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    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.

    Important Diet Precautions continued...

    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 foods.

    • 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.

    The Big Gray Area

    According to ACOG, there is "limited evidence of varying degrees to document teratogenicity" for a number of agents -- some of which may surprise you.

    Linda R. Chambliss, MD, MPH, spokeswoman at ACOG, explains that the lack of conclusive data on such agents is due to research constraints.

    "The best research requires randomized studies in which you have a group of people exposed to a substance and a control group that's not exposed. Researchers are loathe to put pregnant women into randomized studies [exposing some to potential toxins], so they rely on animal studies or on women reporting what they were exposed to during pregnancy," she says.

    Chambliss, a professor of obstetrics and gynecology at St. Louis School of Medicine in Missouri, talks to WebMD about her advice on some of the most common "gray area" substances:


    "You do not want [to take] aspirin or other nonsteroidal anti-inflammatory drugs (NSAIDs), such as Advil or Motrin. They can affect platelet count and bleeding time, and have been associated with fetal defects. I would advise a pregnant woman to avoid these unless they're prescribed by a physician." Acetaminophen, or Tylenol, should be taken instead of aspirin, Advil, or Motrin for fever, headache, minor aches, and pains.

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