This summer, when we learned that my wife was pregnant, our first reaction was jubilation. But soon after, we began to worry about what she should—and shouldn’t—be eating and drinking to make our kiddo grow big and strong. To help my wife (and you) decide whether it’s worthwhile to give up a favorite food, I consulted the conventional wisdom, considered economist Emily Oster’s book Expecting Better: Why the Conventional Pregnancy Wisdom Is Wrong—and What You Really Need to Know, and solicited advice from SLUCare obstetrician Greg Ward. Though the sources didn’t always agree, they provided crucial information for making informed choices.
Sushi
Conventional Wisdom: Don’t eat it.
Oster’s Take: Raw fish can cause foodborne illness, but while salmonella is no fun, “illnesses from these causes are not especially more likely during pregnancy, nor do they typically directly affect the fetus.” Exercise normal caution when eating sushi. Don’t buy it from a gas station.
Ward’s Advice: “You should avoid sushi during pregnancy. With salmonella, you can get severe dehydration, from the diarrhea, which isn’t good for you even when you’re not pregnant. It’s much easier to become dehydrated when you are pregnant.”
Rare Steak
Conventional Wisdom: Don’t eat it.
Oster’s Take: Seriously, don’t eat it. Undercooked meats pose the risk of toxoplasmosis, which is caused by a parasite. (The risk of toxoplasmosis is also the reason you’re not supposed to clean the litter box while pregnant.) “The complications of congenital toxoplasmosis include mental retardation, blindness, and epilepsy.”
Ward’s Advice: “You should avoid raw or undercooked meat at any time but especially when you’re pregnant.”
Deli Meats
Conventional Wisdom: Don’t eat it.
Oster’s Take: “Listeria in pregnancy is very dangerous,” but “it would be difficult or impossible to avoid all foods that have caused a Listeria outbreak—not just deli turkey, but cantaloupes, sprouts, celery, taco salad, grilled chicken, and on and on… There’s just no way to know.”
Ward’s Advice: “If you are going to eat deli meats, you should warm them up in the microwave first, just until they are hot. You are 13 times more likely to contract listeriosis during pregnancy than at other times of your life, but it is still a pretty rare infection.”
Alcohol
Conventional Wisdom: Don’t drink it.
Oster’s Take: “When I looked at the data, I found no credible evidence that low levels of drinking (a glass of wine or so a day) have any impact on your baby’s cognitive development.”
Ward’s Advice: “I say no alcohol in pregnancy. If you do it once a week, you’re probably going to be fine, but truly, we don’t know what the safe limit is. Some people may be able to tolerate more, some maybe less. You don’t really know when you’ll hit that threshold of getting fetal alcohol syndrome.”
Coffee
Conventional Wisdom: Don’t drink much.
Oster’s Take: “The big concern with caffeine and pregnancy is that it might lead to higher rates of miscarriage… Although there is speculation about these effects, they have not been proven… I ultimately concluded that the weight of the evidence didn’t support limiting my consumption very much. I decided the three to four cups a day I was having were fine.”
Ward’s Advice: Limit consumption to “a cup or two a day. As a general rule of thumb, all things in moderation. The specific recommendation for caffeine is about 200 milligrams per day. To put that in perspective, your normal coffee you brew at home is about 140 milligrams. Tea is about 50 milligrams. Soda is about 40.”
