Tag Archives: Pregnant

Setting Boundaries: Pets and your newborn baby

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My ex mother-in-law once told me that if I had a baby I would have to get rid of my cats. I replied, “No cats, no baby.” My step-brother’s cats mysteriously disappeared once his firstborn was old enough to crawl. Doug and I have two cats and two dogs and no intention of giving them up or sending them outdoors once the baby arrives. Sure, there’s dog hair all over the floors and it’s going to be a hassle learning to manage new and old responsibilities – and much more difficult to keep pet hair out of the baby’s mouth once she’s mobile. But we committed to the pets long ago and have been working on teaching them their order in the home.

The Dog Whisperer, Cesar Millan, recommends that the dogs not even be allowed near the baby’s belongings at first to teach them that Baby is Alpha. Let them sniff at a distance until they know their place. When the dogs go for a walk, it should be behind the stroller, and they shouldn’t get unsupervised visitation, if they are allowed at all, in the baby’s room. It’s all about setting boundaries.

The Worms and Germs Blog by Doug’s ex-hockey buddy Scott Weese (he’s still a buddy but no hockey for Doug in Manhattan) recommends in “Old pet, new baby…new problems?” that we visit our veterinarian and the humane society to get advice on introducing the dogs and cats to the baby. Scott provides relevant downloadable pamphlets from the Calgary Humane Society in his blog post.
We want all four pets and the three of us to survive the transition without nips, scratches, or territory marking. We get enough of that from our friends and colleagues.

Food safety in pregnancy is not simple

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Yesterday I enjoyed an aperitif at Houlihan’s with my friend Angélique. Although the conversation was excellent, ordering was complicated for me. I wasn’t supposed to eat at least half of the items offered, and another third of them didn’t sound good to me.

Pregnancy food safety guidelines combined with changing tastes and sensitivity to smells make ordering very difficult. On our trip home from Australia on Sunday, for example, I wanted to grab a sandwich at LAX, and because we were at a deli, that left only one choice for me: a chicken Panini. Everything else had unheated deli meat – known to put me at risk for listeria.

At Houlihan’s, I used to enjoy the tuna wontons, but the tuna is only seared and I don’t trust raw fish right now. I couldn’t eat the very appetizing brie starter because the waitress didn’t think it was heated, and the bruschetta that we did share was a big question mark for me. It had goat’s cheese together with the tomato mix. We now know that tomatoes are all supposedly safe from Salmonella, but how safe was the cheese? I take at least a little comfort in knowing that I’ve been fully vaccinated against Hepatitis A thanks to my past wild travels. Angélique and I also shared a spinach and artichoke dip that came with fresh cilantro and scallions sprinkled all over the chips. I grow my own cilantro at home and know how hard it is to keep it clean and out of the snails’ reach …

Finally, very hungry, I just ate and tried to ignore the smaller risk factors. I did my best but I still didn’t feel confident that my food was safe. Who knows or can control what was happening in the kitchen?

For those who want to tell me, and every pregnant woman, how simple it is to eat safely during pregnancy, I beg to differ. See “Listeria warning for pregnant women” for example. Dr. Paul McKeown says, “Simple measures such as ensuring that the fridge is in good working order with the temperature between two and five degrees Celsius, eating food that is well within its use-by date so that harmful bugs will not have had time to grow and practising good general food hygiene will reduce the risk of listeriosis.”

We, as consumers, can reduce some of the risks but we cannot eliminate them. And I find that the more I know about food safety, the more complicated all of this becomes. When you’re hungry and the airline offers you a roll with cheddar and pastrami … and you ask your food safety expert partner, “if I pick off the pastrami, is the sandwich safe to eat and how much cross contamination might have taken place?” and he shrugs … sometimes you have to decide for yourself.

How to cook hamburger – more from France

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A correspondent in France has provided a July 2, 2008, document published by the French Ministry of Agriculture regarding meat food safety.

From cooking ”a hamburger to the center” (page 21) to “well-cooked” (page 12), the document is short on specifics, and absolutely wrong when speaking to an audience I particularly care about these days – pregnant women.

“For sensitive consumers (pregnant women, children, the elderly…) eat any meat (beef, poultry, pork) “well done” (that is to say at 65°C = disappearance of pink color), and avoid the consumption of raw meat, of some cold cuts (charcuterie) or tripe product.” (p. 15)

The temperature – 65 C or 149 F – is too low for any ground meat or poultry, and simply does not equal the disappearance of pink.

