The second part of this blog deals with the substances that we should avoid during the nine months of pregnancy. If we get these out of the way, a relatively smooth pregnancy can be ensured. I shall try to list almost all the things you need to keep yourself away from in a normal pregnancy, however, if you have any health issues prior to the pregnancy or any problems in previous pregnancies, I would still recommend you taking up the issue with your obstetrician or dietitian.
Despite the fact that alcohol consumption is uncommon in the women of our society, it is still important to mention that it is one of the food items that must be completely avoided during all three trimesters. Alcohol consumption leads to fetal alcohol syndrome and fetal alcohol distress disorders. This includes restricted growth both before and after the birth of the infant along with congenital abnormalities, facial dysmorphia and neurodevelopmental delay.
Since smoking happens to be far more common than alcohol consumption and has significantly increased in younger women in the last few decades, it is important to discuss this in detail. Another factor that makes it important is the fact that quitting smoking is generally harder that altering other eating habits, especially when we take into account the passive smoke a woman may be exposed to.
While considering pregnancy, one might wonder when is the best time to quit smoking. Well, the answer to that is quite clear and exactly the one you must be thinking as well. Consider quitting before pregnancy, however, if due to certain reasons that has not been achieved, it is highly recommended that smoking be stopped during gestation. There adverse effects of smoking (active or passive) include risk for preterm births and miscarriages, early placental abruptions, low birth weight, congenital defects like eye defects, club foot and allergy and obesity. Maternal smoking has also been found to be a major factor in sudden infant death syndrome or crib deaths.
Tea, coffee, cola beverages and energy drinks are the items we consume without any thought and they are a part of the daily routine of most people. Apart from other constituents, all these are rich in a alkaloid commonly known as “caffeine”. Now caffeine is not really toxic like the substances I mentioned earlier and in order to understand why we need to limit the use of caffeine we need to understand its metabolism during pregnancy. To put it in simple words, during pregnancy the time that caffeine stays inside our blood is increased three to four fold as compared to its normal half life. Therefore, we need to limit the use caffeinated drinks. However, we are still allowed 200 milligram of caffeine intake every day which makes it approximately 3 of cups of coffee everyday. (depending upon the strength and the size of the cup) That is quite a considerable allowance for a pregnant woman and a breast feeding mother. However, if the intake of caffeine exceeds more than that there are certain adverse effects such as fetal growth retardation and fetus small for gestational age.
There are three important foodborne illnesses that can affect a pregnant woman. Next, I am going to discuss these three foodborne illnesses in detail emphasizing on the food items that need to be avoided in order to avoid these diseases.
Listeriosis is caused by a bacteria known as listeria monocytogenes. This disease can transmit from the mother to the unborn child and create problems like pre term labor, neonatal meningitis and even death. A study suggests that 20% of pregnancies infected by this bacteria result in spontaneous abortion or stillbirth. An important factor to remember here is that pregnant woman are more susceptible to the infection by this organism a compared to others. However, it is really simple to avoid this infection. Women should practice basic rules of hygiene, wash all fruits and vegetables thoroughly and completely abstain from half cooked meat products like salami, raw meat/ sausages, smoked fish, soft cheese and precooked or prepackaged salads.
Thankfully, pregnant women are not more susceptible to salmonella, however, it still is quite dangerous and can result in spontaneous abortions and complications like septic meningitis. Salmonella is found in foods of animal origins. So, pregnant women must avoid raw and uncooked meat and poultry foods at all costs. This includes undercooked or raw eggs. Women are mostly unaware of the products that may contain raw eggs, for example hollandaise sauce, mayonnaise, tiramisu, caeser salad dressing, home made ice cream, cookie dough and frostings.
Toxoplasmosis gondi, an intracellular parasite, happens to be the source of this infection which is carried by cats in their feces and carried in raw and uncooked meat. The infection is dangerous as it can lead to various congenital malformations especially cardiac abnormalities in the fetus. Hence, all pregnant women should practice strict hygiene around cats, cat litter should be disposed off daily within 24 hours and gloves should be used handling. The cat litter box should also be disinfected on a daily basis. Apart from this, freezing meat to -20 degree Celsius kills this parasite.
This was a brief summary of the food items that need to be avoided during gestational period. In my next blog, we will discuss about the adequate weight change during pregnancy and the proportion of foods that need to be increased during different trimesters.