What is toxoplasmosis?

Toxoplasmosis is an infection caused by the parasite Toxoplasma gondii. Toxoplasma gondii can be found in raw or undercooked meat, raw eggs, and unpasteurized (raw) milk. Cats that eat raw meat or rodents can become infected. Once infected, the cat can shed the parasite in the feces for up to two weeks. Toxoplasma gondii eggs can live in cat feces or buried in soil for up to 18 months.

People can get toxoplasmosis by eating infected meat that has not been cooked properly, drinking water that is contaminated, or handling soil or cat feces that contain the parasite. Some studies suggest that toxoplasmosis can be passed to a partner during unprotected sex, including oral sex. People who have recently gotten a cat or have outdoor cats, eat undercooked meat, garden without gloves, or who have had a recent mononucleosis-type illness have an increased chance of getting toxoplasmosis.

Most adults who are infected with toxoplasmosis have no symptoms. Some people might have swelling of the lymph nodes, fever, headache, or muscle pain. In most cases, once you have gotten toxoplasmosis, you cannot get it again. There have been reports of people who have gotten infected more than one time. For example, people with a weakened immune system could develop another active toxoplasmosis infection.

What are some things I can do to lower the chance of a toxoplasmosis infection?

• Cook meat until it is no longer pink and the juices run clear. Use a food thermometer to measure the internal (inside) temperature to make sure the meat is cooked all the way through. A detailed list of temperatures and foods can be found here: https://www.foodsafety.gov/food-safety-charts/safe-minimum-internal-temperatures.
• Freeze meat for several days at sub-zero (below 0° F/-18°C) temperatures before cooking to greatly lower the chance of infection.
• Do not eat raw or undercooked oysters, mussels, or clams.
• Wash cutting boards, dishes, counters, and utensils with hot soapy water after any contact with raw meat, seafood, or unwashed fruits or vegetables.
• Wash hands carefully after handling raw meat, fruits, and vegetables.
• Wash all fruits and vegetables. Peeling fruits and vegetables also helps to lower the chance of exposure.
• Avoid drinking untreated water.
• Do not drink unpasteurized goat’s milk.
• Wear gloves when gardening and during contact with soil or sand. Wash hands with soap and water after gardening or contact with soil or sand.
• Do not touch cat feces directly; wear gloves if changing cat litter & immediately wash hands.
• Do not feed cats raw or undercooked meat.
• Avoid stray cats, especially kittens.
• Keep outdoor sandboxes covered.

If there is a concern for you or your pregnancy, talk with your healthcare provider about available screening, testing, and treatment options.

I had toxoplasmosis in the past. Can that increase the chance of birth defects or other pregnancy-related problems?

In general, no increased risks to a pregnancy are expected when someone is infected with toxoplasmosis more than 6 months before getting pregnant. If you had toxoplasmosis in the past, you are likely immune, which means there would not be an increased chance for pregnancy complications.

I have/have had toxoplasmosis. Can it make it harder for me to get pregnant?

Based on the studies reviewed, toxoplasmosis may make it harder to get pregnant.

Does having/getting toxoplasmosis increase the chance for miscarriage?

Miscarriage is common and can occur in any pregnancy for many different reasons. An increased chance for miscarriage has been reported with active toxoplasmosis infection during pregnancy.

Does having/getting toxoplasmosis during pregnancy increase the chance of birth defects?

Every pregnancy starts with a 3-5% chance of having a birth defect. This is called the background risk. Toxoplasmosis infection can be passed to the fetus when the person who is pregnant has an active infection during pregnancy. The chance of transmission can change depending how far along you are in pregnancy. Babies who become infected during pregnancy have “congenital toxoplasmosis”. Some infants with congenital toxoplasmosis can have problems with the brain, eyes, heart, kidneys, blood, liver, or spleen. When the infection starts during the first trimester, the fetus has a higher chance for severe problems.

Does having/getting toxoplasmosis during pregnancy cause pregnancy-related problems?

One study suggested toxoplasmosis might increase the chance for pregnancy-related problems such as preterm delivery (birth before week 37) or low birth weight (weighing less than 5 pounds, 8 ounces [2500 grams] at birth). When toxoplasmosis infection starts late in pregnancy, the chance that the fetus will have severe problems is lower. However, the chance of passing the infection to the fetus is higher when infection happens later in pregnancy. An increased chance for stillbirth has been reported in people with active toxoplasmosis infection during pregnancy.

Does having/getting toxoplasmosis in pregnancy affect future behavior or learning for the child?

Based on the studies reviewed, infants with congenital toxoplasmosis (up to 90%) can develop problems over time, such as vision loss, seizures, hearing loss, or developmental delays. These symptoms can occur months or years after birth. Infants with congenital toxoplasmosis should be treated for the infection during the first year of life and then should be checked every so often for problems. Your healthcare team can talk with you about what screenings, tests, and treatments are right for your baby.

Breastfeeding while having toxoplasmosis:

There are no studies suggesting that Toxoplasma gondii is passed through breast milk. The Center for Disease Control and Prevention (CDC) recommends that people with an active toxoplasmosis infection continue to breastfeed unless they have broken skin or bleeding in the nipple area. If you suspect that the baby has any symptoms (fever or flu-like symptoms), contact the child’s healthcare provider. Be sure to talk to your healthcare provider about all of your breastfeeding questions.

If a male has toxoplasmosis, could it affect fertility (ability to get partner pregnant) or increase the chance of birth defects?

Based on the studies reviewed, toxoplasmosis may affect male fertility. Some studies suggest that toxoplasmosis can be passed to a partner during unprotected sex, including oral sex. Talk with your healthcare provider if you have had sexual contact with someone who has toxoplasmosis. For more information about paternal exposures in pregnancy, please see the MotherToBaby fact sheet Paternal Exposures at https://mothertobaby.org/fact-sheets/paternal-exposures-pregnancy/.

Please click here for references.

The post Toxoplasmosis appeared first on MotherToBaby.

I’ll never forget the panic in her voice. “The web said, ‘stay away from cats when you’re pregnant because your baby can be mentally retarded!” It was the first thing this soon-to-be mom could get out the second I picked up the phone. “It is true? I got rid of my cat immediately because I was so worried and I feel terrible about it,” she breathlessly explained. As a teratogen information specialist (someone trained to answer questions about exposures during pregnancy and breastfeeding), I knew her concern was shared by many. She was worried about something called “toxoplasmosis,” and after calling her doctor’s office, a nurse she spoke with didn’t say much or educate her about the infection. The nurse just reaffirmed that by getting rid of her cat, she had done “the right thing.” She was beyond frustrated. Not to mention, she missed her family’s feline!

After hearing her frustration, I asked her some basic questions relative to the cat.
• How long has she had the cat?
• Was the cat only indoor, outdoor, or both?
• Did she feed the cat any raw meat?
• Who changed the cat litter?
• Did she do any gardening?

Based on what she described, there was nothing to indicate that she was at an increased risk. “But I’m sure I’ve harmed my baby,” she said anxiously. So, I broke down the basics about toxoplasmosis. January is Birth Defects Prevention Month, what better time to revisit facts about infection?

Toxoplasmosis infections can occur by eating undercooked, infected meat, or handling soil or cat feces that contain the parasite. Toxoplasmosis is an infection caused by the parasite Toxoplasma gondii. Although most adults have no symptoms, swelling of the lymph nodes, fever, headache or muscle pain may be seen. In most cases, once a person gets toxoplasmosis, he/she cannot get it again. About 85% of pregnant women in the United States are at risk for toxoplasmosis infection.

Women who have recently gotten a cat or have outdoor cats, eat undercooked meat, garden, or who have had a recent mononucleosis-type illness are at increased risk. In Europe where far more undercooked meat is eaten, there is a higher prevalence of toxoplasmosis. Toxoplasma gondii can be found in raw or undercooked meat, raw eggs and unpasteurized milk. Cats that eat raw meat or rodents can become infected, and the parasite lives in the cat’s feces for two weeks. Toxoplasma gondii eggs can live in cat feces buried in soil up to 18 months.