Color is a lousy indicator of doneness. So is well-cooked, cooked to the center, and, as the Brits prefer, piping hot. Use a tip-sensitive digital thermometer. And stick it in.

Pregnant women should eat lots of fish low in mercury

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Knowing what to eat when pregnant can be tough. Like any other area of food safety, different governments and experts often make different recommendations. This can lead to confusion. I got a PhD in food science and struggle with this stuff all the time.

So here goes.

Dr. Emily Oken of Harvard Medical School in Boston and her colleagues reported in the May 15 issue of the American Journal of Epidemiology that three-year-olds whose mothers ate more fish while pregnant with them score better on several tests of cognitive function than their peers whose mothers avoided seafood.

However, the researchers also found that the amount of mercury in a woman’s body rose with the amount of fish she had consumed — and that children exposed to more mercury performed worse on these tests. Based on the findings, they say, it’s possible fish could have even greater brain benefits for babies if mothers-to-be consumed seafood with lower mercury levels.

The authors wrote,

"Recommendations for fish consumption during pregnancy should take into account the nutritional benefits of fish as well as the potential harms from mercury exposure. …  Maternal consumption of fish lower in mercury and reduced environmental mercury contamination would allow for stronger benefits of fish intake."

My take is — and I know more about bugs than I do about chemicals — pregnant women should eat plenty of fish that is low in mercury. The U.S. Food and Drug Administration issued some decent advice in 2004, and has tables of fish lower in mercury. The Australian New South Wales Food Authority also has a decent overview.

The FDA says:

• do not eat Shark, Swordfish, King Mackerel, or Tilefish because they contain high levels of mercury;

• eat up to 12 ounces (2 average meals) a week of a variety of fish and shellfish that are lower in mercury; and,

• five of the most commonly eaten fish that are low in mercury are shrimp, canned light tuna, salmon, pollock, and catfish.

Deli meats sliced at the deli counter should be consumed within 2 days

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The grocery store is my laboratory — or at least part of it.

I often find myself loitering around the deli counter, watching people order pound after pound of sliced roast beef or shaved turkey breast.

At one point a few years ago, I began chatting with one of the customers and politely commented that was a lot of deli meat she was ordering (really, there was a polite context).

She replied it was sandwiches for the kids for the next two weeks.

Uugh.

Yesterday, the Liverpool Daily Post reported U.K. environmental health officers from 42 local authorities purchased 1,127 samples of sliced-at-the-counter cooked meats from food retailers including butchers, delicatessens, market stalls and supermarkets.

Laboratory tests found that 15 per cent of the samples were contaminated with low numbers of listeria on the day of purchase, while 7.3 per cent were contaminated with Listeria monocytogenes, the more serious form of listeria.

Although these were within European Food Safety Standards, when the contaminated samples were tested again after storage for 48 hours in a refrigerator, the L. monocytogenes in some of the contaminated samples had multiplied to unsafe levels.

The tests were carried out at a fridge temperature of six degrees centigrade. However, many domestic fridges are warmer than this, allowing L. monocytogenes to grow faster.

Hugh Lamont, communications manager for the Health Protection Agency North West, said

“We are anxious to ensure that we do not create a scare around freshly sliced cooked meats. We are not saying that people should not buy or eat them, but rather that they should follow ‘use by’ advice where it is given – and consume the products within 48 hours where it is not. We are also reminding food retailers of the advice they should give to customers.”

The U.S. Centers for Disease Control recommendations for persons at high risk from listeria, such as pregnant women and persons with weakened immune systems, includes:

-Do not eat hot dogs, luncheon meats, or deli meats, unless they are reheated until steaming hot

-Avoid getting fluid from hot dog packages on other foods, utensils, and food preparation surfaces, and wash hands after handling hot dogs, luncheon meats, and deli meats

-Do not eat soft cheeses such as feta, Brie, and Camembert, blue-veined cheeses, or Mexican-style cheeses such as queso blanco, queso fresco, and Panela, unless they have labels that clearly state they are made from pastuerized milk

-Do not eat refrigerated pâtés or meat spreads. Canned or shelf-stable pâtés and meat spreads may be eaten

-Do not eat refrigerated smoked seafood, unless it is contained in a cooked dish, such as a casserole. Refrigerated smoked seafood, such as salmon, trout, whitefish, cod, tuna or mackerel, is most often labeled as "nova-style," "lox," "kippered," "smoked," or "jerky." The fish is found in the refrigerator section or sold at deli counters of grocery stores and delicatessens. Canned or shelf-stable smoked seafood may be eaten.

