Eating for Two, the Safe Way:
Preventing Foodborne Illness During Pregnancy

Pregnancy is an important time to educate women about food safety. By following some simple food safety tips and avoiding risky foods, women can eat well and enjoy a healthy pregnancy. And the food safety skills they pick up will benefit them and their children for years to come.

What is Foodborne Illness?

Foodborne illnesses, often called "food poisoning," occur when people eat or drink harmful pathogens (bacteria, viruses, parasites) or chemical contaminants, such as methylmercury, found in some foods and beverages. More than 250 types of foodborne illness have been identified.

Pregnancy and Foodborne Illness

Hormone changes during pregnancy weaken a woman's immune system, particularly in the third trimester, and make her more susceptible to infection by harmful pathogens including those that cause many foodborne illnesses. Pathogens of special concern for pregnant women are Listeria monocytogenes and Toxoplasma gondii.

Infections from these pathogens may result in problems such as miscarriage, still birth, newborn death, premature labor or severe complications for the baby. Certain pathogens such as Listeria monocytogenes and Toxoplasma gondii can cross the placenta and increase the fetus' risk of becoming infected. Since the immune system of the developing fetus is immature, it may not be able to fight off the infection. The developing fetus is also vulnerable to chemical contaminants, such as methylmercury, that may be ingested by pregnant women when they eat certain types of fish and seafood. When present in high enough concentrations, methylmercury can cause severe health consequences for the baby.

These pathogens and chemical contaminants may cause no or even mild symptoms in a pregnant woman, yet are still dangerous to the developing baby. Illness usually happens within one to three days after eating a contaminated food, but can be as soon as 20 minutes after eating or as long as six weeks later. The toxic effects of methylmecury may not appear until later in childhood.

Spread the Word (Not Illness)!

Toxoplasmosis is caused by the parasite Toxoplasma gondii. It is most commonly associated with dirty cat-litter boxes of cats that spend any time outdoors, therefore pregnant women are advised to avoid cleaning the kitty litter box or getting a new cat during pregnancy. The parasite is also found in soil, unwashed fruits and vegetables, raw and undercooked meat. Gardeners need to wash their hands carefully and avoid touching their hands to their mouth after gardening.

Foods to Avoid During Pregnancy:

• Undercooked meat, poultry and seafood
• Hot dogs and deli meats such as ham, turkey, salami and bologna. If eaten they should be reheated until steaming hot.
• Refrigerated patés or meat spreads; canned versions are safe
• Refrigerated smoked seafood unless it has been cooked (as in a casserole); canned versions are safe
• Soft-scrambled eggs and all foods made with raw or lightly cooked eggs
• Soft cheeses made with unpasteurized milk. Examples are Brie, feta, Camembert, Roquefort, blue-veined, queso blanco, queso fresco and Panela. Tell women to check the label to see what kind of milk was used to make the cheese.
• Unpasteurized milk and foods made from it
• Unpasteurized juices or homemade juices
• Raw vegetable sprouts such as and including alfalfa, clover, radish and mung bean
• Swordfish, shark, king mackeral and tile fish
• All large mouth bass caught in North Carolina lakes, streams, and ponds. Catfish, blackfish (bowfin), jackfish (chain pickerel), and warmouth caught east and south of Interstate 85
• Canned white or albacore tuna. Two meals per week of canned "chunk light" tuna is safe.

4 Easy Steps to Prevent Foodborne Illness

The Food and Drug Administration (FDA), U.S. Department of Agriculture (USDA) and the Centers for Disease Control and Prevention (CDC) advise these four simple steps to minimize the likelihood of getting a foodborne illness:

Clean: Before, during and after food preparation, wash your hands and kitchen surfaces with hot water and soap. Always wash hands after going to the bathroom, changing a diaper, changing kitty litter and gardening.

Separate: Keep raw meats separate from other foods, such as fruits and vegetables. Do not cut raw meat and fruits/vegetables on the same cutting board.

Cook: Use a food thermometer to make sure food has reached a safe internal temperature before eating. Thoroughly cook meat, poultry, seafood and eggs. Cook:

• Roasts and steaks to a minimum of 145°F
• Poultry to a minimum of 165°F (innermost part of thigh or thickest part of breast)
• Ground beef, veal and lamb to a minimum of 160°F
• Fish to a minimum of 145°F or until opaque and flaky
• Egg dishes to a minimum of 160°F and eggs until whites and yolks are firm, not runny

Chill: Refrigerators should be at 40°F (4°C) or below. Place a refrigerator thermometer in the refrigerator and check the temperature from time-to-time. Discard any foods left at room temperature for more than 2 hours.