To avoid infection:
• Cook meat until it is no longer pink and the juices run clear.
• Wear gloves while gardening.
• Wash all fruits and vegetables.
• Wash hands carefully after handling raw meat fruit, vegetables, and soil.
• As for furry friends… Pregnancy’s not the time to be on litter box duty, but is a good time to get your partner to do it for you!
• Also, don’t feed cats raw meat.

Taking simple precautions to avoid infection during pregnancy will keep you healthy and keep kitty from landing in a homeless shelter. In addition, it’s very important for women to get prenatal care, talk to their healthcare providers, eat healthy and take their prenatal vitamins (including folic acid) during pregnancy. Remember, #Prevent 2Protect.

Robert Felix is a teratogen information specialist at MotherToBaby California, a non-profit affiliate of the international Organization of Teratology Information Specialists (OTIS). Robert is the past president of MotherToBaby and is based at UC San Diego’s Center for Better Beginnings.

MotherToBaby is a service of OTIS, a suggested resource by many agencies including the Centers for Disease Control and Prevention (CDC). If you have questions about toxoplasmosis, please visit our toxoplasmosis fact sheet, call MotherToBaby toll-FREE at 866-626-6847 or try out MotherToBaby’s new text information service by texting questions to (855) 999-3525. You can also visit MotherToBaby.org to browse a library of fact sheets about dozens of viruses, medications, vaccines, alcohol, diseases, or other exposures during pregnancy and breastfeeding.

The post The Cat Can Stay: Debunking Pregnancy Myths about Toxoplasmosis appeared first on MotherToBaby.

Why should pregnant women care about influenza? Isn’t Zika a bigger deal?

The second you get pregnant, the advice starts coming in from everyone. No eating unpasteurized cheese (Listeria!), don’t change the cat litter (Toxoplasmosis!), and definitely don’t travel to South America (Zika!). While these are all valid concerns, influenza tends to get forgotten, and dismissed as “just the flu.” The Influenza virus may not make sensational headlines, but it’s a serious problem every year, and pregnant women are especially vulnerable to this infection.

In 2009/2010, the United States (U.S.) experienced a flu pandemic. The flu hit the public hard, and many pregnant women were hospitalized. The U.S. saw higher rates of admission to intensive care units for pregnant women, and 109 pregnant women died from confirmed or suspected flu infection. In comparison, Zika virus, which received much media attention and continues to be a source of great concern for many pregnant women, rarely results in hospitalization and has not resulted in any maternal deaths.

5 Quick Flu Facts:

1. The flu is a risk year-round, and is not limited to a particular area of the country.
2. Changes with the immune system, heart, and lungs put pregnant women at an increased risk of developing serious complications from the flu, such as respiratory distress. Pregnant women who get the flu are also much more likely to be hospitalized, and can even die from influenza complications.
3. Fever is a common flu symptom. Research shows that an untreated high fever early in pregnancy can result in an increased risk for a certain class of birth defects known as neural tube defects (spina bifida is one example).
4. Being very sick from the flu can increase the risk of pregnancy complications such as miscarriage and preterm delivery.
5. For pregnant women looking to ensure the healthiest start to life for their little one, influenza is an important infection to be aware of, and to try to prevent.

Is it too late to get a flu shot? It’s January, isn’t flu season over?

It’s never too late to get a flu shot! Flu season can start as early as October, and runs as late as May some years. However, research shows that the highest number of flu cases each year usually occurs in February. While vaccine effectiveness can vary from season to season, the flu vaccine is thought to reduce the risk of illness by about 50% to 60% when the flu viruses that end up circulating in the community closely match the viruses included in that year’s vaccine. Even during years when the flu vaccine is not a good match, it is still thought to provide some protection against the flu. If you haven’t received this year’s flu vaccine yet, talk to your health care provider as soon as possible.

10 Quick Flu Vaccine Facts:

1. The best way to avoid getting the flu virus is to receive the flu vaccine.
2. Women who are planning a pregnancy and women who are currently pregnant are strongly encouraged to get the seasonal flu shot as early as possible during the flu season.
3. There is no known risk from getting the flu shot during pregnancy. The seasonal flu shot is an inactivated virus vaccine, which means that it won’t cause you to get sick with the flu.
4. Pregnant women are asked to avoid the live attenuated flu vaccine (also called the nasal spray vaccine) as it contains a tiny amount of weakened live virus.
5. There is no trimester during pregnancy when the flu shot has to be avoided.
6. Studies of thousands of women who have received the flu shot just before or during pregnancy have found no increased risk for birth defects.
7. Studies have found that when pregnant women get the flu shot, their baby is born with protection against the flu for anywhere from 2 to 6 months after birth.
8. Most women who receive the flu shot will not experience any problems.
9. A small number of individuals who receive the flu vaccine may experience soreness/redness/swelling at the injection site, headache, fever, nausea and/or muscle aches. Reassuringly, these symptoms are usually mild and go away on their own within a few days.
10. Anyone with a severe, life-threatening allergy to any of the vaccine ingredients should talk with their health care provider before getting the flu vaccine.

Is there anything else I can do to avoid the flu?

In addition to getting vaccinated, healthy habits can further reduce your risk of getting the flu. Avoid close contact with other individuals who are sick. If you’re caring for someone with the flu (like a partner or a child), make sure to clean and disinfect common surfaces that may be contaminated with germs. Wash your hands frequently with soap and water. Cover your mouth and nose while coughing or sneezing, and practice good health habits like staying well hydrated and eating nutritious food.

If you develop symptoms of the flu, you should contact your health care provider as soon as possible. When indicated, antiviral medications may be prescribed (ideally within 48 hours) to lessen flu symptoms and reduce the risk of serious illness.

MotherToBaby is a suggested resource by many federal agencies including the Centers for Disease Control and Prevention (CDC), the Food and Drug Administration’s (FDA) Office of Women’s Health, and HRSA, and provides the most up-to-date information. More than 100,000 women and their health care providers seek information about birth defects prevention from MotherToBaby every year. Additionally, MotherToBaby conducts observational research studies in order to contribute more information to the published literature about a variety of exposures. To be connected with a MotherToBaby expert, please call (866) 626-6847, text questions to (855) 999-3525 (standard messaging rates might apply) or visit www.MotherToBaby.org.

REFERENCES:

Flu Shot Effectiveness: https://www.cdc.gov/flu/about/qa/vaccineeffect.htm
Flu Prevention: https://www.cdc.gov/flu/protect/habits.htm
Peaks In February: https://www.cdc.gov/flu/about/season/flu-season.htm
MTB Flu Shot Fact Sheet: https://mothertobaby.org/fact-sheets/seasonal-influenza-vaccine-flu-shot-pregnancy/
MTB Flu Fact Sheet: https://mothertobaby.org/fact-sheets/seasonal-influenza-the-flu-pregnancy/
MTB Antiviral Fact Sheet: https://mothertobaby.org/fact-sheets/antiviral-medications-treatprevent-influenza-the-flu-pregnancy/
Flu Shot Side Effects: https://www.cdc.gov/flu/protect/vaccine/general.htm
Flu Shot Protects Baby: https://www.cdc.gov/features/pregnancyandflu/index.html
CDC Illness/Death Stats: https://www.cdc.gov/flu/about/disease/burden.htm
https://immunizationforwomen.org/uploads/Pregnancy_Related_Mortality_Resulting_From%206.pdf

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“It’s 2018! I didn’t even know you could get syphilis nowadays!” Yes, I mentioned the stats about syphilis and other infections that can affect pregnancy to the caller who had contacted me through our free MotherToBaby helpline. I thought, this is a great time to educate her as well as others about a variety of infections. Some infections, like Zika, seem to make headlines every week, while others tend to be discussed much less frequently. January is National Birth Defects Prevention Month, and this year’s focus is on infection prevention.