The USDA risk assessment for listeria is ready-to-eat foods is available at
http://www.fsis.usda.gov/OPPDE/rdad/FRPubs/97-013F/ListeriaReport.pdf

and one from the World Health Organization is at
http://www.who.int/foodsafety/publications/micro/mra_listeria/en/index.html

Sources of listeria contamination for soft-serve ice cream machines

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After an 18-hour drive to Guelph with Amy and a Russian borzoi , I discovered the potential risks of soft-serve ice cream and the Baskin Robbin’s pregnancy promo has become an Internet sensation.

Celebrity blog TMZ.com reported that several sources in the know — including one pregnant OB/GYN — tell TMZ that there are "definite" health risks associated with soft-serve ice cream for expectant moms because of Listeria bacteria. Softie machines can be studded with bacteria that can cause all kinds of issues for newborns — in fact, Down Under, it’s pretty much forbidden for preggo women.

Baskin Robbin’s told TMZ in a statement,

"Our Soft Serve products are continuously monitored by our suppliers, and our pasteurization process is state inspected and certified on a regular basis. The only way Listeria, which has been found in a variety of raw foods, can be found in soft serve would be through improper pasteurization."

Not quite sure about that one. But we’ll do some more digging.

Healthinspections.com also picked up on the story, and said they had discovered dirty-machine problems in reviewing health inspection reports for soft serve ice cream shops in past years.

Four people had pregnancy complications after getting Listeria

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The North Carolina Division of Public Health is warning pregnant women about the consumption of soft cheeses, hot dogs and deli-style meats and prepared salads after three cases of listeriosis were identified in Moore, Durham and Mecklenburg counties and a probable case was identified in Buncombe County.

The story says that two of the pregnant women miscarried after they contracted the infection. In a third case, the pregnant mom delivered early, but she and her baby are doing well. The probable case involves another pregnant woman who also lost her baby. All four had consumed soft cheeses from a variety of sources.

State Epidemiologist Dr. Jeff Engel said, "This is a tragedy, which could have been avoided. Listeriosis can be prevented by avoiding unpasteurized milk and other potentially contaminated food, especially among vulnerable people."

State Laboratory of Public Health testing showed different strains of the bacteria were involved and that one product doesn’t seem to be the blame, and that’s why public health officials issued a general Listeria warning.

Norwegian hospital liable for listeria deaths

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The Rikshospitalet University Hospital must take responsibility for the death of a pair of unborn twins after their mother ate a soft cheese at Rikshospitalet University Hospital.

Food Safety Authority section leader Christoffer Nilsen told the newspaper Nationen that the hospital has the responsibility for food safety for everything they serve, and that such cheeses should not be given to pregnant women because of the risk of listeria.

"Therefore this is a serious breach of the rules which the managing director of the hospital must take responsibility for."

Rikshospitalet University Hospital strategy director Stein Vaaler was cited as saying that the FSA has been sent a report about the listeria outbreak but would not comment on the statements by the Food Safety Authority.

Hospitals should know better, but it is well documented that many pregnant women are not told about such food safety risks by their doctors.

The U.S. Centers for Disease Control recommendations for persons at high risk, such as pregnant women and persons with weakened immune systems, includes:

-Do not eat hot dogs, luncheon meats, or deli meats, unless they are reheated until steaming hot

-Avoid getting fluid from hot dog packages on other foods, utensils, and food preparation surfaces, and wash hands after handling hot dogs, luncheon meats, and deli meats

-Do not eat soft cheeses such as feta, Brie, and Camembert, blue-veined cheeses, or Mexican-style cheeses such as queso blanco, queso fresco, and Panela, unless they have labels that clearly state they are made from pastuerized milk

-Do not eat refrigerated pâtés or meat spreads. Canned or shelf-stable pâtés and meat spreads may be eaten

-Do not eat refrigerated smoked seafood, unless it is contained in a cooked dish, such as a casserole. Refrigerated smoked seafood, such as salmon, trout, whitefish, cod, tuna or mackerel, is most often labeled as "nova-style," "lox," "kippered," "smoked," or "jerky." The fish is found in the refrigerator section or sold at deli counters of grocery stores and delicatessens. Canned or shelf-stable smoked seafood may be eaten.

