Wednesday 17 January 2018

I can't eat that -- I'm pregnant!

Model Ruth Griffin is expecting her first child this month.
Model Ruth Griffin is expecting her first child this month.

Most women expect their lifestyle to change a little when they get pregnant: the late boozy nights will come to an end and they might try following a healthier diet.

But would you expect to find yourself fretting over whether to eat a ham sandwich or an extra helping of spinach?

With one report after another indicating the myriad substances that could be harmful to an unborn baby's health, pregnant women are faced with an ever-growing list of 'steer-clear' items that can be hard for them to stomach.

"In my first pregnancy I read an awful lot about what foods could potentially be harmful and avoided everything that carried a risk," says Andrea who is now pregnant with her second child.

"I stopped eating all nuts -- including any cereals that could contain traces of nuts. I also avoided things like shellfish and pate which I believed had a high risk of listeria. Now, on my second pregnancy, the restrictions seem to be even worse.

"People are saying you shouldn't eat any deli meats, pre-cooked chickens, mayonnaise, pre-packed salads and sandwiches or even tuna. It's just too much for me this time around.

"It's gotten to the stage that I've stood in the shop at lunchtime and actually can't have anything for lunch -- so I've ended up having a crisp sandwich!"

It wasn't just her diet that Andrea changed.

"I had a crick in my neck and couldn't take any painkillers, so I went into a chemist to get a herbal heat pack. But I was told I couldn't even use that as it contained lavender scent!

"Some people say things like hair dye or fake tan can be absorbed into the blood-stream so I even bought organic hair-dye in the health shop. I'd love to know how true half of these 'surveys' that say to avoid all these things are!"

Dr Peter Boylan is a Consultant Obstetrician at Holles Street Hospital and says much of the advice circulating isn't true at all.

He was so inundated with stories like Andrea's that he wrote The Irish Pregnancy Book in a bid to clear up some of the misinformation.

"There are some women out there who are terrified and are worrying unnecessarily, who think that they can't dye their hair or sleep on their back or have sex or eat peanuts or drink coffee.

"That information is wrong, and I wrote the book in order to reassure mothers and give them the information they do need. There's a subtle message out there that if you don't follow all the advice out there then things will go wrong with your baby, and that is utter nonsense."

It's not just food and beauty products that panic pregnant women -- alcohol too is a source of much anxiety. The government has already indicated their intention to put a label on alcohol pointing out its dangers to pregnant women, but many complain that this measure is ill-advised.

"I don't believe putting a label on a bottle of alcohol will work," says Jene Kelly, a spokesperson for the Association for Improvements in the Maternity Services (AIMS).

"The research on alcohol in pregnancy is all over the shop, and different caregivers give contradictory advice.

"On the one hand there will be a line on a bottle saying any alcohol is bad, and on the other hand a doctor will tell you that a small glass with your dinner is okay, or the midwife may tell you that some wine in late pregnancy will help you relax.

"It is not a black and white area and women can get quite hostile about being told that even a drop of alcohol is a bad thing, when that is not necessarily the case.

"A line on a bottle is just scaremongering and doesn't address the issue. What is needed is comprehensive information -- a booklet or a discussion with your caregiver -- so that you have all the information and can make an informed decision."

Dr Boylan agrees and cautions against vilifying women for drinking a small amount of alcohol.

"I think the label on alcohol bottles is probably unnecessary. Everyone knows by now that large amounts of alcohol throughout pregnancy are dangerous.

"But there is no evidence to say that a small amount of alcohol does any harm to the baby in the long run.

"If a mother wants to have a small glass of wine with her dinner in the evening I don't see any problem with that and don't think a woman should feel guilty about it.

"We're becoming very Americanised, so in a few more years I'll probably be shot for saying it, but you're not a bad person for having one glass of wine."

Ironically, all the misinformation circulating makes it more difficult for pregnant women to follow the information that really matters.

AIMS says that many women don't receive any medical advice on nutrition until their first hospital appointment, which can be as late as eighteen weeks.

In the interim, many women are relying on hearsay and half-truths instead of proper medical advice.

Dr Paul McKeown from the Health Protection Surveillance Centre (HPSC) says pregnant women are growing confused and frustrated about antenatal nutrition.

"There is an information overload and pregnant women are the victims.

"Scientists put out studies all the time and the media are more than willing to broadcast them, so you are constantly being clobbered by information.

"I can fully understand why well-educated women are throwing up their hands and saying "for God's sake, will they ever make up their minds".

The important messages that women do need to hear during pregnancy are getting lost in all the confusion, with distressing results.

Pregnant women are advised to avoid foods that carry a high risk of listeria, yet the cases of pregnancy-related listeria are actually on the increase in Ireland: from zero in 2005 to nine in 2007.

In a bid to clear up some of the confusion, the HPSC and Safefood have published an information leaflet about listeria for pregnant women.

"Many women don't realise that when you are pregnant you are more susceptible to listeria," says Dr McKeown. "While it mightn't harm you, it might harm your baby. Lots of foods such as mayonnaise and deli meats can carry low levels of listeria, although the likelihood of getting a full-blown infection from eating them is low.

"There's a much higher risk with foods like mould-ripened cheese and pates.

"Really it's about shades of grey: when you are pregnant and choosing what to eat you should choose the lightest shade of grey possible in the circumstances while still living your life.

'I n Andrea's case, yes, a pregnant woman can eat a ham or chicken sandwich, and once mayonnaise is fresh it should be fine.

"The other advice is: adhere to use-by dates, thoroughly cook all foods, avoid high-risk foods like unpasteurised milk products, soft and mould-ripened cheeses, raw meats, pates, and smoked fish.

"To avoid other infections, it's also important to wash your hands well if you've been in the garden or in contact with cats, and to wash fruit, vegetables and chopping boards thoroughly."

Dr Boylan advises that moderation and common sense are the most important things to remember.

Unless you're eating your vitamin A face cream or drinking more tea than China can produce you're highly unlikely to do your child any harm.

"The incidence of things going wrong because of something you ate is very small", says Dr Boylan.

"Even if things do go wrong there may be nothing a woman could have reasonably done to avoid that.

"I think there's a huge overreaction out there to what a mother does during pregnancy, and a tendency to attribute problems in children to what a mother did during pregnancy, which is grossly unfair to the mother and doesn't take account of the environment the child is brought up in."

The Irish Pregnancy Book: A Guide for Expectant Mothers by Peter Boylan and Laura George (A.& A.Farmar) stg£11

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