In keeping with the theme Prevent to Protect: Prevent Infections for Baby’s Protection, read on to learn more about the top five preventable infectious diseases that we get questions about here at MotherToBaby, and what you can do to prevent exposure during pregnancy.

#1: Zika Virus
One of our most common Zika questions comes from couples who have just returned home after a tropical vacation: How long do we need to wait to get pregnant after returning from a country with Zika, and what should we do in the meantime to minimize risk? Can we be tested?

Many countries continue to see active transmission of Zika virus from infected mosquitoes. If a woman is infected with Zika during pregnancy, it can increase the risk of microcephaly (small head and brain) and other severe brain defects. It may also cause eye defects, hearing loss, seizures, and problems with the joints and limb movement. That’s why it’s so important for couples who are planning a pregnancy to make sure the virus is completely out of their bodies before they attempt to conceive.

So, how long do couples need to wait? The Centers for Disease Control and Prevention (CDC) recommends that women who travel to a country with Zika wait at least two months before attempting to get pregnant. If a male partner travels, the CDC recommends waiting six months. Some callers ask, “Why so long? We’re ready to get pregnant now!” Although the virus is expected to leave most people’s blood in about two weeks, this could vary depending on a number of factors including their own immunity. The CDC considers 2 months to be a long enough wait time for women. As for men? Zika has been found in the semen for up to 6 months after a man is first infected. The six-month wait time ensures that men do not pass the virus to their partners during intercourse if it is still present in their semen.

Practicing safe sex is important during these wait times! Since Zika can spread through sexual contact, using condoms or dental dams is recommended every time a couple has intercourse. Don’t want to use protection? 100% abstinence is another option. These safe sex precautions significantly reduce the risk of transferring the virus from one partner to another during these important wait times.

Couples who want to get pregnant right away will often ask, “Instead of waiting, isn’t there a way my doctor can just test me for the virus?” Unfortunately, the answer to that question is not so simple. The CDC does not recommend testing as a way to know if it’s “safe” to get pregnant. For one reason, the virus could have already left your blood, but could still be hanging out in other areas of the body (like semen). In this case, you could get a negative blood test result, but still have the virus. Second, no test is 100% accurate. There’s always a chance that your result could be a false negative, especially if you are tested too soon or too late after returning home from a country with Zika.

So, the bottom line? It’s a waiting game. Couples should follow the CDC’s official recommendations to make sure their pregnancy has the healthiest start possible. Still have questions or concerns about Zika? Check out Zika Central on MotherToBaby.org or call us at 866-626-6847 to speak with a specialist who can assess your specific exposure.

#2 Listeria
I just ate unpasteurized cheese and I’m worried I have Listeria. What symptoms should I watch for? Do I need to be tested?

Eating unpasteurized cheese does put you at risk for a Listeria infection (called listeriosis). So during your pregnancy it’s important to avoid unpasteurized cheeses and other foods made with unpasteurized milk. The US Food and Drug Administration has developed additional food safety guidelines specific to pregnancy.

While listeriosis has not been found to cause birth defects, it can increase the risk for miscarriage, preterm delivery, and still birth. It also increases the risk of infection in newborns which can result in very serious long-term complications for baby.

Not everyone who is infected with Listeria will have symptoms, but some will have mild to severe symptoms that appear a few days or even weeks after eating contaminated food. Symptoms of a Listeria infection to watch for may include: diarrhea, fever, muscle aches, joint pain, headache, backache, chills, sore throat, swollen glands, and sensitivity to light.

Since not everyone has symptoms, it is important to be tested if you think you might have listeriosis. Your health care provider can order a simple blood test to confirm a Listeria infection. Treatment will reduce the risks of infection for you and your baby.

#3: Toxoplasmosis
I didn’t find out I was pregnant until 12 weeks, and I’ve been changing my cat’s litter box this whole time. Am I at risk for toxoplasmosis?

Toxoplasmosis infection is caused by the parasite Toxoplasma gondii. You can get it from handling cat feces or soil, or eating undercooked, infected meat that contains the parasite. Eating raw eggs or drinking unpasteurized milk are also possible sources.

Most adults with toxoplasmosis don’t have symptoms, but some have symptoms similar to the flu or mononucleosis, with swelling of the lymph nodes, fever, headache or muscle pain. In most cases, once a person gets toxoplasmosis, they cannot get it again. If a woman has an active toxoplasmosis infection during pregnancy, it can pass to the developing baby (called congenital toxoplasmosis infection). Not every infected baby will have problems, but the infection could cause a variety of developmental problems for the infant.

Up to 85% of pregnant women in the U.S. are at risk for toxoplasmosis infection. Generally, women who have recently acquired a cat or care for an outdoor cat may be at an increased risk for toxoplasmosis. Ask yourself: Have you ever been diagnosed with toxoplasmosis? How long have you had your cat? Is your cat indoor only, outdoor only, or both? Do you feed the cat raw meat? Talk to your healthcare provider if you have concerns and want to learn more about a blood test that can determine if you have ever had toxoplasmosis.

To avoid future infection, here are some precautions you can take: (1) wash your hands carefully after handling raw meat fruit, vegetables, and soil; (2) do not touch cat feces, or else wear gloves and immediately wash your hands afterwards if you must change the cat litter; (3) wash all fruits and vegetables; peeling fruits and vegetables can also help reduce risk of exposure; (4) cook meat until it is no longer pink and the juices run clear; and (5) do not feed your cat raw meat.

#4 Syphilis
I just found out I have syphilis and my doctor recommended medication to treat it, but I’m worried the medication will hurt the baby. What should I do?

Syphilis is a sexually transmitted infection (STI) caused by bacteria that can be treated and cured with antibiotics. Learning that you have syphilis when you are pregnant is frightening, but the earlier you treat the infection, the better the outcome for you and your baby.

The syphilis bacteria can spread to the baby during pregnancy (called congenital syphilis or CS). CS can cause stillbirth, prematurity, or other pregnancy problems, including birth defects of the bones, the brain and other body systems. If you are diagnosed with syphilis during pregnancy, be sure to talk with your baby’s pediatrician since a baby might develop symptoms of CS even after being born.

The medications that are used to treat syphilis have been around for many years and are well studied. While there is always the possibility of side effects with any medication, the antibiotics used to treat syphilis during pregnancy are very well tolerated by most women.

The MotherToBaby website contains fact sheets on many of the medications doctors prescribe during pregnancy. If you still have concerns about the medication your doctor has prescribed to treat your syphilis, you can review the fact sheet and contact a MotherToBaby specialist at 866-626-6847.

#5 CMV (Cytomegalovirus)
I’m pregnant, and my 3-year-old came home from daycare with symptoms of CMV. Should I be worried? What can I do to prevent getting CMV from her?

CMV is a common virus that spreads through urine, saliva and other body fluids. In pregnancy, CMV can pass from mom to the developing baby (called congenital CMV infection). This could happen if you already had CMV before you got pregnant or if you got a new strain of CMV from your daughter, but it might be more likely to happen if you get a first-time CMV infection from your daughter while you’re pregnant.

Reassuringly, most babies born with congenital CMV infection don’t get sick or have health problems. But about 1 out of every 5 babies with congenital CMV infection has health problems at birth or complications that develop later in childhood. These include developmental disability, vision problems, and hearing loss, even in babies with no signs of congenital CMV infection at birth.

So, how can you prevent getting CMV from your daughter? There is no surefire way to guarantee that you won’t get it, but the best prevention is the easiest one: wash your hands often. Especially after any contact with your daughter’s urine or saliva. Kissing her on the cheek or the top of the head instead of the mouth or the hands is another way to prevent contact with her saliva. And if you are still concerned, talk to your health care provider about blood tests to detect a current or past CMV infection. For more information, check out our Baby Blog about this topic.

If you have more questions about infections during pregnancy, contact a MotherToBaby expert by phone, email, text message or chat. During National Birth Defects Prevention Month and every day, moms-to-be have the opportunity to #prevent2protect, ensuring the healthiest start to life for their new additions!

