I have been reading your column since it began and look forward to it every week. I have a question I'd like answered. I have been hearing what a pregnant mum can and can't eat these days and it just seems diabolical the foods she must avoid. Surely the advisers are going over the top. For instance, no cabinet foods or deli meats, so no quick lunches during the early part of the pregnancy, no sushi, no this, that, and the other. My daughter-in-law, who is expecting our first grandchild, is always wary when eating with us in case it's something on the list she has to avoid, and the list is long. She says she is getting sick of eating tuna and brown rice for lunch every day at work. Perhaps you could give us all a balanced view? - Vicki
Thanks for your kind words, Vicki.
To answer your question, yes, there's a lot of paranoia today about food, and health in general, but it shouldn't really surprise us. Humans have spent millenia worrying about plagues and starvation, hoping desperately that their kids might live to the ripe old age of 40.
Now, suddenly, we have access to piles of delicious, clean food within arm's reach, and lives that commonly stretch into the seventh decade of life. With all that extra time on our hands we have to worry about something, right?
Your daughter-in-law needs to be aware of the risks, yet keep them in perspective. Take sushi. We know that sushi can contain parasites, and that those parasites can cause infections in humans. But those infections are extremely rare, even in sushi-loving Japan.
Women there are taught that sushi is a health food, full of omega-3 fatty acids, good for developing brains. They eat lots of sushi, and still have some of the lowest infant mortality rates in the world.
Similarly, the French eat unpasteurised cheese, but don't suffer plagues of listeriosis-related foetal deaths. If you prefer hard numbers, in 2005 the US had about one mother/infant case of listeriosis per two million people. That's an extremely low risk ... but not zero.
Basically, I'd say that if avoiding sushi, unpasteurised cheese, or canned food lets a New Zealand mum sleep easier at night, great. I don't want us to overestimate what is in reality an extremely low risk.
Having said that, there are some higher risk activities that mums-to-be would do well to avoid, such as eating too much mercury (a neurotoxin contained in larger fish like tuna and swordfish), or exposing themselves to toxoplasma (found in cat faeces, kitty litter, garden soils and undercooked meat).
But honestly, the real risks to pregnancy are not eating this or that, they're the big killers: lack of prenatal care, being unimmunised, suffering from domestic violence, having a chronic illnesses like diabetes, smoking, and consuming drugs like alcohol.
If any Kiwi mum has managed to steer clear of these health dangers, she's really done well for herself and her baby.
Gary Payinda MD, is an emergency medicine consultant in Whangarei.
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(This column provides general information and is not a substitute for the advice of your doctor.)