Is it safe to eat fish while pregnant?

Is it true that pregnant women should not eat fish yet fish is very nutritious? Mustapha
Dear Mustapha, 
Fish is a nutritious food for everyone, including children and pregnant women. Unfortunately, due to human activity and natural reasons, mercury compounds may find their way in water bodies where fish may be inhabiting, leading to fish taking in mercury from the foods they eat or even direct entry into the fish through the gills used to breathe.

Fish, especially those that live longer such as Tuna or sharks, or those found in mercury polluted waters, especially oceans may have high levels of mercury that may be toxic to the unborn child. Therefore, it may be prudent to avoid eating these types of fish in pregnancy.

That said, mercury is a highly toxic element with no known safe level of exposure. Fortunately, the most consumed fish in Uganda, the Tilapia, do not seem to have toxic levels of mercury in them and, therefore, can be consumed in pregnancy unless one’s antenatal doctor advises otherwise. 

However, tilapia should not be undercooked or eaten raw because of the likelihood of causing infections such as listeria or E. coli since pregnant women are usually susceptible to infections.
 
In the same vein, pregnant women should avoid eating undercooked, raw meat or eggs, hotel or town made vegetable salads or fruit juice, and raw (unpasteurised) milk, to avoid getting several infections including Toxoplasma, E. coli, listeria, and salmonella since they can affect both the mother and foetal health.

 Also, they should avoid eating liver because of its high content of Vitamin A, which can lead to foetal abnormalities.

Why are pregnant women given drugs yet they have a number of side effects? Victoria
Dear Victoria,
Of course, a pregnant woman more than one who is not may become vulnerable to disease conditions including infections such as malaria for which treatment and prevention using drugs may require to be carried out during pregnancy.

That said, some pregnant mothers will eat lots of food (mainly fatty and sugary foods, which are usually more tasty than other foods) claiming that they are eating for two. This, however, may lead to pregnancy-related obesity, which comes with other health complications, apart from failing to shed off the weight after delivery.

Pregnant mothers, just like anybody else, require to eat a balanced diet although the demands of feeding an extra human being (foetus) means that the balanced diet may not be enough requiring supplementation using ‘food pills’.

The type of food pills may differ from region to region, depending on their type of usual diet and likely nutritional deficiencies that may worsen with pregnancy but in Uganda, supplementation mostly involves Iron and Folic Acid.
Folic acid should ideally be taken at least three months before a planned pregnancy until one delivers. Folic acid, apart from helping form blood, can help prevent birth defects of the baby’s brain and spinal cord.

Another main supplement is iron, which helps boost the mothers iron stores and blood apart from the foetus’s blood.

 Even with iron supplementation, monitoring a pregnant mother’s amount of blood is necessary because Ugandan mothers are mostly anaemic by the time they become pregnant because of among many other reasons, chronic or recurrent malaria, hookworm and short spaced pregnancies.

Iron (ferrous) pills should not be taken with tea because tea contains Tannins, which prevents iron absorption (because of forming complexes). Also, iron may irritate the stomach and should be taken after morning sickness of early pregnancy has ceased, usually after four months.

Iron can also cause serious constipation, requiring to first correct the constipation the pregnant women are usually prone to and then resume with iron supplements.

Overall, the supplementation pills do not have serious side effects and the drugs given to treat health conditions in pregnancy are usually chosen carefully, making sure they are safe for the foetus and mother.