About MotherToBaby
MotherToBaby is a service of the Organization of Teratology Information Specialists (OTIS), suggested resources by many agencies including the Centers for Disease Control and Prevention (CDC). If you have questions about exposures during pregnancy and breastfeeding, please call MotherToBaby toll-FREE at 866-626-6847 or try out MotherToBaby’s new text information service by texting questions to (855) 999-3525. You can also visit MotherToBaby.org to browse a library of fact sheets about dozens of viruses, medications, vaccines, alcohol, diseases, or other exposures during pregnancy and breastfeeding or connect with all of our resources by downloading the new MotherToBaby free app, available on Android and iOS markets.

The post “Spread Prevention, Not the Infection” during Pregnancy appeared first on MotherToBaby.

What are raw, undercooked, or cold meats and seafood?

Raw meat or seafood is any meat or seafood product that has not been cooked at all. Undercooked meat or seafood has been cooked in part but has not been heated to the safe minimum internal temperature. Deli meats (also known as cold cuts) and cold seafood are precooked meats or seafood that have been frozen or chilled for later use.

Raw, undercooked, or deli meats and seafood can contain bacteria and/or parasites that can cause foodborne illnesses. For this reason, it is recommended to cook meat and seafood up to at least the minimum internal temperature, and to reheat pre-cooked cold meats or seafood. See below:

More information on specific bacteria and parasites that can be found in foods is available in these MotherToBaby fact sheets:

• E. coli (https://mothertobaby.org/fact-sheets/e-coli-pregnancy/),
• Listeria (https://mothertobaby.org/fact-sheets/listeriosis-pregnancy/),
• Salmonella (https://mothertobaby.org/fact-sheets/salmonella-pregnancy/),
• Toxoplasmosis (https://mothertobaby.org/fact-sheets/toxoplasmosis-pregnancy/),
• Vibrio (https://mothertobaby.org/fact-sheets/vibrio-pregnancy/).

Methylmercury amount is another concern with seafood. Please see our fact sheet at https://mothertobaby.org/fact-sheets/methylmercury-pregnancy/ for more information.

I heard on the news that a product I might have eaten has been recalled. Is there a place I can check?

The U.S. Food and Drug Administration (FDA) has a website where you can check for food recalls here https://www.foodsafety.gov/. If you heard about a recall on the news, write down all the information from the news article and call the phone numbers or check the websites that they have provided.

There can be a chance of infection from food cooked at home and not handled safely. You can learn about safe handling of meats and poultry on the U.S. Department of Agriculture (USDA) site. Click on the consumer section on their website: https://www.fsis.usda.gov/wps/portal/fsis/home.

How do I know if I have eaten raw, undercooked, or cold meat and seafood that is infected with bacteria or a parasite?

People can get sick from unsafe food handling practices from eating at a restaurant, on a cruise, on a trip, a home-cooked meal, or other food-related occasions. These situations are unlikely to get reported. Some people who become infected with bacteria or parasites show no symptoms. Others might have fever, diarrhea, stomach cramps, stomachache, headache, muscle pain, swelling of lymph nodes, joint pain, and/ or vomiting, depending on the infection. The symptoms can start hours to weeks after eating contaminated food.

If you are concerned that you have been infected with bacteria and/or parasites from meat or seafood,

ask your healthcare provider if there are tests to diagnosis the infection. In some cases, there might be medications that can treat the infection and reduce the chance of harm for your baby.

Does eating raw, undercooked, and/or cold meat and seafood increase the chance for miscarriage?

Miscarriage is common and can occur in any pregnancy for many different reasons. If the meat/seafood is infected with certain bacteria or parasites and a person who is pregnant becomes ill from eating it, there might be an increased chance of pregnancy loss. High fever can also increase risks to the baby. For more information on fever during pregnancy, please see our factsheet at https://mothertobaby.org/fact-sheets/hyperthermia-pregnancy/.

Does eating raw, undercooked, or cold meat and seafood increase the chance of birth defects?

Every pregnancy starts out with a 3-5% chance of having a birth defect. This is called the background risk. When exposure to raw, undercooked, or cold meat and seafood happens, the chance for birth defects depends on whether the person who is pregnant becomes infected and by which parasite or bacteria.

For example, infants born to a person who had toxoplasmosis infection during the first trimester of pregnancy have about a 10-15% chance of being born with the infection themselves (called congenital toxoplasmosis). While the chance of passing the infection to the baby (transmission) increases later in pregnancy, the most observed effects are seen with first trimester infection. Some infants with congenital toxoplasmosis will have problems with the brain, eyes, heart, kidneys, blood, liver, or spleen. Other foodborne infections such as E. coli, Listeria, and Salmonella have not been associated with a higher chance of birth defects.

Would eating raw, undercooked, or cold meat and seafood increase the chance of other pregnancy related problems?

If the food is contaminated with bacteria or parasites and a person who is pregnant becomes infected, there can be other risks to a pregnancy. This can include preterm delivery (birth before week 37) or pregnancy loss.

Does eating raw, undercooked, or cold meat and seafood in pregnancy affect future behavior or learning for the child?

Toxoplasmosis infections can cause long-term problems for the baby, such as vision loss, hearing loss, or developmental delays. Many infected infants will have no problems at birth, but symptoms of congenital toxoplasmosis can happen months or even years after birth. For this reason, infants with congenital toxoplasmosis should be treated for the infection during the first year of life and then should be checked for problems over time.

Listeriosis infections are uncommon in newborns but can also increase the chance for long-term health complications in children. Newborns with Listeria infection can have symptoms of sepsis (blood infection) or meningitis after birth. Meningitis is a condition where there is swelling around the brain and spinal cord. If not treated quickly with antibiotics, the effects of meningitis can lead to long-term problems for some children.

Breastfeeding while eating raw, undercooked, or cold meat and seafood:

Breastmilk can help protect your baby from infections. There have been case reports suggesting Salmonella might be passed from a person who is breastfeeding to a nursing child. However, most people with these types of infections do not need to stop breastfeeding. Diarrhea and other symptoms of E. coli infection might lower milk supply. In the case of E. coli and Salmonella infections, be sure to practice good hand washing. If you suspect that the baby has symptoms, such as diarrhea, contact your child’s healthcare provider. Be sure to talk to your healthcare providers about all your breastfeeding questions.

If a male eats raw, undercooked, or cold meat and seafood, can it make it harder to get a partner pregnant or increase the chance of birth defects?

Although most people get Salmonella or E. coli from eating contaminated foods or animals, these infections can also be passed from person to person. Wash hands often to help reduce the chance of passing the disease among people living in the house. In general, exposures that fathers or sperm donors have are unlikely to increase the risks to a pregnancy. For more information on paternal exposures, please see the MotherToBaby fact sheet at https://mothertobaby.org/fact-sheets/paternal-exposures-pregnancy/.

Please click here for references:

The post Eating Raw, Undercooked, or Cold Meats and Seafood appeared first on MotherToBaby.

It’s officially summer! Time for pool parties, cook-outs, and beach-side picnics. Bring on the hamburgers and hotdogs, potato and pasta salads, fish fry, and barbecue chicken.

You may be wondering if it is safe to eat that food that has been sitting in the sun? Also, didn’t I hear somewhere that pregnant women shouldn’t eat fish or undercooked meat during pregnancy? Is it safe to swim in lake water or at the beach? How can I protect my baby during my pregnancy while still enjoying summertime fun and food with my family and friends?

Easy! There are just a few simple tips to keep in mind.

Tip 1 – Thoroughly cook all meat and seafood
Food safety is important whether you are pregnant or not. But some food-borne illnesses can be more of a concern if you are pregnant. Safe handling, preparation, and storage of foods reduces the chance that you could be exposed to little organisms that could make you feel bad in a big way.

