Food Safety During Pregnancy Fact Sheet No. 9.372 Food and Nutrition Series|Food Safety by J. Dean and P. Kendall* Pregnancy is an exciting, yet critical to survive unfavorable conditions, Quick Facts time in a woman’s life. Because a mother’s including refrigeration temperatures, health behaviors have direct effects on food preservatives (salt), and conditions • During pregnancy, the health of her baby, expectant mothers with little or no oxygen. It is, however, changes in hormones receive a lot of health information. Along easily destroyed by cooking. cause a woman’s immune with nutrition concerns, a growing topic Infection from L. monocytogenes system to become of importance is food safety during typically occurs in individuals with a suppressed, so that pregnancy. Pregnant women are at weakened immune system, including it is harder to fight off increased risk for getting some foodborne pregnant women. There is an estimated infections. infections because of the hormonal 14-fold increase in the incidence of • Pregnant women are at changes that occur during pregnancy. listeriosis among pregnant women While such changes are necessary for compared to non-pregnant adults. increased risk for some survival of the fetus, they also suppress Pregnant women make up 17 percent types of food borne illness. the mother’s immune system, thereby of all cases of listeriosis. Once in the • Some food borne illnesses increasing the chance of infection from bloodstream, Listeria bacteria can travel certain foodborne pathogens. can cause a woman to any site, but seem to prefer the central to have a miscarriage, Examples of pathogens of special nervous system and the placenta. The stillbirth or serious health concern to pregnant women are Listeria fetus is unusually prone to infection monocytogenes, Toxoplasma gondii, from L. monocytogenes, which can lead problems for the baby after Brucella species, Salmonella species to a miscarriage, stillbirth, or infection birth. and Campylobacter jejuni. Certain of the neonate and health problems • Pathogens are organisms organisms can cross the placenta and following birth. (bacteria, virus, parasite) increase the fetus’s risk of becoming Gastrointestinal symptoms may that can cause illness in infected. Infection can result in appear within 2 to 3 days of exposure. humans. miscarriage, stillbirth, premature labor If the body does not clear itself of the or severe complications for the baby. pathogen and the infection becomes Certain organisms, including Listeria invasive, symptoms such as fever, chills, monocytogenes, Toxoplasma gondii, headache, muscle aches and back aches Salmonella typhi and Campylobacter may develop in 11 to 70 days after jejuni, can have adverse consequences for exposure. A blood test can determine the fetus if they cross the placenta. if symptoms are caused by Listeria infection and if confirmed, the patient can then be treated with antibiotics. Listeriosis Foods typically associated with Listeriosis is a form of infection that listeriosis include refrigerated ready-to- may result when foods containing the eat perishable foods with a long shelf life bacteria Listeria monocytogenes are that are eaten without further cooking. consumed. L. monocytogenes is widely Outbreaks have involved foods such as distributed in nature and is found in coleslaw, Mexican-style soft cheeses, soil, ground water, plants and animals. milk, pâté, pork tongue, cantaloupe, hot L. monocytogenes is often carried by dogs, processed meats and deli salads. © Colorado State University humans and animals, and has the ability Examples of foods that may harbor this Extension. 5/04. Revised 8/12. pathogen include unpasteurized milk, www.ext.colostate.edu *J. Dean, former graduate student, department of food science and human nutrition; P. Kendall, Colorado State University, associate dean for research, food science and human nutrition. 8/2012 raw milk products, raw and smoked not experience recognizable symptoms, seafood, and any refrigerated ready-to- and will develop a protective resistance eat processed foods, such as hot dogs, to the parasite. However, if a woman luncheon meats or deli meats, that have not previously exposed to T. gondii not been heated to proper temperatures first acquires the parasite a few months before serving. before or during pregnancy, she may To avoid infection from L. pass the organism to the fetus. This monocytogenes, pregnant women could result in stillbirth, early prenatal are advised to practice safe food death, or serious health problems for handling procedures, such as storing the baby after birth such as eye or brain all perishable foods between 35 and damage. Symptoms in the baby may 40 degrees F and using perishable not be visible at birth, but can appear are eaten. The bacteria are spread refrigerated ready-to-eat foods as soon months or even years later. through direct or indirect contact as possible. If a potentially hazardous If symptoms of infection with with the intestinal contents or waste perishable food cannot be eaten within T. gondii do appear in the pregnant of animals, including humans. It is four days, it is best to freeze or discard woman, they usually appear about estimated that 1.2 million cases of it. Kitchen surfaces, cutting boards and 10 days after exposure to the parasite