PREGNANCY AND AVOIDING FOOD RELATED ILLNESS (INCLUDING TOXOPLASMOSIS AND LISTERIOSIS)

Transcription

1 PREGNANCY AND AVOIDING FOOD RELATED ILLNESS (INCLUDING TOXOPLASMOSIS AND LISTERIOSIS) Information Leaflet Your Health. Our Priority.

2 Page 2 of 8 Healthy Eating For the healthy growth and development of your baby and to look after your own health, it is important you follow a healthy balanced diet. A balance diet includes a wide variety of foods. There are no foods that are banned, however, it is advised you consider the proportions of the different food groups in your diet overall, as the diagram below illustrates: You can see in the diagram above that the largest sections are the starchy carbohydrate foods (rice, pasta, bread, cereals, potatoes) and fruits and vegetables. These foods are relatively low in fat and calories but are rich in important nutrients. These should form the main part of each meal. The protein section (meat, fish etc) and dairy (milk, cheese, yoghurts etc) also provide important nutrients but should form a smaller part of the diet. If concerned about gaining too much weight, try to choose lean protein options e.g. chicken, turkey, fish and low fat dairy choices e.g. semiskimmed milk, diet yoghurts, reduced fat cheeses etc. You can see that the section with the high fat/high sugar foods form the smallest part in the diagram above. These have little nutritional value and should be included only as an occasional treat. The steps below will help you to get off to a good start. If you would like more detailed dietary advice, you may request a referral to the Dietician via your Consultant or GP.

3 Page 3 of 8 1. Eat regular meals based on starchy foods such as bread, pasta, potato, rice, cereals and chapatti 2. Enjoy plenty of fruits and vegetables every day Try to choose high fibre varieties of these foods, such as wholegrain bread and whole grain breakfast cereals Include fruit and/or vegetables at every meal All fruits are suitable, aim for 2-3 portions per day You could try fruit or raw vegetables as a snack between meals Limit fruit juice to one small glass per day and aim to take with a meal 3. Cut down on sugar Cut back on sugary foods such as sweet biscuits, cakes, sweets, Indian sweets and chocolate Use diet, sugar-free or low calorie squashes and fizzy drinks, as ordinary drinks can cause blood glucose levels to rise quickly Do not add sugar, honey, glucose or fructose powder to food or drinks 4. Take less fat Cut down your total fat intake (to help prevent excess weight gain) Aim to use less cooking oil, butter, margarine, fatty meats, lard and ghee Choose low/reduced fat dairy products Grill, boil, poach, steam or oven bake your food rather than frying or cooking with oils or other fats 5. Alcohol For the health of your baby it is best to avoid alcohol altogether 6. Use less salt Use less salt in your cooking and at the table Use less processed and tinned foods, aim to use fresh/whole foods when cooking. Vitamins and Minerals Eating a healthy, varied diet will help you get all the vitamins and minerals you need while you are pregnant. However, some are especially important. a. Iron During pregnancy, you will have a blood test to check your iron levels. If they are low, you will be advised by your Midwife / GP to take supplements. Low iron can mean you become anaemic and often make you feel very tired. Iron can be found naturally in lean red meat, green leafy vegetables, dried fruit and many breakfast cereals. b. Folic Acid Folic acid is important in pregnancy as it can reduce the risk of neural tube defects such as spina bifida. It is advised to take prior to getting pregnant and up to 12 weeks of pregnancy;

4 Page 4 of micrograms. Folic acid can be found naturally in green, leafy vegetables, fortified breakfast cereals and brown rice. See your GP for more information. c. Vitamin D Vitamin D is required to keep bones healthy by regulating the amount of calcium and phosphate in the body. Lack of Vitamin D can cause children s bones to soften and lead to a condition called rickets. The best source of Vitamin D is mainly through sunlight (approximately 90%), but it depends on the time of year, skin type, factor of suntan lotion used, hemisphere in which you live and clothing (i.e. covering of head and body). Vitamin D can be found in oily fish like sardines, fortified margarines and some breakfast cereals, but the amounts are small. It is advised that Vitamin D supplements; 10 micrograms, should be taken every day throughout the pregnancy. See your Midwife for more information. Caffeine High levels of caffeine can result in babies having a low birth weight. Too much can cause miscarriage. Caffeine is found naturally in lots of foods such as coffee, tea and chocolate and added to some soft drinks and energy drinks. You do not need to cut caffeine out completely, but you should limit how much you have to no more than 200mg a day. Don t worry if you do occasionally have more than this as the risks are quite small: E.g. 1 mug of instant coffee = 100mg 1 mug of filter coffee = 140mg 1 mug of tea = 75mg 1 can of cola = 40mg 1 x 50gm bar of chocolate = 50mg Fish in pregnancy You can eat most types of fish when you're pregnant. Eating fish is good for your health and the development of your baby. But you should avoid some types of fish and limit the amount you eat of some others. Fish to avoid: When you're pregnant or planning to get pregnant, you shouldn't eat shark, swordfish or marlin. Fish to restrict: You should also limit the amount of tuna you eat to: no more than two tuna steaks a week (about 140g cooked or 170g raw each), or four medium-sized cans of tuna a week (about 140g when drained) This is because tuna contains more mercury than other types of fish. The amount of mercury we get from food isn't harmful for most people, but if you take in high levels of mercury when you're pregnant, this could affect your baby's developing nervous system.

