Food Safety in Pregnancy

I recently had a pregnant patient email me and ask about which foods to avoid in pregnancy- do I really have to avoid deli meats?  I explained the rationale behind it- that certain foods have a higher risk of foodborne illness, for pregnant and non-pregnant folks, but that we want to try to avoid that risk particularly in pregnancy.  I referred her to the FDA site on food safety in pregnancy:

I was emailing her as I was eating my cold roast beef sandwich for lunch. 😛

The truth is, I don’t follow the guidelines exactly.  Would I eat raw oysters, or put alfalfa sprouts in my sandwich?  No, but would I eat raw sashimi at a reputable Japanese restaurant?  Probably.  I certainly don’t want to put myself or my fetus at undue risk, but I also don’t feel the need to be super paranoid, either.

I was surprised when one of my colleagues, also an OB/Gyn doc and pregnant, said she still has a daily latte.  Unlike my husband who LOVES coffee like it’s crack, I’ve never been a coffee person.  I’m sensitive to the effects of caffeine (which my 23andMe DNA test confirmed), so although I’ll enjoy a cup now and again, I’m not so keen on how I feel after.  I get a delayed reaction of feeling really jittery, and it’s not pleasant.  It’s easy for me to avoid caffeine, but I can see how it can be hard for people like my husband who love their coffee.  ACOG (The American Congress of Obstetricians and Gynecologists) says up to 200 mg of caffeine per day is acceptable.  I would still prefer to avoid daily use, though.

Alcohol of course I avoid.  I do miss those handcrafted cocktails at some of my favorite places in SF like Trick Dog and The Alembic.  Taking a little sip of my husband’s cocktails does help me get my fix.  And I do drink the occasional kombucha.  I avoid the ones that have the required 21 and up labeling for 0.5% or more alcohol content.  The others are supposed to have just a trace of alcohol, so hopefully for my baby’s sake that’s ok.

To my patient asking about the deli meat, I was obligated (particularly since my response was in writing where it’s documented in her chart) to tell her that yes, according to the FDA recommendations, it’s best to avoid unless it’s hot.  But do I have patients that aren’t as with it, and don’t read the recommendations from the materials we give them?  Certainly.  I can’t specifically go over every little thing with each patient at their prenatal visits, so while everyone knows to avoid alcohol in pregnancy, I’m sure I have patients who don’t know to avoid deli meat and in the end their babies do just fine.  Ultimately, it’s every woman’s personal decision- like mine to go ahead with the cold deli meat, or my colleague’s to have her daily latte- about how closely she wants to follow the guidelines.


6 thoughts on “Food Safety in Pregnancy

  1. PracticeBalance April 1, 2015 / 9:28 am

    Have you seen the book Expecting Better? It is written by an economist who goes through all the studies on the things that pregnant women are told to avoid, sifting through what has real data behind it and what doesn’t. Interesting. It got some flack because she reported that the data on alcohol is not very good, and people of course misinterpreted that as her saying that it was ok to drink during pregnancy. But the one that had the really strong data is the listeria/cold cuts/etc.

    I also did 23 & Me. Side note: I have a copy of ApoE4, which made me change the way I was eating “paleo”. I stopped eating so much fat (although I still love fat) but changed from animal fat to other types mainly. ANYway, I am an intermediate caffeine metabolizer. I LOVE my coffee and don’t plan to give up a morning espresso (approx 100 mg/cup) if I get pregnant (working on that now). That is, unless I am so nauseated that I can’t stomach it. I have already given up my afternoon espresso in preparation :).


    • Paleo OB April 1, 2015 / 8:34 pm

      Interesting. I hadn’t heard of the book before, but maybe I should avoid the cold cuts, then. It’s interesting because most OB/Gyns have probably never seen a case of listeriosis, and I’m sure there are many women out there who are not avoiding risky foods completely.
      I thought I’d try to stay pretty strict Paleo in pregnancy, but now that I’ve been feeling sick, that’s kinda gone out the window at the moment. We’ll see how you feel about the coffee when pregnant. Good luck to you!


  2. PracticeBalance April 2, 2015 / 7:30 am

    Whoops… What types of non-paleo foods did/are you eating? Just curious what you could stomach…


    • Paleo OB April 5, 2015 / 5:02 pm

      Oh man, you name it, I’m eating it. As in bread, rice, cupcakes. It’s pretty bad. Though I’m eating more meat now, there are certain foods, like most seafood or chili that even the thought of is still very unappealing.


  3. bostongal :) April 2, 2015 / 6:28 pm

    I literally laughed out loud when I read the line about your roast beef sandwich! Thank you for keeping it real!! My dentist surprised me recently by admitting that he doesn’t brush and floss everyday. As a lawyer, I also can relate; I do a great job advocating for my clients and best situating them for potential risks, but admit that I’ve been procrastinating on some personal legal stuff (getting around to drafting a health care proxy, for example), so totally get the difference between being extra cautious in advising clients versus making decisions with respect to myself!


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