One of the most common questions about food during pregnancy is about eating meat, especially deli sandwich meat, or undercooked meat (like that medium-rare steak). There are all these warnings about what to eat and what not to eat. So, how do you know what is a concern and what can you do about it?

Well, there are several microorganisms (bacteria and parasites) that can be found in meat before it’s cooked, if it’s only partially cooked, or if it has been cooked and then frozen or refrigerated to be eaten later. These include things like Escherichia coli (E. coli), Salmonella, Listeria, and Vibrio. (See MotherToBaby.org for more info in our fact sheets.) Some types, or strains, of these microorganisms are not harmful and are actually good for us, helping with digestion for example. But others can make you sick causing stomach cramps, diarrhea, vomiting, joint and muscle pain, and fever. Symptoms may last only a few hours with some infections or up to a week with others. In women who are pregnant, exposure to some microorganisms might make you sick, but are unlikely to directly affect the baby’s development. Other microorganisms may increase the chance for miscarriage or other pregnancy complications, like early delivery.

You may have heard that women who are pregnant should not clean out their cat’s litter box due to a risk of toxoplasmosis, but did you know that this same parasite, Toxoplasma gondii, is also found in undercooked meats? When moms are infected during pregnancy, there is a chance for congenital toxoplasmosis in their babies. This can cause liver, spleen, heart, brain, and eye problems including blindness, deafness, seizures, and cognitive delays. This is usually only a risk with a new infection during pregnancy, not if you have had toxoplasmosis in the past.

Cooking meat and seafood until the center reaches a safe minimum temperature or reheating meat destroys the bacteria or parasite, thereby preventing illness. While great chefs will tell you all sorts of tips and tricks for determining how done your steak is, invest in a meat thermometer! They are easy to find in most grocery stores and really take the guess work out of not only your next backyard party but also your weeknight dinners. Below is a table with the recommended temperatures for different meats. You can find our fact sheet on meat and seafood at https://mothertobaby.org/fact-sheets/eating-raw-undercooked-or-cold-meats-and-seafood/.

Tip 2 – Safe food preparation and handling are also important
Some of the same bacteria and parasites can also be found on fruits and vegetables, or in unpasteurized dairy products like milk, cheese, and eggs. Washing your fruits and vegetables thoroughly and eating only pasteurized dairy products are the best ways to prevent exposure. And don’t forget to wash your hands, cutting boards, and utensils thoroughly after handling uncooked meat, as well as unwashed fruits and veggies to avoid contaminating other foods.

Oh, and that grilled chicken that has been sitting in the sun for three hours – forget it! Once cooked, meat and seafood should be eaten right away. Leftovers of all types (including those pasta and potato salads, and anything with mayo or salad dressings) should be refrigerated at or below 40o F (4oC) as soon as possible and then meats thoroughly reheated before they are eaten.

Tip 3 – It is good to eat fish during pregnancy, but some are better than others
Another frequent question is about eating fish during pregnancy. Many fish contain a substance called methylmercury. Some fish have higher levels of this type of mercury than other types of fish – this usually depends upon the size of the fish, how long it lives, and where it lives prior to making it to your table.

But fish and seafood are actually a good source of protein and other vitamins that are good not only for adults but also for developing babies. The key is to eat the right types of fish and seafood in the right amounts. See our fact sheet athttps://mothertobaby.org/fact-sheets/methylmercury-pregnancy/pdf/ for more information. The Food and Drug Administration (FDA) also has a quick guide which can be helpful to determine which are the best options for you: https://www.fda.gov/downloads/Food/ResourcesForYou/Consumers/UCM536321.pdf%20

Tip 4 – Do some research before going swimming
Some of the bacteria mentioned earlier in this blog can be found in water, like your local lake or warm coastal waters. In addition to bacteria, lakes and rivers can contain things like protozoa and worms which cause diarrhea, abdominal cramps, and fever. Besides eating contaminated food, these organisms can get into your body if you swim in infected water especially when you have an open wound, even a small scrape, if you swallow any water, or if water goes up your nose. Risks are often highest during and after a storm as this increases rain water runoff and pollution from the surrounding area.

There also can be certain types of algae in the water that may be harmful in high amounts. I recently received a call from a pregnant mom on vacation in Florida concerned about a red tide warning in her area. Red tides are caused by a high concentration of algae (an algal bloom) and happen mainly in Florida but can occur along the Gulf Coast or as far north as Delaware. Many algal blooms are not harmful, but others can cause low oxygen levels in the water harming marine animals and causing a build-up of toxins (called brevotoxins) in the water.

Pay attention to the warnings in your area because it is not a good idea to swim in areas where you know that there is an algal bloom or high bacteria counts, particularly if you have an open wound. Check out the Environmental Protection Agency’s website https://www.epa.gov/beaches to find info about freshwater and saltwater beaches in your area. Also, look around the area that you plan to swim for obvious signs of pollution like a neighboring farm, trash in the water, or even dead fish floating in the water.

It is also important not to eat locally, recreationally caught shellfish during a red tide – shellfish in grocery stores and restaurants are regulated and are not caught during an algae bloom so they aren’t contaminated but recreationally harvested shellfish could be. The brevetoxins which are found in red-tides are not destroyed by cooking.

Bottomline, planning is key! While often the risks associated with food-borne illnesses are bigger for you than for your baby, a few simple precautions can help you have a healthy pregnancy and still enjoy your favorite foods and summertime activities. Just remember to pick up a meat thermometer, give those veggies a good wash before you make that salad, avoid foods that have been sitting out in the sun, and know your lakes and beaches!

Lindsey Morse, MS, CGC, is a senior genetic counselor for Ferre Genetics, a program of the Ferre Institute based in Binghamton NY. Lindsey is also a teratogen information specialist with Pregnancy Risk Network, also known as MotherToBaby New York, and has served as co-director of the program since 2015. Lindsey counsels patients in all areas of genetics from prenatal to adult genetics. She also lectures on a variety of genetic issues to community organizations including high school, university, and medical students, physicians, and community health programs.

About MotherToBaby
MotherToBaby is a service of the Organization of Teratology Information Specialists (OTIS), suggested resources by many agencies including the Centers for Disease Control and Prevention (CDC). If you have questions about exposures during pregnancy and breastfeeding, please call MotherToBaby toll-FREE at 866-626-6847 or try out MotherToBaby’s new text information service by texting questions to (855) 999-3525. You can also visit MotherToBaby.org to browse a library of fact sheets about dozens of viruses, medications, vaccines, alcohol, diseases, or other exposures during pregnancy and breastfeeding or connect with all of our resources by downloading the new MotherToBaby free app, available on Android and iOS markets.

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C-M-V. Three letters that keep me up at night and shake me to the core. Three letters that have managed to routinely shatter my expectations, body slam my optimism, expose my vulnerability, alter my perspective and even now, force me to recalibrate daily. My daughter, Evelyn Grace, was born on March 12, 2013 at 36 weeks with congenital cytomegalovirus. Or CMV.

Evelyn was my first pregnancy; I was thirty-one years old. My husband and I had been married for five years, and together since college, and we were ready. Emotionally, fiscally and socially ready.

The beginning of my pregnancy was largely uneventful. My husband and I talked with anticipation about the future, shared names we liked, vetoed ones we didn’t, and spent many evenings dreaming about who he or she would become. We agreed that most importantly, we wanted to raise a kind, compassionate human being that positively contributed to society. Easy right? I met with my OB at all required appointments, avoided all of the “things” like sushi, soft cheese, alcohol, etc., and at the mid-point anatomy scan, my husband and I were ready to learn whether we were expecting a boy or a girl. We wanted the tech to write it down in an envelope so we could open it together, privately, when we were ready.

After 45 minutes, the Maternal-Fetal Medicine specialist came into the room and started explaining something about an echogenic bowel. What? My heart rate accelerated and I held my breath. His lips were moving but I literally could not decipher the words. What did this mean? Should we be concerned? Is this a genetic issue? Will my baby be ok? The truth was, it could be something, or it could be nothing.