The USDA risk assessment for listeria is ready-to-eat foods is available here

http://www.fsis.usda.gov/OPPDE/rdad/FRPubs/97-013F/ListeriaReport.pdf

and one from the World Health Organization is here

http://www.who.int/foodsafety/publications/micro/mra_listeria/en/index.html

Scientist says listeria caused by consumer mishandling; company recalls dip anyway

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In response to a recent University of Wollongong study which found that 57 per cent of the pregnant Australian woman surveyed were not aware of foods they should avoid to prevent listeriosis, Food Standards Australia New Zealand’s (FSANZ) Chief Medical Advisor, Dr Bob Boyd, said,

"listeriosis is usually caused by people at risk eating food that has not been stored or handled properly once the food has been produced or cooked.

"Listeria bacteria are found widely in nature and may be present in pre-prepared uncooked foods or pre-cooked foods which have been kept for some time after they have cooled down.

"If you or anyone in your household is pregnant, immuno-compromised or elderly, it is important you reduce your risk by taking a few simple precautions. For example: by eating only freshly prepared and well-washed food, following good food hygiene practice such as washing and drying hands, by cooking foods thoroughly, and by refrigerating leftovers immediately and keeping them no more than a day. …

"I would like to remind health professionals of the dangers of Listeria and to make sure they have supplies of the FSANZ brochure on Listeria."

OzFoodNet data show that during 2006 in Australia there were eight Listeria infections in pregnant women with two deaths out of the eight babies and that there were 51 Listeria infections in the elderly or immuno-compromised with 7 deaths.

This is a serious issue, one that Christina and JLo, above, should know about, but pointing to a brochure is not enough. Information on any food safety issue needs to be rapid, reliable, relevant and repeated.

About the same time as Dr. Boyd’s comments, Coles Group Supermarkets voluntarily recalled You’ll Love Coles basil pesto dip (150g) from all Coles, Bi-Lo and Pick and Pay stores across Australia after testing by the manufacturer revealed the possible presence of Listeria monocytogenes.

Customers are encouraged to check in their homes to ensure they do not have any of the affected product. Customers should return any affected product to their nearest Coles, Bi-Lo and Pick and Pay store for a full refund.

A quick check of the CSPI outbreak database reveals that many listeria outbreaks happened at point of sale. It’s a processing issue; yes, consumer storage can contribute to the problem, bt in the absence of data — none was presented by Dr. Boyd — why taint a good message with a dubious claim about how listeria is primarily the consumer’s fault?

Pregnant women not receiving food safety info

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Researchers report in the latest Australian and New Zealand Journal of Health that in a survey of 586 women attending antenatal clinics in one private and two major public hospitals in New South Wales between April and November 2006, more than half received no information on preventing Listeria.

It’s long been government advice that pregnant women should avoid soft cheeses, smallgoods, raw seafood and pre-prepared vegetable salads such as coleslaw because of their potential to contain the bacteria Listeria monocytogenes.

Listeria can produce a toxin that crosses the placenta and can cause miscarriages.

Lead researcher Dolly Bondarianzadeh, from the University of Wollongong’s School of Health Sciences, said,

"In my experience, food was not high on the list of health risk topics for doctors, nurses and midwives to discuss with clients. Our results show that when it comes to food, women who have enough information and knowledge from a trusted source change their eating behaviour."

"Health professionals who deal with pregnant women should all be raising the importance of educating women about food safety in pregnancy."

The U.S. Centers for Disease Control recommendations for persons at high risk, such as pregnant women and persons with weakened immune systems, includes:

-Do not eat hot dogs, luncheon meats, or deli meats, unless they are reheated until steaming hot.
-Avoid getting fluid from hot dog packages on other foods, utensils, and food preparation surfaces, and wash hands after handling hot dogs, luncheon meats, and deli meats.
-Do not eat soft cheeses such as feta, Brie, and Camembert, blue-veined cheeses, or Mexican-style cheeses such as queso blanco, queso fresco, and Panela, unless they have labels that clearly state they are made from pastuerized milk.
-Do not eat refrigerated pâtés or meat spreads. Canned or shelf-stable pâtés and meat spreads may be eaten.
-Do not eat refrigerated smoked seafood, unless it is contained in a cooked dish, such as a casserole. Refrigerated smoked seafood, such as salmon, trout, whitefish, cod, tuna or mackerel, is most often labeled as "nova-style," "lox," "kippered," "smoked," or "jerky." The fish is found in the refrigerator section or sold at deli counters of grocery stores and delicatessens. Canned or shelf-stable smoked seafood may be eaten.

The USDA risk assessment for listeria is ready-to-eat foods is available here

http://www.fsis.usda.gov/OPPDE/rdad/FRPubs/97-013F/ListeriaReport.pdf

and one from the World Health Organization is here.

http://www.who.int/foodsafety/publications/micro/mra_listeria/en/index.html