Pregnancy Nutrition “No-No’s”

How are the things you’re eating affecting your baby? What foods should you cut out? Where can you give your diet some wiggle room?

Getting pregnant for the first time really made me hyper-vigilant about what foods I put in my body. At the very beginning of pregnancy I took extreme lengths to avoid any potentially “dangerous” foods.

My views on what types of food were harmful were very black and white. I only ate hard cheeses – never soft – because I was convinced that all soft cheese causes listeria. I never ate salami – my favorite deli meat – because all deli meats contain listeria and nitrates. No grey areas. This went on for the first month or two of my pregnancy and it made my life pretty miserable.

Pregnancy does place certain limits on our diets because our babies are not conceived with developed immune systems. Many things that are normally safe for us to eat risk causing miscarriage and birth defects in our unborn children. Nitrates are absolutely damaging to your fetus. Sushi (unfortunately) is off the menu for the duration of your pregnancy because it can contain listeriosis and high levels of mercury, which contribute to birth defects. Some caution must be taken. This doesn’t mean that we should deprive ourselves of every food we’ve every loved for nine months!

Below I’ve listed which foods to avoid for the safety of your baby. I’ve also listed alternatives for these foods, or ways they can be eaten during pregnancy, so you don’t lose your mind when you have a perpetual craving for salami.

You’re welcome!

  • Raw Fish & Raw Shellfish –

If you’re a sushi lover (like me) you’ll be sad to hear that sushi made with raw fish is 100% off the menu during pregnancy. So are raw oysters, raw clams, ceviche, tartare, poke, carpaccio, and any other raw or partially cooked (seared) seafood. When seafood isn’t fully heated through it can cause food poisoning and possibly harbor dangerous bacteria. Since your baby doesn’t have an immune system to protect them they can be seriously damaged by any pathogen in your bodies.

*AlternativesCooked shellfish, baked sushi, raw salmon roe

If you’re craving sushi then nothing is preventing you from ordering cooked salmon rolls, veggie rolls or egg nigiri. With sushi you simply want to avoid raw fish and cooked fish that is high in mercury, like tuna. Cooked salmon rolls are actually very healthy for you. Avocado rolls provide a nutritious source of fat for your baby. You don’t have to cut out sushi entirely during pregnancy.

Baked oysters are also safe to eat during pregnancy. So are dishes made with fully cooked shrimp, crab, muscles and clams. Make sure that whatever shellfish you eat is fully cooked to prevent harmful bacteria from entering your body.

You can also eat raw fish eggs during pregnancy if they are available in your area. I try to eat 4 ounces every week. The most economical eggs you can buy are salmon roe. I purchased 2 lbs of frozen Alaskan salmon roe from our local fish monger for $100. At 2 to 4 oz a week, these salmon eggs will last me many months. They can last in the freezer for up to a year.

Historically cultures all over the world have gone to great lengths to provide the pregnant women in their communities with fish eggs. Salmon roe are a wonderful source of omega 3 vitamins. These round globes should taste fresh, not fishy, and have a pleasant “sea” taste when they pop in your mouth. Eat over steamed rice, on buttered crackers or simply swallow whole to enrich your baby’s diet. Avoid eggs from farmed salmon or those cured with preservatives instead of salt.

  • High Mercury Content Fish/ Farmed Fish

Fish is very, very healthy for you and your baby during pregnancy. Most fish are packed with vitamins, nutrients and protein that are essential for your baby’s development. You should try to eat two to three portions of fish each week. However, make sure you choose the right fish to put in your body.

Studies conducted by the PEW Foundation, among others, have shown that farmed fish contains significantly concentrated levels of environmental contaminants and pollutants than their wild counterparts. These contaminants have been linked to an increased risk of birth defects and brain abnormalities in unborn children. They have also been a suspected cause of cancer in adult mothers. When choosing fish for your table (and your baby) choose wild-caught fish over farmed varieties.

Please don’t choose just any wild fish though. Slow-growing ocean fish contain high levels of mercury which is damaging to unborn babies. To reduce the risk of mercury contamination avoid eating king mackerel, marlin, orange roughy, shark, swordfishtilefish, ahi tuna and bigeye tuna.

*Alternativesalbacore tuna, wild-caught salmon, wild-caught trout, canned-light tuna, cod

Wild-caught fish that is low in mercury but high in omega-3 vitamins (salmon and trout) are your healthiest options for eating fish during pregnancy. These fish might be pricey in their wild-caught forms. You can also eat two to three servings a week of cod and canned tuna. To make sure you get the proper omega-3 vitamins for your baby’s brain development supplement your diet with a natural, mercury-free fish oil pill.

  • Cold-Smoked Fish

I love lox (cold, smoked salmon) almost as much as I love tuna sushi. Its been difficult for me to give up some of my favorite foods during pregnancy. All cold-smoked fish – often labeled kippered, lox or jerky style – should be avoided during pregnancy because of the risk of listeria. However, you can eat cold-smoked fish in a cooked dish, like a casserole, provided you heat and reheat the dish thoroughly before eating. This will remove the listeria risk.