My pregnancy progressed and after several tests and consultations with specialists in pediatric cardiology, pediatric neurology, genetic counseling, and social work, we still did not have a realistic view of what we were dealing with. We were terrified. We remained hopeful for a healthy baby but the remainder of our pregnancy was clouded with fear of the unknown.

My daughter was breech and after five weeks of extensive monitoring of both me and the baby, my maternal fetal medicine physician made the call to move up my C-section due to low amniotic fluid. My husband and I practically skipped to the hospital that Tuesday afternoon. We couldn’t wait to hold our baby girl in our arms.

The surgery was fast and cold and clinical. I snuck a peak at Evelyn, all three beautiful pounds and 14 ounces, before they whisked her off to the NICU. But even then I did not have a real sense for the gravity of the situation. It was not until the neonatologist uttered the letters “CMV” did I truly realize the weight. Even though I understood very little about CMV, I knew that Evelyn was going to have special considerations. We were devastated for our daughter. The hopes and dreams we had shared for her, and the things we once believed to be big issues or milestones, now seemed trivial and small in comparison. We were in mourning for our “atypical” daughter and for what we wished we had known that may have potentially improved her prognosis. What should we have done differently? What questions should we have asked?

I experienced a primary (first-time) infection, likely during my first or second trimester. Evelyn (pictured right) was severely affected by CMV, receiving weekly early intervention services and private sessions in occupational, physical and speech therapies, in addition to countless specialist appointments. She couldn’t do much independently but she had a smile that lit up the room, a laugh that was beyond infectious, and a determination that continues to motivate every cell in my being. She gave my husband and I twenty-one months of unconditional, unequivocal love. Tragically, we lost Evelyn in December 2014 due to complications from a surgery, three weeks before our son, Jack, was born. It was an impossible time. I don’t remember much from the weeks that followed but at some point, my adrenaline kicked in while my heart exploded in my chest, and through my tears, I knew my daughter’s journey was going to help change the outcome for future babies. Her legacy will positively contribute to society.

There is an overwhelming amount of scary information bombarding pregnant women every single day. Information overload is real, yet simple dialogue between a patient and her caregiver (e.g. midwife, doula, OB, maternal fetal medicine specialist, primary care physician, etc.) is extremely important and sometimes, it’s the patient who has to lead the conversation. I only wish I had known more or had time to effectively plan before Evelyn arrived. I felt overwhelmed and ill-prepared.

Only 9% of women have heard about CMV according to a 2016 HealthStyles Survey, yet it’s more common than Down Syndrome, Fetal Alcohol Syndrome, Fifth Disease, Spina Bifida, Sudden Infant Death Syndrome (SIDS), and Toxoplasmosis. Absorb that for a minute. It is an often symptomless virus, or may present as a cold or flu, and only causes harm when a pregnant woman passes it through the placenta to the baby in utero (or in a person with a weakened immune system). More than half of the adult population has been infected with CMV before the age of 40, and once it’s in a person’s body, it stays there for life.

How do we successfully educate pregnant women about the risks associated with this virus, if hardly anyone has heard about it?

My best advice is to take control of your health! Have you ever been infected with CMV? If you’re thinking about becoming pregnant, ask your doctor for an IgG vs. IgM antibody test to understand if you’ve had CMV in the past, and whether or not you currently have an active infection. Already pregnant? No worries, ask for it anyway. It’s a simple blood test and is covered by most insurances. Professionals’ advice and recommendations will vary depending on the results and where you are in your pregnancy.

June is CMV Awareness Month. Our mission is to educate women of childbearing age about congenital CMV, with the goal of eliminating congenital CMV for the next generation. Whether you’re pregnant with your first or you’ve been down this road a few times, know this:

• CMV is common. Congenital CMV is the most common viral infection that infants are born with in the United States — totaling 30,000+ babies each year, with 5,000+ suffering from permanent disabilities.
• CMV is serious. Congenital CMV is the leading cause of non-genetic childhood hearing loss. Complications from congenital CMV results in up to 400 deaths yearly.
• CMV is preventable. Pregnant women who have toddlers, or work with young children, are at the highest risk of acquiring CMV. The virus is typically spread through urine, blood, mucus, tears, semen or saliva, and there are simple behavior modifications that will help reduce this risk:
  • Do not share food, utensils, drinks or straws
  • Avoid contact with saliva when kissing a child
  • Do not put a child’s pacifier or toothbrush in your mouth
  • Wash your hands thoroughly, especially after changing a diaper

Please take a deep breath, practice the above prevention methods, and report any sign of illness to your midwife or doctor. If you are screened for CMV while pregnant, and the result is a positive active infection, your medical professional can do an amniocentesis to see if congenital CMV has spread through the placenta to the unborn baby. And if it has, interventions and therapies may be recommended.

CMV. Know Your Risk. Protect Your Family.

Kristen Hutchinson Spytek is the President of the National CMV Foundation. She has an M.A. in Global Marketing Communications & Advertising from Emerson College and a B.A. in Communication Studies from the University of Michigan. Kristen resides in Tampa, FL with her husband John, and sons Jack (2) and Thomas (4 mo).”

The National CMV Foundation is a non-profit organization dedicated to promoting awareness, providing access to resources and sharing prevention information to eliminate congenital CMV. Learn more at www.nationalcmv.org.

The post Guest Blog: CMV. The Most Common Viral Infection Affecting Newborns That You’ve Never Heard About appeared first on MotherToBaby.

Preconception health and pregnancy planning present a terrific opportunity to assess a wide range of factors that can give your baby the best start. This blog will outline the things to consider, as I relayed to Tanya:

Your Personal Health

Are you generally healthy? If you already get headaches or have acid reflux, know that pregnancy can make these more frequent. Ask your doctor if the way you treat these common conditions should change once you are pregnant. Ask about your current exercise routine and if you need to alter it during pregnancy. Get checked for sexually transmitted infections because some may not show symptoms. Also discuss your medications – some should be stopped before you start trying to conceive, such as Valproic acid, leflunomide (e.g. Arava®), teriflunomide (Aubagio®), methotrexate, and isotretinoin (e.g. Accutane®) to name just a few. For others, you’ll want to weigh the risks vs. the benefits with your health provider before you conceive. Talk with your doctors now to make a plan.

Caffeine

Do you drink caffeinated coffee, tea, or soda? What about energy drinks, protein powders, or Kombucha? MotherToBaby’s fact sheet on caffeine may put your mind at ease and encourage you to think about all your beverage options.

Body Weight

Is your weight a concern? One of the best things you can do before conception is to get to a healthy weight. Women who are overweight or obese have increased risks for miscarriage, birth defects, gestational diabetes, high blood pressure and preeclampsia, and unplanned cesarean birth. Now is a good time to meet with a nutritionist or go on a sensible diet to get to a healthy weight in anticipation of pregnancy. Once you are pregnant, continue to watch what you eat but don’t try to lose weight. Weight gain is inevitable during pregnancy but guidelines from the American College of Obstetricians and Gynecologists (or ACOG, the leading professional society for OB/GYNs) advise women to gain anywhere from 11-40 pounds, depending on your pre-pregnancy weight. It’s a myth that you need to “eat for two,” so don’t set yourself up for postpartum weight gain by eating more than you should. After delivery of an average 7-8 lb. baby, you may lose 2 lbs. in amniotic fluid, 1.5 lbs. of placenta, 5-7 lbs. in blood volume, and 2 lbs. as the uterus returns to its normal size. That could still leave you with 10 pounds of excess weight, or more if you gained more weight during the pregnancy. Some women never take off those extra pounds, and their weight creeps up with successive pregnancies and age, which can lead to pregnancy complications and chronic health problems later on. See our exercise fact sheet for more information.

