The list of do’s and don’ts when you find out you are pregnant can get very overwhelming! Add to this the fact that many sources contradict themselves and it can leave an expecting mom overwhelmed and unsure what to do. In this post I wanted to break down the reasons behind the recommendation of some of the main foods to avoid during pregnancy so you can make informed decisions for you and your baby! As well as add in some foods to include (because it’s no fun when it’s just a list of don’ts!).
What are the most common recommendations with respect to foods to avoid during pregnancy?
- Raw fish (oysters, clams, sushi)
- Fish high in mercury (mackerel, marlin, orange roughy, shark, swordfish, tilefish, and tuna)
- Undercooked meat, poultry and seafood
- Raw or slightly (soft) cooked eggs (including Caesar salad dressing)
- Unpasteurized milk products including soft and semi-soft cheeses (Brie, Camembert)
- Unpasteurized juices (apple cider and apple cider vinegar)
- Raw sprouts (alfalfa sprouts)
- Food colouring/Red food dye
- Deli meats that have not been heated
- Dirty dozen
Today I wanted to cover the three I get the most questions about: deli meat, sushi and cheeses.
What is the deal with lunch/deli meat and pregnancy?
Every wonder what all the fuss is about with deli meat in pregnancy? The recommendation to avoid or deli sandwiches and subs is due to the risk of Listeria bacteria in cold cuts and deli meats. Deli meats account for 89% of listeria infections in the US each year.
What is the big deal about a listeria infection? While most individuals exposed to listeria do not become ill, pregnant women are at a greater risk for complications due to the infection. In the first trimester a Listeria infection can lead to miscarriage, in the second and third trimester, Listeria can increase the risk of premature labour, delivery of a low birth-weight infant and infant death. Other risks to baby include paralysis, seizures, blindness or impairment of major organs.
The good news! Heating your deli meat eliminates this risk – ensure the meat is cooked to the point that it is steaming (not just lightly reheated).
How about soft cheeses? I miss my brie!
The recommendation against soft cheeses (Brie, camembert, etc.) is due to the same infection as the risks of deli meat – the Listeria bacteria. However, this recommendation has somewhat evolved over the years into much confusion. The recommendation to avoid soft cheese was due to the fact that soft cheeses prepared in countries such as France often use unpasteurized milk – which is thought to be of a higher risk for contracting listeria due to its raw nature. However, in North America, most soft cheeses are made with pasteurized milk and don’t convey any more of a risk than if you were to have a glass of milk.
The funny thing about this, is that if you examine all of the Listeria infections in the past several years from dairy products, pasteurized (not unpasteurized) dairy products account for the majority of listeria infections. Therefore, your regular cheese products are more likely to lead to a listeria infection than these unpasteurized soft cheeses (especially with the strict scrutiny these unpasteurized products face in North America for safety testing). Now keep in mind, the risk even for pasteurized is extremely rare – so this isn’t to scare you away from dairy in general. It’s important to remember that all foods if mishandled can lead to infections (think of the outbreaks of E coli in vegetables), and so the quality of your food sourcing is more important than some of these broad foods to avoid during pregnancy.
What about sushi?
The concerns surrounding sushi in pregnancy are related to the risk of parasites in raw fish. A parasitic infection can lead to anemia, malnourishment and potentially miscarriage. The recommendation on the safety of sushi during pregnancy differs by country, with Japan encouraging pregnant woman to consume fish and England reporting raw fish as safe to consume in pregnancy. Now is this because they have higher quality standards on their raw fish? Not necessarily. Seafood in Canada is screened for microbial contamination prior to being sold to the public. Flash freezing (a method commonly used for raw fish in sushi) also drastically reduces the risk of parasites and other infections. The one exception I would make to this is raw shellfish – think oysters, clams, etc.. Raw shellfish makes up 75% of seafood-associated foodborne illnesses and so is not worth the risk!
How much should I be eating in pregnancy?
We have all heard the expression “eat for two”. This can lead to lots of confusion for expecting moms, as this often is interpreted as eating double what you did prior to pregnancy. Remember that baby is not the size of a grown adult! In most cases it’s recommended that you consume 300-500 more calories daily (mainly in the second and third trimester, as well as if you are breastfeeding) to accommodate the growing needs of baby – with the majority of these calories coming from protein and vegetables.
What foods to consume during pregnancy?
- Protein is crucial for baby’s growth and development
- Ideally you want to aim for 75 g of protein daily from a variety of sources (unless you have a medical condition that restricts your protein intake)
- While fruit is important, it’s often one women find easier in pregnancy, but don’t forget about your veggies
- I usually recommend 3 servings of cruciferous vegetables and 1-2 servings of your colourful veggies (think orange, red, purple) daily
- Nourishing warm soups and stews, including bone broth
- Drink 2 litres of water per day – spread this out throughout the day so you aren’t spending the whole day with trips to the bathroom!
- If you are finding your iron is chronically low during pregnancy, here are a few dietary tips to boost your iron:
- Increase consumption of:
- Red meat
- Dried apricots
- Pumpkin seeds
- Black strap molasses
- Pair your iron with fresh fruit high in vitamin C (oranges, strawberries, black currants, green and red peppers, broccoli, tomatoes and avocados)
- Avoid coffees, teas and calcium supplements with your dietary or supplemental iron intake
- Stewing tomatoes in a cast-iron pan (think the black cast iron pans not the glazed ones) for several hours is a great option to increase iron intake (can then consume as a sauce or side) – the acidity of the tomatoes pulls iron from the pan
- Cooking in a cast iron pan overall
- Adding the lucky iron fish to your meals when cooking
- Increase consumption of:
What about teas to avoid during pregnancy?
While there is a lot of discussion surrounding caffeine in pregnancy, I often get questions about the type of tea as well. As a general rule I tend to recommend avoiding most botanicals and teas in the first trimester of pregnancy – not including exceptions such as ginger that can help with morning sickness!
Once you reach your second trimester, the following teas are safe to consume:
- Mint (peppermint and spearmint)
- Red raspberry leaf (once in second trimester)
- Nettle (stinging nettle)
- Black tea (up to 200 mg caffeine)
- Green tea (up to 200 mg caffeine) – note: have green tea away from your folate supplements as it can decrease absorption (especially important in the first trimester)
- Rooibos tea
- Once you reach your third trimester, dandelion tea is also safe to consume.
Teas to avoid during pregnancy (in all trimesters):
- Black Cohosh
- Blue Cohosh
- Dong Quai
- Senna (commonly used in constipation formulas)
- Cascara (commonly used in constipation formulas)
- Note that these botanicals should also be avoided in any supplements as well. If you are ever unsure about the safety of an ingredient in a product you would like to consume during pregnancy please consult your Naturopathic Doctor or other health care provider.
I hope this blog post helps you feel more confident in your decisions as a mama! Eat well!
Yours in Health,
Naturopathic Doctor and Co-Owner of Abaton Integrative Medicine