The international randomness of Banned Pregnancy Foods

[roary]

Hi,
I just wanted to ask/rant about the complete randomness of what is on the Thou Shalt Not Eat list in different countries. It is so variable that it strikes me that there is not much evidence behind some of these rules!!

I'm Canadian and have lived in Australia and here, and the rules are completely different. There: any processed meets, incl prosciutto/parma ham: BANNED. My doctor: OK.

I was in Japan and saw literally dozens of pregnant women scarfing up massive quantities of sushi. Canada: Sushi banned!!

My friend who lives in Italy: told not to eat salad, for it is banned!

Also: Soft cheese. Soft cheese is FINE, unpasteurized cheese is not, but soft cheese seems to be banned here because it appears that the med profession think that 'unpasteurized' is a concept too difficult for the preg brain to grasp.

What are some of the 'rules' that you've heard of from different countries, and do you agree that there is something a bit odd about all the differences?

I never understood the peanut ban here, it just didn't make sense that my eating peanuts could give my baby an allergy.

But since they changed the rule in August, I'm allowed them now (but wasn't allowed in the first trimester). Ridiculous!

maybe someone will correct me but soft yolks in eggs - aren't these banned due to salmonella risk? What if they come from hens vaccinated against salmonella (most supermarket eggs are I think) - surely these would be fine?

The pate one also confuses me, risk of overdose on Vitamin A - surely you could eat pate just once a month or something and be ok?

I am on pg3 so the rules (and reasons behind them) are all a bit blurry now!

"soft cheese seems to be banned here because it appears that the med profession think that 'unpasteurized' is a concept too difficult for the preg brain to grasp."

No, soft cheese is banned because it's a listeria risk regardless of whether it's pasteurised or not.

In fact unpasteurised hard cheeses are passed as OK in the UK, as there is no risk from them.

Sushi is also OK in the UK if you read the FSA guidelines, but they suggest that you ask if it has been frozen because totally raw fish can pose a risk with worms. Some drs warn against sushi anyway though, because there is relatively less knowledge about sourcing and preparation in the UK, therefore the quality may not be as high across the board as in Japan.

Often it is about specific health screening in different countries - for eg in France they are not as bothered about rare meat, but that is because they routinely test for Toxoplasmosis. Here they do not, so if you do contract it, it's less likely to be picked up and therefore more serious if it is contracted.

I agree that some advice is conflicting or confusing, but you should look into the reasons behind the different legislation, not just rubbish the advice across the board because it differs.

Read that in Brazil, pregnant women shouldn't drink tea because of high caffeine, but apparently OK to drink coffee

Also people often confuse advice that "a friend" received in a specific country with the official policy.

I have been told COUNTLESS times that French doctors are fine about drinking in pregnancy. In fact the official French advice is the same as here - no alcohol in pregnancy.

Yes, I am sure you can find individual French doctors who are ok with drinking in moderate amounts, just as if you asked a MW here she would probably say the same. Often these things are not as different as people choose to believe, they just don't understand the guidelines fully.

Yep, sushi (or actually sashimi - sushi without the rice) is cited as excellent low-fat, high-protein food for pregnant women in Japan.
Coffee is a bit of no-no, but drink as much green tea as you like (loads of caffeine!).
Bizarrely, fruit is frowned upon because it is high in sugar (fructose) and therefore fattening.
They are still really strict on weight gain in Japan - they weigh you every visit and you get a telling off for putting too much on

It's funny, because the official advice (given to you in a leaflet by the doctor) in Canada is that pasteurization kills listeria so therefore pasteurized items of all kinds, including soft cheese are OK. This is kind of my point - I think there is huge inconsistency still.

My roommate from uni is a paed ICU specialist in Canada, and says she has seen one child affected by listeriosis in her practice, and it was awful. Although they are fairly sure the cause was...unwashed fruit. She always points out that you can get listeria from so many things that this causes the variation - people just tell you the things they deem most likely to cause the problem.

The sushi advice in Canada is related to food poisoning issues, not worms. It is impossible in Canada to purchase sushi that has not be pre-frozen for the worm reason - don't know about here!

But the very thought of sushi turns my stomach....

My doctor here in Belgium - just said everything in moderation and to use my brain, which I found refreshing. They also keep a close eye on weight gain here and having now gained 4 kilos at 7 months I feel huge maybe I am more aware because I am weighed all the time.

it depends on the kind of cheese - if you are talking about pasteurised soft cheese like philedelphia then yes, the pasteurisation will have killed the bugs and reintroduction of bacteria is then excluded by the packaging.

Soft mould-ripened and blue cheeses though (like brie, camembert, roquefort etc) are deliberately prepared and stored in conditions conducive to bacteria and so listeria can be introduced after pasteurisation.

I don't know about the Canadian cheese market, but it may be that they are not as worried because the relative sales of brie and camembert etc are not high enough to justify concern.

That's my point - often the difference in guidelines is not based on bad science, but on an assessment of the relative risks in those countries. If the brie market in Canada is tiny, then why bother to warn against the risk of listerosis? If the brie market in the UK is huge and there has been a recent listeria scare in soft cheese, then it's more sensible to advise against eating it.

They make a precise exception for brie, camembert, and blue cheeses - should have said!

I only get worked up about this because I know so many people who've gotten into a state over eating Philly or similar, and it's not worth it.

Smoked salmon is another interesting one - completely and utterly banned in Oz, apparently fine here! Equally common in both places, BTW.