5 Page 5 of 8 When you're pregnant, you should also avoid having more than two portions of oily fish a week, such as salmon, trout, mackerel and herring, because it can contain pollutants such as dioxins and polychlorinated biphenyls (PCBs). Remember, fresh tuna is an oily fish, so if you eat two fresh tuna steaks in one week, you shouldn't eat any other oily fish that week. Tinned tuna doesn't count as oily fish, so you can eat this on top of the maximum of two portions of oily fish (as long as it's not fresh tuna or swordfish). But remember not to eat more than four medium-sized cans of tinned tuna a week when you're pregnant or trying to get pregnant. Fish that's safe to eat: There is no need to limit the amount of white fish and cooked shellfish you eat when you're pregnant or breastfeeding, apart from shark, swordfish and marlin. Shellfish in pregnancy Always eat cooked rather than raw shellfish (including mussels, lobster, crab, prawns, scallops and clams) when you're pregnant as they can contain harmful bacteria and viruses that can cause food poisoning. Cold pre-cooked prawns are fine. Smoked fish in pregnancy is safe Smoked fish, which includes smoked salmon and smoked trout, is considered safe to eat in pregnancy. Sushi and pregnancy It's fine to eat raw or lightly cooked fish in dishes such as sushi when you're pregnant as long as any raw wild fish used to make it has been frozen first. This is because occasionally wild fish contains small parasitic worms that could make you ill. Freezing kills the worms and makes raw fish safe to eat. Cooking will also kill them. Certain farmed fish destined to be eaten raw in dishes like sushi, such as farmed salmon, no longer need to be frozen beforehand. This is because farmed fish are very unlikely to contain parasitic worms because of the rearing methods used. If you're unsure, contact the Food Standards Agency (FSA) for advice. Lots of the sushi sold in shops is not made at the shop. This type of sushi should be fine to eat if a shop or restaurant buys in ready-made sushi, the raw fish used to make it will have been subject to an appropriate freezing treatment. If you're in any doubt, you might want to avoid eating the kinds of sushi that contain raw fish such as tuna. The safest way to enjoy sushi is to choose the fully cooked or vegetarian varieties, which can include: cooked seafood for example, fully cooked eel (unagi) or shrimp (ebi) vegetables for example, cucumber (kappa) maki avocado for example, California roll fully cooked egg

6 Page 6 of 8 If a shop or restaurant makes its own sushi on the premises, it must still be frozen first before being served. If you're concerned, ask the staff. If you make your own sushi at home, freeze the fish for at least four days before using it. (Reference: NHS Choices- Your Health, Your Choices, Gov Uk, January 2013) Avoiding Food-Related Illness in Pregnancy As you may be aware, there are two rare infections (Toxoplasmosis and Listeriosis) which are of importance particularly during pregnancy, because if the mother is affected, her unborn baby may be harmed. The good news is that there are things you can do to avoid exposing yourself to this risk. Toxoplasmosis may be caught from cat and dog droppings and urine, home grown vegetables that may have been contaminated by cats and dogs, raw or undercooked meat and milk or milk products that have not been pasteurised. Listeriosis is a form of food poisoning most commonly acquired by eating deli-counter products and ready-to-eat products such as soft cheeses, pâtés, cold meats, hot-dogs, pre-prepared salads and other ready to eat meals that don t need cooking prior to eating. AVOID the following: Raw eggs, soft boiled / poached eggs and dishes containing raw egg, including home-made mayonnaise Ready-prepared meals that don t need further cooking such as ready-prepared salads Pâté, deli-counter meats Unpasteurised milk Soft cheeses that have not been pasteurised e.g. Brie, Camembert and blue vein types Some other advice: Cook meat and poultry thoroughly After handling raw meat, always wash your hands Wash kitchen utensils and work surfaces thoroughly after contact with raw meat. Do not use them for any other food preparation before they are washed. Store raw meat at the bottom of your fridge Check your fridge temperature Observe standing times after microwave cooking Wash fruit, vegetables and salads thoroughly General advice to avoid Toxoplasmosis Wear rubber gloves when gardening Wash and store pet bowls separately from your own china

7 Page 7 of 8 Avoid handling of cat litter. If unavoidable, wear rubber gloves and afterwards wash your hands. Disinfect cat litter trays daily by rinsing out with hot soapy water, then disinfect. Do this outside over a drain, wear rubber gloves and afterwards wash your hands. Other advice to protect your baby Avoid liver and vitamin supplements containing Vitamin A Avoid drinking alcohol during pregnancy PLEASE DO NOT WORRY ABOUT ALL THIS. THE VAST MAJORITY OF BABIES ARE BORN PERFECTLY HEALTHY. Contact us Need extra information, support or advice? Contact a Supervisor of Midwives by ringing the main switchboard at Stepping Hill Hospital: A Supervisor of Midwives is available 24 hours a day. Supervisors are concerned with ensuring the safety and well-being of mother and baby and with the provision of high quality midwifery care.

8 Page 8 of 8 If you would like this leaflet in a different format, for example, in large print, or on audiotape, or for people with learning disabilities, please contact: Patient and Customer Services, Poplar Suite, Stepping Hill Hospital. Tel: Information Leaflet. PCS@stockport.nhs.uk. Our smoke free policy Smoking is not allowed anywhere on our sites. Please read our leaflet 'Policy on Smoke Free NHS Premises' to find out more. Leaflet number MAT169 Publication date September 2014 Review date September 2017 Department Maternity Location Stepping Hill Hospital