Wednesday, October 27, 2010

Cheese and Pregnancy

While working as a cheesemonger, I have had many customers voice the need for pasteurized cheeses because of pregnancy. Once, I even had a male customer confess that his wife was pregnant and I was the first person he told the good news. I also had a very upset woman asking for cheese she can eat while pregnant who went on to say that she could not have any goat cheese, or soft cheese, or raw cheese. She was very dismayed by her lack of cheese options.

I don't know who her doctor was but I have never heard of avoiding goat cheese during pregnancy unless it was made from raw milk. I was very happy when I visited my OB for the first time and was given a short list of foods to avoid during pregnancy. Currently I am 13 weeks along, which has been part of the reason I have not been posting as much as I would like. I have just spent so much time sleeping! I was told to avoid alcohol, raw fish, predatory fish, undercooked meat, raw eggs, and raw milk as well as cheeses made from raw milk. No mention of soft cheese, hot dogs, smoked fish, or deli meats. And I go to a high risk obstetrician due to health complications so I thought I would have a longer list of things to avoid.

I have had a raw cow milk share for two years and have been using raw goat milk for a year and a half. All the cheeses I have made to date have been raw milk cheese. This includes some aged wheels that were aged for over 60 days as well as some fresh cheeses and fresh raw chevre. When I told this to the OB during a consultation before I was pregnant, I could see the look of concern on her face while she told me it would be best to avoid raw milk. I have never had an issue with my milk and cheese and I think this is because of the wonderful quality of my raw milk. I know my raw cow's milk is tested often and my raw goat milk is collected in small batches.

Once I asked my cow farmer if she drank raw milk while she was pregnant. She kind of laughed and said she did during each of her 12 pregnancies and nothing was wrong with her kids that they knew of yet. I also had a boss who consumed raw milk cheese with gusto and did not shy away from tasting wines during her pregnancy and they seem to have turned out alright. So what is the threat of raw milk and raw milk cheese?

After getting a copy of What to Expect When Your Expecting, I signed up for their email newsletters and received a list of foods to avoid during pregnancy just last week:

"Soft cheeses: Saying cheese is one of the tastiest ways to score calcium. But to make sure you don't also score Listeria, which are bacteria that can easily be passed on to your fetus, say no to any cheese that's unpasteurized (or "raw") — including soft cheeses like queso fresco, Brie, Camembert, feta, goat cheese, or Roquefort. Any pasteurized soft cheeses are fine, but if you're desperate for a chunk of Brie, make sure it's domestic and pasteurized — or cook it until it's bubbling before you dig in (for the same Listeria reason, heat cold cuts until steaming before serving, too). The ban on anything raw also applies to other unpasteurized dairy products and juice (including fresh-off-the-farm-stand cider)."

The above paragraph should not have started with "Soft Cheese" but "Raw Milk Cheeses". At first glance you would think that you had to avoid soft cheese during pregnancy but all soft cheese in the US must be aged for a minimum of 60 days if they are made from raw milk. I know Kenny's in Kentucky makes a raw milk brie called Awe-Brie but it is really hard to make a creamy brie and then age it for 60 days.

The threat is listeria which is a bacteria found in water and soil. Listeria may occur in uncooked foods such as meats and vegetables as well as raw milk and raw milk cheese. Pasteurization and cooking will kill the listeria bacteria. But listeria can also occur in processed foods and ready to eat foods like hot dogs and deli meats if contamination occurs after the food is cooked and before packaging.

The illness caused by ingesting Listeria is called Listeriosis. This is a rare illness but pregnant women are more susceptible to it other people.

"According to the Center of Disease Control (CDC), an estimated 2,500 persons become seriously ill each year in the United States and among these, 500 will die. According to research, pregnant women account for 27% of these cases. CDC claims that pregnant women are 20 times more likely to become infected than non-pregnant healthy adults.

Symptoms of listeriosis may show up 2-30 days after exposure. Symptoms in pregnant women include mild flu-like symptoms, headaches, muscle aches, fever, nausea, and vomiting. If the infection spreads to the nervous system it can cause stiff neck, disorientation, or convulsions. Infection can occur at any time during pregnancy, but it is most common during the third trimester when your immune system is somewhat suppressed. Be sure to contact your health care provider if you experience any of these symptoms."

Listeriosis can cause miscarriage, premature delivery, infection of the newborn, and death to the newborn, as well as death to the mother. This illness is treated with antibiotics and must be caught in time to prevent infection to the baby.

This site recommends you eat hard cheeses instead of soft cheeses but does not mention raw milk. There are plenty of hard cheeses made from raw milk and few people seem to realize that Parmigiano-Reggiano is made from raw milk. There seems to be some conflicting information regarding cheese and pregnancy. The CDC recommends you avoid soft cheese and blue veined cheese as well as raw milk and products made with raw milk.

"It is very important that pregnant women and people with weakened immune systems avoid eating foods that are more likely to contain the Listeria bacteria, such as soft cheeses—including Brie, feta, and Mexican style soft or semi-soft cheese—unless the product clearly states it is made with pasteurized milk,” Dr. Damon state director of public health, said, reported Medill."

The most recent outbreak of Listeria was linked to chopped celery killing 4 people in Texas. Should I just cook the shit out of everything? No more fresh, crisp salads, all my veggies must be steamed and wilted with a loss to vitamins and nutrients?

So, what is a pregnant girl to do? This one has cancelled her raw cow milk and goat milk shares for now. Personally, I already have a high risk pregnancy, I can stay off the raw milk for 9 months. I have consumed small amounts of raw milk cheese here and there but have been seeking out pasteurized options. I have not given up on my soft cheeses and make sure they are make from pasteurized milk. I still enjoy my salad but avoid salad bars and processed veggies like precut celery and baby carrots.

I just wonder if they tell pregnant women in France to avoid raw milk cheeses and they have many raw milk soft cheeses. Do they tell pregnant women in Japan to avoid sushi and sashimi? After this baby is born, I will celebrate with some sushi and get back to making my raw milk cheeses but until then, I will err on the side of caution because there is something growing inside of me that is way more important than my food preference. It is also helpless and dependent on me and my choices for its survival. And there is plenty of good cheese out there to enjoy!