Unfortunately lox tastes really bad reheated – I tried.

*Alternativessardines, anchovies

Sardines and anchovies are an acquired taste. I catch my husband cringing slightly every time I open up a tin of flavored sardines. To me, they are delicious with butter and crackers and no one can deny that both are very healthy for pregnant women. They are naturally low in mercury, high in protein and packed full of omega-3 vitamins.

Want to give sardines a try? Purchase a flavored tin and get snacking! Throw a few anchovies into your next batch of pasta sauce and watch them melt away (leaving a deep, protein-rich depth to your cooking). Your tastiest option – assuming you live near the coast – is to purchase fresh sardines. Batter the fresh fish in an egg/flour wash and fry them in oil until crisp. The taste is heavenly!

  • Raw or Under-cooked Meat

There aren’t many people who regularly eat raw meat. If you’re like me you might like to eat a rare or medium-rare steak every once in a while. That can be dangerous while you’re pregnant. Under-cooked meat can harbor listeria, toxoplasmosis, salmonella and coliform bacteria (all of which can  cause complications for your unborn baby). You can minimize the risk of contamination by cooking all meats and leftovers fully. When pregnant be extra cautious of how you handle raw meat while cooking to make sure that bacteria doesn’t get a chance to spread to other foods in your kitchen.

*Alternativesfully-cooked meat

Cook your medium-rare burger to medium-well during pregnancy to protect your baby. Invest in a meat thermometer to make sure the center of your dinner is cooked to the correct temperature. Always reheat leftovers to the correct internal temperature to avoid food poisoning during pregnancy.

  • Deli Meat and Lettuce

We can add Italian-style subs to the list of “foods that I love but can’t eat during pregnancy”. Spicy cappicola, deli style ham, cold turkey – all of these delicious deli meats are excellent homes for listeria bacteria. To avoid a possible miscarriage or fetal contamination from listeria cook all deli meats to well-done before consuming them.

This also means that you have to be very careful about eating sandwiches, salads and other foods from delis. Even if they toast your sandwich for you it might not heat the meat inside up to the correct temperature necessary to kill bacteria. The lettuce in deli salads might not be thoroughly washed and can contain enough bacteria to harm your vulnerable baby. That quiche sitting in the bakery window might smell heavenly – but how long has it been sitting out? Possibly long enough to become contaminated for a baby with no immune system.

I’m not trying to make you paranoid. Usually these foods don’t contain enough bacteria to make an adult sick. Over the years we have developed enough immunity to fight off bacteria in deli items. The risk is to your baby – remember their immune systems begin to develop when they’re 2 to 3 months old. Avoid eating deli-style foods that you haven’t made yourself.

*Alternativessalami, pepperoni, well-cooked deli meats, homemade salad

Deli meats like salami and pepperoni are safe for pregnant women because of the way they’re cured. The risk of contracting listeria from either of these meats is extremely low. Any other deli meat should be heated to well-done before eating and they should be eaten while hot.

To eat deli-style foods safely while pregnant make your own quiche and salad at home in advance. Wash all of your produce with a natural vegetable wash to remove contaminants and bacteria. Remember to always reheat leftovers to their proper internal temperature before eating them.

  • Raw Eggs

I know what you’re thinking – no one but bodybuilders eat raw eggs for breakfast every morning. Think again. Many delicious pudding and desserts (like certain ice creams and meringue) are made from raw egg whites and yolks. While pregnant, especially during the vulnerable first trimester, you’ll also want to avoid eating eggs with runny yolks. This will prevent the risk of contracting salmonella.

*Alternativesscrambled egg, commercial products made with pasteurized eggs

Many tasty foods (like ice cream and ceaser dressing) are safe to eat when purchased from a store because they use pasteurized eggs. For breakfast stick to scrambled or hard-fried eggs for the duration of your pregnancy.

  • Raw Sprouts/Unwashed Produce

Unwashed produce and sprouts have a very high risk of containing e-coli and listeria bacteria. These can cause brain abnormalities in unborn children. E-coli is particularly harmful to babies. When shopping at the grocery store avoid green mixes that contain sprouts and wash all of your greens thoroughly in vegetable wash.

*Alternativeswell-washed leafy greens like spinach and kale

Greens are packed with vitamins and micro-nutrients that fuel your baby’s development. Choose greens with high levels of calcium and iron (like baby spinach, kale and red-leaf lettuce) over iceberg lettuce, which is mostly water.

