No Hot Dogs? No Sushi? It's Gonna Be a Long Nine Months.
Pregnancy Food Rules Are No Fun at All, And Some Are as Squishy as Cheese

By Moira E. McLaughlin
Washington Post Staff Writer
Tuesday, November 4, 2008

I am a bad mother. Granted, at six months pregnant with my first child, I am not sure I can call myself that yet. But I feel like a bad mother. You see, a couple of months ago, at a baseball game, I ate a hot dog. Yes, a hot dog. Only four months into this whole mom deal and I was already goofing. These days, you see, hot dogs are off the menu for pregnant women.

Now, I knew from the moment I saw the line go blue that beer (Ah, delicious summer brews! Sweet Octoberfests! Thick winter stouts!) would be against the rules. And of course wine and any liquor. What I didn't know about were all the other no-nos.

No deli meats, no sushi, no blue cheese, no soft cheese (unless pasteurized). No homemade ice cream, no cookie dough, no sprouts, no pepperoni. No massages in the first trimester, no saunas, no hot tubs and no heart rate over 140.

And fish? That proved way too challenging for my pregnant mind to muddle through. Because they contain fatty acids crucial for fetal brain development, the Food and Drug Administration says pregnant women should eat two meals a week of shrimp, salmon, pollock or catfish. But because of their toxic mercury content, the FDA says pregnant women should avoid shark, swordfish, king mackerel and tilefish. A little canned tuna is okay, but not albacore. Locally caught fish might be okay; just check the Environmental Protection Agency's fish advisory Web site. Ocean fish is better than lake fish. Crab is low in mercury but not totally free of it and, according to some Web sites, pregnant women should avoid it.

So . . . eating the right fish will get my kid into Harvard? Eat the wrong fish and we should give up on the idea of college altogether.

I know, I'm over-thinking it all, beginning to see potential harm (and the occasional bizarre benefit) to my unborn child in almost everything I put in my mouth. Is halibut high in mercury or low? (I wish I were near a computer so I could Google that.) Is mozzarella a soft cheese? It's not really hard or soft. Can I eat medium soft cheese?

Weddings have proved to be an all-consuming nightmare. Sure, I'll gladly toast the happy couple with water or cranberry juice, but then there are the hors d'oeuvres. Couples in love, I realize, love to serve mini pie crusts stuffed with crab. And blue cheese . . . blue cheese is everywhere at weddings: in the salad, on the pasta, with the cheese platter. I went to one reception starving, only to find whole tables of deli meats, soft cheeses and, yes, mini pie crusts stuffed with crab.

I always figured I would be one of those super-chill pregnant women who train for marathons and drink a glass of red wine at dinner. In my pre-pregnant life, I was even annoyed by women who freaked out about sugar, caffeine, the chemicals in their hair dye. "Come on!" I would think. "Get over it! You are not the first woman on the planet to be pregnant!"

Now I'm hearing those same comments from friends and relatives.

"Bobbie smoked marijuana before she realized she was pregnant with [the now-healthy 21-year-old] Tom," my cousin confided. "Think about all those pioneer women who were pregnant!" another noted. "ML drank a highball every night with every one of her 10 kids," said yet another.

If that is the case, I wondered, why are there so many rules today, and where did they come from?

"There're not universally agreed upon," said Ernest Graham, an associate professor of obstetrics and gynecology at Johns Hopkins University. "They're more theoretical risk than actual risk."

Awesome! Hot dogs for dinner!

But John Larsen, chair of obstetrics at George Washington University Medical Center, was more cautious. There are reasons, he explained, to avoid certain foods: because of toxins, such as mercury in some fish, and bacteria, such as listeria in unpasteurized milk products and undercooked meat that can cause miscarriage or stillbirth. And then there's toxoplasma, a meat-borne parasite that generally causes minor illness but can be fatal for a fetus -- not to mention unsanitary conditions in delis and potentially cancer-causing nitrites in hot dogs.

The warnings are "based on some good data," said Helain Landy, a professor and chair of obstetrics and gynecology at Georgetown University Medical Center. "You have to be smart."

Listeria is 20 times more likely to affect pregnant women than healthy people, according to the Centers for Disease Control and Prevention. About 2,500 people become seriously ill from the bacteria every year in the United States. I guess you just don't want to mess with the odds, whatever they are.

Which is why I focused on choosing the right food rather than on how much I ate -- until my doctor told me recently to watch my weight.

You see, I've already put on 28 of the recommended 24 to 35 pounds. So his comment put me over the edge. What did he know? Then, a little more than a week ago, Kaiser Permanente released a study showing that more than one in five women gain too much weight during pregnancy, leading to bigger babies and potential risks at birth such as bleeding, tearing, stuck shoulders and broken collarbones. One more thing to worry about.

I have decided that nine months is a long time to abide by so many new rules. And who knew about all these rules, anyway?

"This information has been known for many years," Landy said.

Oh. Wow.

With three months to go, I have decided I need to relax, to take a step back and look honestly at myself and the many pregnant women who came before me.

If one hot dog can consume me with such guilt, I must be a little off balance. You know, now that I think about it . . . my mom drank beer when she was pregnant with me.

Clearly that must have something to do with it.

Comments: mclaughlinme@washpost.com.