wild salmon or no more than one meal per month of farm-raised salmon.

As guidelines specific to Massachusetts, the Massachusetts Department of Public Health (MDPH) advises pregnant women not eat any fish caught in Boston Harbor (defined as Hull to Manchester) or New Bedford because of the chemical contamination of these waters. The MDPH also advises against eating bluefish due to levels of PCBs.