  • Unpasteurized Milk, Cheese and Fruit Juice

I mentioned at the beginning of this post that I refused to eat soft cheeses at the beginning of my pregnancy for fear that my baby would contract listeria. Pasteurized cheese, milk and fruit juice is perfectly safe during pregnancy – no matter how soft the cheese is. When pregnant you’ll want to avoid Brie, Camembert, Roquefort, Feta, Gorgonzola, Queso Blanco and Queso Fresco unless they clearly state that they are made from pasteurized milk. Similarly if you juice some apples at home and drink the juice immediately that juice is safe. When purchasing juice at the store or farmers market you will need to make sure it has been pasteurized before consuming safely.

*AlternativesAny cheese, milk or fruit juice that has been pasteurized

Check the back of your food labels. Any item that has been pasteurized will be clearly labeled on the back of the container.

  • Jerky-style Meat

Jerky-style meat, bacon or other smoked meats are only unsafe during pregnancy if they contain nitrates. Nitrates preserve meat from bacterial contamination. They also produce compounds when you eat them that are potentially very harmful to your unborn child. Specifically nitrates and nitrites stop hemoglobin from sending oxygen to your body – this is how your baby breathes inside your womb. Eating nitrate-rich foods during pregnancy can increase the risk of fetal abnormalities and birth complications.

Preserved meats typically have a very high salt content. You’ll want to limit your consumption of these meats during pregnancy because too much salt is unhealthy for you and your baby.

*Alternativesnitrate-free meats

Certain meats cannot be free of nitrates. Nitrate-free jerky is not common. However, you can purchase nitrate-free bacon, ham and hot dogs at many local grocery stores or butchers. Choose these healthier alternatives  during pregnancy for a healthy baby.

  • Processed Junk Foods

Most processed junk food is very low in nutrients, high in calories and high in refined sugars. This combination is bad for both you and your baby. The extra calorie content means you gain excess weight from junk foods. That extra weight does not come with extra nutrients – or even the essential nutrients – that your baby needs to grow strong. Eating large amounts of processed junk foods can lead to prenatal complications for expectant mothers. It can also increase the likelihood of obesity and diabetes in children after birth.

*Alternativesorganic raw produce, homemade desserts, fresh fruit

When a craving for sweets and carbs hits you during pregnancy choose fresh fruit, berries or homemade blueberry bran muffins. Try whole grain bagels with organic hummus spread. Drink honey in your tea instead of granulated sugar. By choosing natural, more organic foods over heavily refined, processed junk food you are setting yourself (and your baby) up for a healthy lifestyle.

  • Excessive Caffeine

Caffeine is easily absorbed into your bloodstream when you drink coffee, soda and tea. Dark chocolate also contains high amounts of caffeine. The substance passes very easily into the placenta and fetus. High concentrations of caffeine during pregnancy cause low birth weight babies. Babies exposed to concentrated caffeine are also under-sized throughout their lives.

*Alternativeslower amounts of caffeine, decaf coffee, herbal tea

Caffeine does not have to be cut out of your life entirely during pregnancy. It just has to be monitored and kept at low levels. Keep your coffee intake to a maximum of one 12-ounce coffee every day. One 12-ounce coffee, cappuccino, or iced coffee contains the recommended 200 mg of caffeine daily limit. You can also splurge on a dark chocolate bar (or two – darker chocolate is very healthy for your heart) and drink decaf coffee or soothing herbal teas instead of caffeine.

During my first trimester I avoided caffeine and drank chamomile, oatstraw and lemon balm tea instead. These teas helped to calm down my hormonal bursts of anxiety and nausea. I also ate small amounts of dark chocolate to help lift my mood if I was feeling down. Many women find that caffeine during the first and third trimesters is too much for their adjusting hormones to handle. Caffeine puts them on edge and makes mood swings much more intense.

  • Alcohol

There is no safe level of alcohol consumption that is recommended during pregnancy. Since it is unethical to test the effects of alcohol on pregnant women and fetuses there probably never will be a safe level of alcohol for pregnant women to consume. Alcohol is never beneficial for your baby. At best it can do no harm to your child. At worse, alcohol can lead to stillbirth, miscarriage and – if heavily abused – fetal alcohol syndrome.

*Alternativesuse extreme moderation or limit entirely for duration of pregnancy

I know no doctor that will recommend – or even condone – that their pregnant patients drink any amount of alcohol during pregnancy. Yet I know many women who have had “the occasional 2nd trimester beer” or “that birthday glass of wine”. I personally drank a glass of cider for my birthday.

Ultimately I believe that alcohol is a risky thing to regularly consume during your pregnancy. Even consuming a drink once-a-month during pregnancy is unsafe for your unborn child. As mothers we make sacrifices for our babies even before they’re born. How much of a sacrifice you choose to make is ultimately your decision.

Many indulgences during pregnancy are about risk versus reward. I personally don’t believe that having one small glass of alcohol to celebrate a special occasion during my pregnancy – considering I have a low risk, normal pregnancy – constitutes a big enough risk to my baby to be worried about it. I would not recommend this indulgence in the first trimester.

The choice is up to you and what you feel comfortable doing.

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