Chronic Health Conditions

Do you have chronic health conditions like diabetes, high blood pressure, migraines, asthma, high cholesterol, heart conditions, varicose veins, or anemia? Do you have an autoimmune disease like Crohn’s or ulcerative colitis, lupus, rheumatoid arthritis, ankylosing spondylitis, multiple sclerosis, psoriasis or psoriatic arthritis? Meet with your obstetrician for a “preconception” appointment to discuss how a pregnancy might impact your health, and how your health might affect a future pregnancy. Your specialist can provide an important opinion too. A maternal-fetal medicine specialist (MFM) is a doctor who specializes in high-risk pregnancies, and consulting with a MFM once you are pregnant could help you learn how to optimize your and your baby’s health.

Mental Health

What about your mental health? If you have a history of anxiety or depression, ADHD or other conditions, ask your psychiatrist and OB about treatment, and don’t make changes before you do. Many medications can be continued during pregnancy and while breastfeeding. In fact, mental health is incredibly important – for example, when a woman doesn’t treat her mood disorder or inadequately treats it, some studies suggest risks for miscarriage, premature birth, low birth weight, and preeclampsia. Talk therapy is vitally important too. And if you struggle with mental health concerns during the pregnancy, you are at risk for postpartum depression. Let’s face it – pregnancy and caring for a new baby is stressful, so now is the time to marshal your helpers – friends, relatives, therapists and doctors – to ensure you have enough support. Your obstetrician should ask about mental health but if not, speak up. Your doctor can be your ally here, helping you get treatment and addressing concerns related to pregnancy and postpartum mental health. And MotherToBaby can give you an overview of the research related to any prescriptions you might choose to take.

Dental Health

Have you seen a dentist lately? Oral health can impact a pregnancy, meaning that if you have swollen or bleeding gums, a toothache or an infection, it can increase risks to the pregnancy. If you need to have a dental x-ray, take antibiotics, or have local anesthesia for a dental procedure, these are generally acceptable during pregnancy, but best to complete before you get pregnant. Contact MotherToBaby for more details.

Your Workplace

Where do you work? MotherToBaby can give you information to minimize exposures in a veterinarian office, dry cleaners, salon, laboratory/hospital, imaging center, pest control service, or other business. Your occupational safety department can recommend personal protective equipment (PPE) and tell you about ventilation that may be in place to ensure workplace safety. Safety data sheets (SDS) give an overview of chemicals used in industry and are available online or at work.

Food Safety

Read up on food safety and learn how to minimize your exposure to foods that have commonly been associated with foodborne illness such as E. coli or listeria. Get in the habit of washing your fresh fruits and vegetables well. Check out other blogs on our website too.

Vitamins and Supplements

Have you started taking a prenatal vitamin? Are you getting enough folic acid? ACOG recommends that women take at least 400 mcg of folic acid before getting pregnant and at least 600-800 mcg/day once they are pregnant. This can help prevent birth defects of the brain and spinal cord. Call MotherToBaby if you want to learn the recommended daily intake for specific vitamins or minerals. In general, taking more than what is recommended is not advisable – we haven’t studied how mega-doses of vitamins may impact a pregnancy. Other supplements beyond taking a prenatal vitamin are not advisable either – the Food & Drug Administration (FDA) doesn’t supervise their manufacturing plants and past surveys have shown some supplements actually contain contaminants. Furthermore, we’ve seen instances where the label didn’t match the contents of the bottle and could cause ill effects. Pregnant and breastfeeding women should avoid herbal supplements unless specifically recommended by your doctor.

Alcohol, Cannabis, and Tobacco

Do you smoke cigarettes? Do you use cannabis for medicinal or recreational purposes? Do you drink alcohol? Recent research has demonstrated that marijuana use very early in pregnancy causes changes in brain development, which could result in behavioral or learning challenges we see later in the child’s life. Cigarettes increase risks for pregnancy loss, among other things. And alcohol is known to cause a variety of birth defects known as fetal alcohol spectrum disorder (FASD). We don’t believe that there is a “safe” amount of alcohol which when consumed doesn’t cause issues for a developing child. Now is the time to quit smoking, drinking, and using cannabis – your baby will be heathier for it. MotherToBaby can provide resources, or check with your doctor.

Vaccinations

Are you up to date on all your vaccines? Did you get a flu shot this past season? You don’t want a vaccine-preventable illness to have an impact on your pregnancy. Flu infection can increase risks for more severe symptoms, longer-lasting illness, pregnancy loss and premature delivery, which can have a lifelong impact on your baby. Flu vaccine helps prevent infection. Another benefit to vaccinating during pregnancy? Studies show the protection extends to your baby, and gives them a little extra immunity from birth until they can receive vaccines. Also good to know: some vaccines can be given and are recommended during pregnancy, like a flu shot or TDAP, but others are best given before you conceive to avoid a small risk of spreading the illness to the fetus (e.g. the measles, mumps, and rubella (MMR) vaccine, as well as the Varicella (chicken pox) vaccine) – so try to get these done at least a month before trying to conceive. Check your medical records to see the last time you received any of these vaccinations. If you don’t know if you were previously vaccinated, your doctor can draw blood to check if you have immunity.

Your Pets

Do you have a cat? There is some concern in pregnancy about an infection called toxoplasmosis, which is caused by a parasite that can be found in cat feces. Read our blog for more info on what you can do to prevent this infection if you have a fur baby at home.

Other Illnesses

Do your upcoming travel plans involve travel to a warm tropical place? Check out our Zika fact sheet to learn more before you book nonrefundable tickets. In general, women will want to wait to try to conceive for eight weeks from the time of your return home; the wait time is three months if your male partner travels with you. COVID-19 is also spreading around the globe and our fact sheet can give you the latest information on whether and how it could affect a pregnancy.

Finally, your obstetrician or primary care doctor would be glad to see you for a Preconception consultation. Make an appointment to discuss your personal history and health. It’s a great way to get you and your baby off to the best start.

The post Planning a Healthy Pregnancy appeared first on MotherToBaby.

What types of hazards might be at my workplace?

In general, workplace hazards that veterinarians (vets) and veterinary technicians (vet techs) might face could include:

• anesthesia and waste gases
• X-rays / ionizing radiation
• medications
• pesticides
• cleaning agents and other chemicals
• accidents (bites, falls, needle sticks)
• infections from bites or scratches
• animal-transmitted diseases and parasites
• allergic reactions
• heavy lifting and physical strain
• shift work
• mental stress

Veterinary staff work in a variety of settings and each person will likely have different concerns regarding their specific workplace exposures. Remember, just because you work around potential hazards, it does not mean you actually have levels of exposure that would cause a problem. In addition, there are safety measures that all workers can take to limit exposures.

General Pregnancy Information:

Miscarriage is common and can occur in any pregnancy for many different reasons and regardless of exposures. Every pregnancy starts with a 3-5% chance of having a baby with a birth defect. This is called the background risk. If an exposure can cause birth defects, it is most likely to do so during the first trimester (through week 13) of your pregnancy. Dose (how much) of an exposure is also important to consider when evaluating workplace hazards. For more information on how the baby develops during pregnancy, please see the MotherToBaby fact sheet on critical periods of development at: https://mothertobaby.org/fact-sheets/critical-periods-development/.  

I work around anesthetic agents. Can this harm my pregnancy?

Older studies, which were mostly done before the use of modern scavenging equipment (devices that collect anesthesia from the air to avoid inhalation by staff), suggested that repeated exposure or high levels of exposure to inhaled anesthetics in an occupational setting might increase the chance for a birth defect or miscarriage. However, occupational exposure to inhaled anesthetics with the use of scavenging equipment and correct technique is not expected to lead to a higher chance of miscarriage or birth defects.

Anesthetics can be given through injection, IV infusion, intubation, or mask inhalation. For each person, the risk of exposure to inhaled anesthesia will depend on the specific drugs used, how they are given, and the protective measures that are in place. Workers often face their highest chance of exposure during induction and recovery and when filling the vaporizer. Air monitoring can be done to evaluate staff exposure. The Occupational Safety & Health Administration (OSHA) has a document (https://www.osha.gov/waste-anesthetic-gases/workplace-exposures-guidelines) with detailed information on workplace controls and recommended exposure limits for anesthetic gases.

