Toxins and Pregnancy
You're finally pregnant – and the world seems fraught with dangers. Here's a guide to help you navigate through the legitimate concerns and the baseless worries.
Confusion Over Paxil
Black-box warnings on prescription labels indicate the highest level of risk
determined by the FDA.
But the recent black-box labeling of the antidepressant Paxil causes
confusion for pregnant women, says Martinez.
"Two recent published studies show a slight risk for heart defects with
Paxil, a selective serotonin reuptake inhibitor, or SSRI. But four large cohort
studies that followed women through pregnancy and followed the children until
they were 9 years old don't show higher risk.
"We're letting people know about the studies, but we're withholding
judgment," she says.
Martinez explains that a problem arises when depressed women are taken off
Paxil and other SSRIs, which have been associated with problems of neonatal
adaptation. "Some women are then given tricyclic antidepressants, which
carry a much higher risk for far more significant neonatal withdrawal. Or
they're taken off antidepressants altogether.
"In the cohort studies, the children in a control group of depressed
women taking no antidepressants were more likely to have delayed developmental
milestones and more difficulties in school than the children whose mothers took
antidepressants," says Martinez.
Important Diet Precautions
The U.S. Environmental Protection Agency (EPA) estimates that 630,000 babies
in the U.S. are born annually with high levels of mercury, which can lead to
neurological, cognitive, and developmental problems. Most often, the mothers
were exposed to methylmercury from eating contaminated fish. Nursing mothers
can also pass mercury to their infants.
Because mercury lingers in the blood, all women of childbearing age should
follow these guidelines issued jointly by the EPA and FDA:
- Do not eat shark, swordfish, king mackerel, or tilefish.
- Eat no more than 12 ounces (two average servings) a week of fish with lower
levels of mercury, like shrimp, canned light tuna, salmon, pollock, and
- Eat no more than 6 ounces a week of albacore (fancy, white) tuna.
- Check fish advisories before eating locally caught fish.
Don't exclude fish and shellfish from your diet, however, says Lola
O'Rourke, spokeswoman for the American Dietetic Association. They are sources
of high-quality protein and omega-3 fatty acids, and are low in saturated fat.
She advises varying the types of "safe" fish you consume to lower any
risk of contamination.
O'Rourke offers these additional food tips:
Avoid raw sprouts and unpasteurized juices, milk products, and soft cheeses.
They are potential sources of harmful bacteria such as salmonella, E.
coli, listeria, and shigella.
Avoid raw or undercooked meat, fish, poultry, and eggs.
Avoid cold cuts and deli meats unless heated until steaming.
All leftovers should be heated until steaming.
Wash hands often. Wash produce well. Keep raw meats separate from other
Refrigerated foods should not be left out more than two hours. Set the
refrigerator between 35 and 40 degrees.
Also, "The more whole food and the fewer processed foods, the
better," O'Rourke tells WebMD. "You'll get fewer preservatives, trans
fats, and additives.
"Also, consult your doctor about vitamins. There's such a thing as
getting too much," she says.