Safely Eating for Two

By Deborah Jeanne Sergeant

Amid the many changes a pregnant woman makes in her lifestyle to nurture and protect her baby, her diet can be among the most important. What a woman eats can directly affect the baby’s health, both positively and negatively.

April Ward, owner of Botanic-Her in Skaneateles, is a nationally board-certified nurse-midwife and state-licensed midwife. She said safe food handling can help prevent listeriosis, a bacterial infection caused by the bacterium Listeria monocytogenes.

The infection can cause miscarriage, stillbirth and premature delivery.

One surprise to many women is that deli slices of meat can cause problems because of the frequency of Listeria outbreaks with this type of food.

“Avoid eating deli meat exposed to open air or salads bars because of the risk of food borne illness which can harm the pregnancy,” she said.

While many sandwich shops lightly toast subs, Ward said that the meat must be heated to steaming hot to kill Listeria.

A juicy, grilled steak with a pink center may sound enticing, but it should be well done with a minimum internal temperature of 145 F. (Ground beef should be 160 F and poultry 165.)

She listed other foods frequently contaminated with Listeria. They include unwashed produce, soft cheeses and unpasteurized milk and other beverages.

“Be careful about Crock-Pots,” said Laurel Sterling, natural food educator and registered dietitian practicing in Canastota. “A friend of mine had food poisoning from eating food that wasn’t heated through.”

She warned about raw sushi or raw eggs for pregnant women. She added that pregnant women should make sure grilled meat is cooked all the way through.

Other picnics favorites can also cause problems.

“Foods should be kept either hot or cold,” Jane Burrell Uzcategui, registered dietitian and instructor of Nutrition, Public Health, Food Studies and Nutrition at Syracuse University’s Falk College. “There’s a two-hour period at room temperature. If it’s out longer, then bacteria start to grow exponentially. Bacteria likes time, temperature, and moisture.”

That’s why food left outside on a hot day is at higher risk of spoiling faster than food in an air conditioned environment.

Burrell Uzcategui also cautions pregnant women about caffeine.

“Research shows the higher caffeine intake increases risk of pregnancy loss, but that’s at high levels,” she said. “If a woman has 200 mg. a day, considered safe.”

Portion size matters. She added that for reference, the smallest size coffee offered by Starbucks is 180 mg.

Black tea is about 50 to 100 mg. per serving.

Kathryn Szklany, registered dietitian at St. Joseph’s Health, advises pregnant women to limit their consumption of large fish known to be contaminated with mercury, which can harm baby’s developing nervous system and brain. These include shark, swordfish, king mackerel, marlin, orange roughy, and tilefish.

“Some other types of fish can provide an array of nutrients that are important for your baby’s early development,” Szklany said. “Most experts agree that DHA and EPA are difficult to find in other foods.”

She listed fish considered safe to eat during pregnancy (2-3 4-oz. servings/week) include salmon, trout, anchovies, herring, sardines, haddock, flounder, and shad.

Szklany added that pregnant women must strictly avoid alcohol and tobacco products, as these cross through to the baby and cause abnormal development. Alcohol exposure can cause fetal alcohol syndrome or other problems.

What Should Women Eat While Pregnant?

• “Cultured foods like yogurt, sauerkraut and kefir helps improve good flora in the vaginal canal so it supports the baby’s immune system.

Laurel Sterling, natural health educator and a registered dietitian practicing in Canastota

• “In general, avoid highly processed foods with refined flours and sugar. They are empty calories. It’s best to get micronutrients from whole foods instead of supplements.
• “Water is really best as the main source of hydration. There’s really no place at all for soda, whether diet or full calorie. it’s worthless and possibly harmful.
• “Pregnant women don’t always grasp that 4 to 6 oz. of juice is okay, but it doesn’t deliver the fiber content of fresh fruits and vegetables. Coconut water is also a good choice as it’s a natural source of electrolytes.

April Ward, registered professional nurse, licensed midwife and owner of Botanic-Her in Skaneateles

• “Pregnant women need a balanced diet. This should include whole grains, fruits, vegetables, lean protein and low-fat or fat-free dairy. Healthful fats from foods such as avocados, nuts and seeds, as well as vegetable oils including canola and olive oil should be included in the diet.
• “Folic acid: Folic acid reduces the risk of birth defects that affect the spinal cord. All women of childbearing age and pregnant women should consume at least 400 micrograms of folic acid each day. Natural food sources of folate include legumes, green leafy vegetables and citrus fruits. Folate also can be obtained through fortified foods such as cereals, pastas and bread, as well as supplements.
• “Iron: Maternal iron deficiency is the most common nutritional deficiency during pregnancy. Pregnant women need at least 27 milligrams of iron each day. Foods with high and moderate amounts of iron include red meat, chicken and fish, fortified cereals, spinach, some leafy greens and beans.
For vegetarians and women who do not eat a lot of meat, increase iron absorption by combining plant-based sources of iron with vitamin C-rich foods. For example, try spinach salad with mandarin oranges or cereal with strawberries.
• “Calcium: During pregnancy, calcium is needed for the healthy development of a baby’s teeth, bones, heart, nerves and muscles. The recommended amount of calcium during pregnancy is 1,000 milligrams per day for women aged 19 to 50. That means at least three daily servings of calcium-rich foods such as low-fat or fat-free milk, yogurt or cheese, or calcium-fortified plant-based beverages, cereals and juices.

Kathryn Szklany, registered dietitian at St. Joseph’s Health

• “No extreme dieting if you’re trying to get pregnant or are pregnant.
• “During the first 13 weeks, there’s no need to eat more food. During the second trimester, then calories needs are 350 more daily. That means one additional serving from each food group, not go have a milkshake. During the last trimester, she should eat 450 additional calories to her pre-pregnancy calorie needs.”

Jane Burrell Uzcategui, registered dietitian and instructor of Nutrition, Public Health, Food Studies and Nutrition at Syracuse University’s Falk College.