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.