SIL pregnant in Germany - encourtaged to eat peanuts as she is a vegetarian.

Sister pregnant in France - Cheese OK but no to salad and, (Gasp), brought a glass of red wine by midwives immediately after giving birth to 'build her up' (or fall over crossed eyed and pi**ed in her case)

I was living in the Netherlands when pg with ds1. There was no mention in the official blurb there about mould ripened cheese only unpasturised cheese. Consequently I went on holiday to France in my 1st trimester and ate tons of brie, camembert and other lovely cheeses (all pasteurised) without a second thought. I moved to the UK and was told this was wrong.

The problem is that medicine is not science at all but lots of educated guess-work. This is one of my biggest bug-bears about medics (as a "hard" scientist).

Was also tested for listeria immunity here but don't recall if I had it done when I was pregnant with ds1 in London.

Well then I don't get your point roary??! In that case the advice in the UK is exactly the same, see here on the FSA website:

"What to avoid
There are certain foods that you should avoid when you're pregnant, because they might make you ill or harm your baby:

Some types of cheese
Avoid cheeses such as Camembert, Brie or chevre (a type of goats' cheese), or others that have a similar rind. You should also avoid soft blue cheeses."

Or here is the advice from the NHS "pregnancy planning" leaflet here, "Women who are pregnant: Foods to avoid: Severe food poisoning during pregnancy can cause miscarriage, stillbirth or damage to the developing baby. Pregnant women are advised to avoid foods that have a higher risk of causing food poisoning. The following foods can contain harmful bacteria. You should avoid them, and any foods made with them, if you are pregnant.

• Unpasteurised milk and cheese. Check food labels to make sure milk is pasteurised.
• Soft cheeses with rind, such as Brie. You can eat cottage cheese and processed cheese spread.
• Blue cheeses, such as Stilton."

This is exactly the same as the Canadian advice, from what you've said. There's no difference in the banned foods at all, which was my point below - you are confusing hearsay with official advice.

The official advice is a) the same and b) pretty clear, I'd have thought?

Everyone needs to chill out, and thing about the advise...

1. Sushi - its safe in Japan as its been frozen at a cold enough temp. I am not sure about the sushi here.

1. Cheese - cream cheese is definately ok!

1. Liver - I think the point here is "within reason" ie Vit A, total ban is madness. But easier to give total ban. I wouldn't have a problem with eating a small amount occasionally, esp after 3 months. They used to advise preg women to eat liver a lot as its high in iron.

1. Eggs - salmonella risk - but all hens now vacinated and risk now very low. If you are worried about the risk don't let your DC eat dippy eggs!

1. Peanuts - the truth is they don't really know. There is speculation that eating peanuts in pregnancy might increase allergy risk, but they don't actually know. If there are allergies in your or DP's family maybe this is something to consider.

My amaerican friends nearly dropped down in shock when i had a smal glass of wine , tea and coffee when pregnant.

I must have gone to the wrong clinic, because I have given birth 3 times in France and never been given wine!

Official advice in France is to avoid:

• undercooked meat
• unpasteurised milk and cheese
• smoked fish
• pates
• alcohol

And to buy pre-packed cold meats rather than cut at the counter, to keep coffee consumption low and cut all rind of cheese.

And of course to avoid gaining too much weight, officially because it can cause problems for mother and baby, unofficially because it will make you less attractive

Disagreements aside (best place for 'em ) Thanks for this thread. I was very confused about the cheese thing but now I get it. Ta!

What's the deal with salad? Don't understand why that would be bad

lol @ disagreements!

Sorry Roary, I hope I wasn't too shouty, I do agree with lots of what you said.

The thing is, the whole issue of alleged international differences in pg advice is a pet hate of mine because my inlaws spent both my pregnancies telling me I was being neurotic and that "it's fine in France you know."

EXCEPT IT'S NOT!!!! The bloody advice is the SAME on most points. (the shouting is directed at them btw )

I don't mind a bit of healthy scepticism over medical advice, but I'd prefer it to be based on facts, not on what their neighbour's friend's nephew told them after his 1998 day trip to Calais.

women shouldn't drink tea because of high caffeine

are you sure that isn't due to tannin in tea - I know that is the reason not to drink tea when pg due to the tannin

whereas there is none in coffee

I was told to aviod eating offal - is that still the case?

Youngvisiter, I do agree re: hearsay from random friends. I think that part of the problem is that what doctors often tell people IS different from the 'official' advice webpages. It was my GP here who made the Soft Cheese comment, which confused and annoyed me. Also, there are differences, like the smoked salmon and deli meats and sushi which are substantially different. (In Canada and Australia for sure you are advised to eat NO raw fish, regardless of whether or not it has been frozen).

I think it's also worth pointing out that on some big things (alcohol, limits on caffeine, smoking) while old wives' advice and doctors may differ, the official advice IS the same.

(Also, Youngvisiter, sympathize with your inlaw problem: a great variation is well, I ate my weight in camembert while pregnant in 1978 and my child is fine!!)

oh roary don't get me started on the "in my day... and all my children are fine" lecture. That's a whooooooooooole other thread!

Other than the worms thing, I thought it was best to avoid sushi because of the rice (chilled rice being an absolute bugger for causing food poisoning). The pate risk is not just down to vit A afaik (not all pate contains liver after all) but, like some cheeses, listeriosis.
I'd be wary of prepared salads etc for the same reasons.
This is stuff I've picked up from having worked in catering and therefore receiving a fair bit of food safety training btw, rather than from being pg.

Listeriosis Info