salmonellosis occur each year in the utensils should be washed before and and include a low grade fever with United States. Salmonella bacteria after food preparation (especially after rash, muscle aches, headache and do not grow at refrigerator or freezer contact with raw meat or poultry). possibly swelling of the lymph nodes. temperatures and are easily destroyed Pregnant women are advised to avoid Infection may be confirmed by a by heating foods to 165 degrees F. eating soft cheeses made with raw milk blood test and treated with antibiotics. Symptoms of salmonellosis include (e.g., Feta, Brie, Camembert, blue- Prompt treatment of the mother with headache, diarrhea, abdominal pain, veined cheeses, queso fresco, queso antibiotics reduces the risk of passing nausea, chills, fever and vomiting; these blanco and Panela), unpasteurized the parasite to the fetus, but cannot usually appear within 12 to 72 hours milk and uncooked foods made with change the course of the disease once after eating the contaminated food. raw milk, raw or undercooked seafood, the fetus has been exposed. Foods most often involved include raw refrigerated smoked or precooked Toxoplasmosis most often results (unpasteurized) milk and raw milk seafood, deli seafood salads, and hot from eating raw or undercooked meat, products, raw or undercooked meat dogs, luncheon meats, deli meats eating unwashed fruits and vegetables, and poultry, raw or undercooked eggs, and pâté unless reheated to steaming cleaning a cat litter box or handling raw sprouts (alfalfa, clover, radish, hot before serving or reformulated to contaminated soil. broccoli), salads (including chicken, prevent Listeria. Leftover foods should tuna, potato), and cream desserts and be reheated to 165 degrees F before To avoid infection from T. gondii fillings. eating. it is important that pregnant women practice safe food handling procedures Pregnant women are not at an such as washing all surfaces, cutting increased risk for getting salmonellosis; Toxoplasmosis boards and utensils with hot, soapy however, one type of Salmonella water, especially those that come bacteria, called Salmonella typhi may be Toxoplasmosis, the infection caused in contact with raw meat. Pregnant passed to the fetus. S. typhi is rare in the by the parasite Toxoplasma gondii, can women should wash hands often, United States, but if transmitted to the be passed to humans by water, dust, especially after handling animals or fetus, can cause abortion, stillbirth or soil, or through eating contaminated working in the garden, avoid eating premature labor. foods. Cats are the main host for T. raw or undercooked meat (particularly To avoid infection from Salmonella gondii, and the only host where the mince meat, mutton and pork), and bacteria, pregnant women should parasite can complete its life cycle. T. if they own or take care of a cat, make follow general safe food handling gondii may be carried in the fur or feces sure the litter box is changed every practices, including washing hands of cats and then passed to other animals day, preferably by a friend or family often with hot, soapy water, especially and people. If an animal becomes member. after using the bathroom and before infected and its meat is then eaten raw and after handling food. Hands and or undercooked, the parasite is passed working surfaces should be thoroughly to the human or animal that consumes Salmonellosis washed after contact with raw meat, the meat. Salmonellosis is a common form fish, poultry, and foods that will not It is estimated that 1.5 million of food infection that may result when undergo further cooking. Fresh fruits people in the U.S. become infected with foods containing Salmonella bacteria and vegetables should be rinsed well T. gondii each year. Most individuals do before eating, and food such as raw abortion, stillbirth or preterm delivery. instructions on the package or milk and raw milk products, raw or Symptoms usually appear within 2 to 5 simmer for at least 5 minutes. undercooked eggs, raw sprouts, raw or days after eating the contaminated food • Heat lunch meats and deli meats undercooked meat and poultry, and and include fever, stomach cramps, to steaming hot before eating. This unpasteurized fruit juices should be muscle pain, diarrhea, nausea and includes packaged lunch meats and avoided. vomiting. Infection from C. jejuni may those purchased at the deli. You can be treated with antibiotics. use a microwave, oven or grill. If you C. jejuni is most often found in prefer lunch meats cold, they can Campylobacteriosis raw (unpasteurized) milk and raw be heated and then cooled before Consuming food or water that milk products, raw or undercooked eating. contains the bacteria Campylobacter meat and poultry, and raw shellfish. • Cook shellfish until the shell opens jejuni causes an infection called To avoid campylobacteriosis, pregnant and the flesh is fully cooked; cook campylobacteriosis. C. jejuni is found women are advised to consume only fish until flesh is firm and flakes in the intestinal tracts of animals pasteurized milk and milk products easily with a fork or to 145 degrees F. (especially chickens) and in untreated and to thoroughly cook meat, poultry water. It’s a very common cause of and shellfish. Hands, surfaces, cutting diarrhea accompanied by