I am around our x-ray machine. Does this mean that I am exposed to radiation?

Please see our MotherToBaby fact sheet on working around ionizing radiation for more information on working with x-ray machines at: https://mothertobaby.org/fact-sheets/ionizing-radiation-workplace-pregnancy/. In veterinary work settings, ionizing radiation could also occur with use of radioactive isotopes and radiation therapy machines (for example, assisting in fluoroscopy procedures and I-131 treatments for hyperthyroid animals).

Should I be worried about handling medications while I’m pregnant?

There are some medications that are considered unsafe to directly handle while pregnant without taking proper precautions. A list of some hazardous drugs can be found in Appendix A (https://www.cdc.gov/niosh/docs/2016-161/pdfs/2016-161.pdf) of the electronic document available from the National Institute for Occupational Safety and Health (NIOSH).

Workers could be exposed to hazardous drugs while handling them during: reconstitution, transfer between containers, spiking and unspiking IV containers, priming IV tubing, connecting or disconnecting syringes from injection ports, disposal, and/or with equipment maintenance. Handling body fluids of treated animals such as vomit and urine can also be a way to get exposure to medications. Exposure can also occur when stocking and storing hazardous drugs as surface contamination studies have shown that areas where the drugs were stored and handled were often contaminated.

Infertility, loss of pregnancy, birth defects, and poor fetal growth have been reported with handling exposure for some medications at work. However, most of these studies were among nurses who spent a lot of time around hazardous drugs. All employees handling medications should have training that covers ways to lower exposure to hazardous medications including opening, handling, administering, storing and disposal.

NIOSH has a document with tips to prevent occupational exposure to hazardous drugs (https://www.cdc.gov/niosh/docs/2023-130/default.html). If you handle hazardous medications, be sure to wear protective gear. When you are finished handling the drugs, clean the preparation area and wash your hands. Do not eat or drink in the area where these drugs are prepared or administered or when wearing contaminated gloves or other protective clothing.

Are there animal (zoonotic) or parasitic diseases that I should be concerned about?

A zoonotic disease is a disease that can be passed between animals and humans. Zoonotic diseases can be caused by viruses, bacteria, parasites, and fungi. Exposure can occur when people come into contact with the saliva, blood, urine, or feces of an infected animal, or when bitten by a tick or mosquito. When you are pregnant your body has a harder time fighting infections and you have a greater chance of developing serious complications from diseases. If you are pregnant or breastfeeding and think you have contracted a disease, illness, or parasite contact your healthcare provider.

Some of the diseases that vets and vet techs might be exposed to include Q Fever, Toxoplasmosis, Lymphocytic Choriomeningitis Virus, Rabies, Mites, Scabies, Brucellosis, Chlamydophila psittaci, Ringworm, Giardiasis and Helminths (worms). MotherToBaby has fact sheets on several of these exposures at https://mothertobaby.org/fact-sheets-parent/.

Veterinary staff who are pregnant and who are responsible for dealing with bodily fluids from the animals, such as cleaning cages, litter boxes, or feces from an infected animal, can consider passing this responsibility to another co-worker. However, all staff members should wear proper protective equipment such as thick disposable gloves, protective clothing, and a mask while handling sick animals and their samples regardless of if they are pregnant or not. Proper hand washing is critical. In addition, make sure you are up to date on all of your immunizations.

The veterinary infection control committee of the National Association of State Public Health Veterinarians has a document (http://nasphv.org/Documents/VeterinaryStandardPrecautions.pdf) that outlines protocols for the prevention of zoonotic disease.

How can I learn more about the pesticides and cleaning chemicals I work with?

Vet workers use strong cleaning chemicals to sterilize equipment and rooms and could be around pesticides. Some chemicals that might be used in a veterinary worksite include: acetamine compounds, chromium salts, nickel salts, phenols (Lysol®), formaldehyde, glutaraldehyde, betadine or chlorhexidine, sodium hypochlorite (bleach, Clorox®), aldehydes (Cidex®), peracetic acid/hydrogen peroxide/acetic acid solutions (Spor-Klenz®), aldehyde/phenol solutions (Sporcidin®), and organic solvents. You can learn about the ingredients in the products that you use by looking at their Safety Data Sheet (SDS). The SDS should be made available in your workplace. These sheets will describe the proper way to use, store, and dispose of these chemicals. Proper workplace practices and precautions will limit your exposure to most of these products. Check to make sure that you are using the correct type of gloves and other personal protective equipment. Make sure the ventilation/air exchange in your workspace is working properly. An industrial hygienist can help make sure your worksite has the correct protections in place.

Can heavy lifting, strain or stress pose a risk for my pregnancy?

Vet workers have a physically demanding job that involves lifting and restraining animals and long periods of standing as well as long work hours. Ligaments (the tissue that connect bones) start to loosen throughout pregnancy, which makes them more prone to injury. In addition, pregnant women will be adjusting to a shifted center of gravity. This can make balancing more difficult. The risk of heavy lifting and strain is for the mother, not the baby.

Some but not all studies have suggested that prolonged standing during pregnancy is associated with lower birth weight or preterm labor and birth before week 37. Some of the data showing low birth weight are from developing countries, where nutrition and more extreme work conditions might also play into the results. There are some published recommendations on occupational lifting related to pregnancy. However, you should discuss your personal limits with your healthcare provider. In addition, you should request training on proper lifting technique to reduce chances of personal injury. Consider asking for help when you need to lift or restrain animals. If your job requires you to be on your feet for long periods of time, take regular short breaks of about 5-10 minutes every 2 hours.

How do I reduce job related exposures as a vet or vet tech?

MotherToBaby has a general fact sheet on working during pregnancy and breastfeeding (https://mothertobaby.org/fact-sheets/reproductive-hazards-workplace/) with ways to reduce potential chemical exposures. Your worksite should provide SDS on all chemicals and also proper personal protection for all parts of your job. Be certain to use them, even when not pregnant or breastfeeding.

One of the most important steps you can take is to practice proper hand washing. Wash hands before and after each patient and after contact with any bodily substance or articles contaminated by them. Wash hands before eating or drinking; after cleaning animal cages or animal-care areas; after handling chemicals; and whenever hands are visibly soiled. The National Association of State Public Health Veterinarians (NASPHV) created a Model Infection Control Plan for Veterinary Practices that outlines hand washing, use of gloves, sleeves, facial protection, and protective outerwear, along with animal-related injury prevention, protective actions to use during veterinary procedures, and environmental controls. This plan is available on the NASPHV Web site at nasphv.org/Documents/ModelInfectionControlPlan.docx.

Who can I contact for more information?

If you have specific concerns regarding your work site discuss them with your healthcare provider or call MotherToBaby with your questions. In addition, you or your employer can contact an industrial hygienist (https://aiha.org/public-resources/consultants-listing) to have your work site evaluated for ways to keep all workers there as safe as possible. Small businesses can also contact OSHA’s on-site consultation services to help determine whether there are hazards at their worksite: https://www.osha.gov/consultation.

Some additional web resources:

• American Veterinary Medical Association (AVMA): AVMA.org
• The National Association of State Public Health Veterinarians (NASPHV): nasphv.org
• The National Institute for Occupational Safety and Health (NIOSH): https://www.cdc.gov/niosh/
• NIOSH – The Effects of Workplace Hazards on Female Reproductive Health: https://www.cdc.gov/niosh/docs/99-104/
• Occupational Safety and Health Administration (OSHA): https://www.osha.gov/SLTC/reproductivehazards/index.html
• Office of Women’s Health at the US Food and Drug Administration (FDA): https://www.fda.gov/consumers/consumer-information-audience/women
• The Centers for Disease Control and Prevention (CDC): https://www.cdc.gov/niosh/topics/veterinary/hazard.html

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