Being pregnant in the 21st century is becoming increasingly complex. While their baby-boomer mothers simply carried on as normal during pregnancy, Generation X is struggling to remember all the items on the ever-increasing "do not eat" list. There is no question increased knowledge empowers women to make healthier, more informed choices that affect themselves and their child, but the growing list is a cause for consternation for many women.
In fact, if pregnant women heeded every snippet of dietary advice from well-meaning friends, family and health proponents holus-bolus, they would over-analyse the merits of everything they put in their mouth, says one of Australia's leading obstetricians, Dr Christine Tippett.
"I think there are many foods that women are told not to eat when there is very little evidence it is likely to cause a problem," says Dr Tippett, vice-president of the Royal Australian and New Zealand College of Obstetricians and Gynecologists (RANZCOG). "Pregnant women need to be reassured they can eat almost anything very safely."
This ever-increasing list of dietary do's and don'ts can actually be counterproductive, says Dr Tippett. "I am concerned that there are so many things we are telling pregnant women not to do that it gives the message that if they do all the right things, their baby will be perfect," she says. "But things can go wrong and it is extremely unlikely they did anything to cause it, yet these messages can make women feel it is their fault."
When we pare back the collection of dietary claims to just those important few that have been scientifically proven, the road to relaxed and healthy eating for two becomes much easier to navigate.
The lowdown on listeriosis
One of the main concerns for pregnant women is the bacteria that causes listeriosis. If contracted, listeriosis can cause premature delivery, miscarriage and severe illness or death of a newborn. But, as Dr Tippett points out, the risk of contracting the bacteria is incredibly low. A total of 34 to 71 cases were reported throughout Australia each year during the period of 1991 to 2001.
According to the National Institute for Health and Clinical Excellence (NICE) in the UK, high-risk foods are primarily ripened soft cheeses such as blue-veined cheese, brie and camembert, pate and foods made from non-pasteurised milk. Dr Tippett emphasises that while it's wise to avoid these foods, the risk of infection is actually very low and pregnant women shouldn't panic if they have eaten some.
Various public health groups in Australia and the US add everything from hot dogs, prepared chicken and rare steak to soft serve ice-creams, deli meats, most soft cheeses (pasteurised included) and smoked seafood to the "do not eat" list. Dr Tippett says, however, women shouldn't spend nine months worrying that everything they eat is putting their baby at risk of listeriosis. "We have very strict food handling regulations in Australia so if you are buying fresh food and packaged products within their use-by dates from reputable stores, the risk is incredibly low."
The facts on fish
While some pregnant women avoid fish altogether because of concerns about high levels of mercury (which can affect the unborn baby's nervous system), the fact is most fish is safe to eat. In fact, fish is a nutritious food high in protein and rich in important vitamins and minerals such as vitamin D, iodine and omega-3 fatty acids.
The few varieties that are higher in mercury are shark, swordfish, marlin, ray, gemfish, ling, barramundi and southern blue fin tuna. Food Standards Australia and New Zealand (FSANZ) recommends pregnant women limit their intake of these fish to no more than one serve per fortnight with no other fish consumed over that time. Sea perch and catfish should not be consumed more than once per week, with no other fish consumed during that time.
Will a cup coffee or a glass of wine hurt my baby?
There is no question that excess alcohol can have adverse effects on a foetus such as miscarriage, low birth weight, cognitive defects and congenital abnormalities, but the jury is still out on whether the occasional glass of wine is harmful. The Australian government's National Health and Research Medical Council (NHRMC) says that while the research is limited, current studies show one drink per day has no measurable impact on an unborn baby's development. However, it adds that because no-one knows for sure the effects of lower levels of drinking on an unborn child, some women prefer not have any alcohol.
The Flinders Reproductive Medicine group in South Australia recommends women have no more than two to three cups of coffee, tea or cola per day. Caffeine can cross the placenta and the developing baby cannot metabolise large amounts. Dr Tippett says that with alcohol and caffeine moderation is the key. "If you want to have a glass of wine occasionally enjoy it, but don't have more than two in one sitting. If you want a cup of coffee or tea then do so and enjoy it, but don't throw back six short blacks."
Do cravings mean I am lacking in vital nutrients?
No. Finding hard scientific evidence to back up this claim is difficult. Studies have shown that while cravings can be common, there is nothing to link them to a bodily need. A study published in the Indian Journal of Public Health in 1994 showed that the most common cravings were for sour food (65 percent), followed by meat and fish (47 percent), unripe fruits (40 percent) and ripe fruit (30 percent).
Dr Tippett says just because women like the taste or wellbeing effect of certain foods during pregnancy, she is unaware of any evidence that suggests cravings are the body's way of ensuring it gets nutrients that are lacking. "If you have a healthy, varied diet you are not likely to be suffering certain food deficiencies. You just need good food and throw a few treats into the mix," she says.
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