fever in the boards and utensils that come in Avoid Cross-Contamination United States. This organism thrives in contact with raw meat, poultry or • Wash knives, cutting boards and a reduced oxygen environment and is fish should be washed well with hot, food preparation areas with hot, inhibited by acid, salt and drying. C. soapy water. soapy water after touching raw jejuni also is easily destroyed by heat poultry, meat and seafood. (120 degrees F). • As an added precaution, sanitize Although pregnant women are not Preventing Foodborne cutting boards and countertops by at increased risk of becoming infected Illness During Pregnancy rinsing them in a solution made of with C. jejuni, if they do get sick, the Preventing foodborne illness is 1 tablespoon liquid chlorine bleach infection may spread to the placenta. always important, but is especially per gallon of water. Consequences of fetal infection include so during pregnancy when the • Wash hands with soap and warm consequences can adversely affect the running water after handling raw mother and the unborn child. Listed foods. below are key behaviors important in ) ensuring the safety of the food you eat. • Wash fresh produce well. Rinse fruits and vegetables, and scrub firm-skinned produce, under Practice Personal Hygiene ) running tap water, including those • Always wash hands well with soap with skins and rinds that are not ) 7XUNH\DQGFKLFNHQOHIWRYHUV and warm running water for at least eaten. Pat dry with paper towels. VWXIÀQJFDVVHUROHVKRWGRJV 20 seconds before handling food, DQGOXQFKPHDWV • Keep cooked and ready-to-eat foods after using the toilet, after changing separate from raw meat, poultry, ) *URXQGEHHIDQGSRUN a baby's diaper, and after touching seafood and their juices. *DPHPHDW animals. (JJGLVKHV Keep Foods at Safe Temperatures Cook Foods Safely • Store all perishable foods at or below ) %HHISRUNODPEDQGYHDOVWHDNV • Use a food thermometer to make FKRSVDQGURDVWV ZLWKPLQUHVW 40 degrees F. Use a refrigerator WLPHEHIRUHVHUYLQJ sure meat, poultry (including thermometer to make sure your ground meats) and eggs are cooked refrigerator is between 35 to 40 )LVK ÁDNHVZLWKDIRUN to safe endpoint temperatures. See degrees F. (JJV ÀUP\RONDQGZKLWH Figure 1. • Store eggs and other perishable • Use a thermometer to make sure foods in the refrigerator. Figure 1: Safe endpoint cooking leftovers are reheated to 165 temperatures. degrees F. • Use perishable foods that are precooked or ready-to-eat as soon as To test the temperature of food, insert • Always heat hot dogs to steaming possible. If the food cannot be eaten thermometer in the middle of the thickest hot before eating. Follow the part of the food you’re cooking and allow within 4 days, it is best to freeze or a few seconds for the thermometer to discard it. register. When testing the temperature of a hamburger, lift it out of the pan on a spatula and insert the thermometer from the side. Table 1. Use the following guide to help choose safe foods during pregnancy, while avoiding foods from unsafe sources.
Instead of… Choose Cold hot dogs, deli meats and luncheon Hot dogs, luncheon meats and deli meats reheated to steaming hot or 165F meats Raw or undercooked meat and poultry Fully cooked meat and poultry Raw or undercooked seafood Fully cooked seafood Refrigerated smoked fish and precooked Tuna, salmon and crab meat in cans or pouches seafood such as shrimp, crab and deli seafood salads Refrigerated pâtés and meat spreads Canned or shelf stable pâtés and meat spreads Raw sprouts and unwashed fruits or Cooked sprouts; Well washed fresh vegetables, including salads; Cooked vegetables, including lettuce/salads vegetables Soft cheeses made from raw milk such as Hard cheeses, processed cheeses, cream cheese, cottage cheese, mozzarella, and Feta, Brie, Camembert, blue-veined cheeses, soft cheeses made from pasteurized milk queso fresco, queso blanco and Panela Raw or undercooked eggs Eggs that are cooked until the white and yolk are firm Raw (unpasteurized) milk and milk products Pasteurized milk and milk products Unpasteurized juice (May be called “fresh Frozen concentrate, canned juices and refrigerated juices that are labeled as squeezed” or “chilled”) pasteurized
Avoid Foods from Unsafe Sources Smith J. L. 1999. Food borne Infections For additional safe food handling Because pregnant women are at high during Pregnancy. J. Food Protection. guidelines, please see Colorado risk for infection from the pathogens 62: 818-829. State University Extension discussed above, they are advised to Smith J. L. 1997. Long-Term avoid foods that may be contaminated fact sheet 9.300, Bacterial Consequences of Food- Foodborne Illness. with these harmful pathogens. See borne Toxoplasmosis: Table 1. Effects on the Unborn, the Immunocompromised, the Elderly, and the Immunocompetent. J. Food References Protection. 60:1595-1611. FSIS-USDA. 2010. Protect your Baby USDA/FDA. 2011. Food Safety and Yourself from Listeriosis. for Pregnant Women. http:// Available at: http://www.fsis.usda. www.fda.gov/downloads/Food/ gov/PDF/Protect_Your_Baby.pdf ResourcesForYou/Consumers/ Jackson, K.A., Iwamoto, M., Swerdlow, SelectedHealthTopics/UCM312787. D. 2010. Pregnancy-associated pdf listeriosis. Epidemiol. Infection. 138:1503-1509.
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