Gastroenteritis — diarrhea caused by bacteria from our foods — peaks in the summer but can occur all year. This is common all over southeast Asia, especially during the summer months as bacteria thrive in the heat. Expats can easily get gastro from street food vendors, but even 5-star restaurants aren’t immune from this if the staff and cooks aren’t using proper bathroom and food handling protocols. Pregnant women have the same risks of infection and should be especially choosy about where and what they eat, since a bad bout of “gastro”, while usually not serious for mom, can sometimes cause serious problems for her baby. Most infectious causes don’t directly affect your baby, but specific bacteria like listeria and salmonella can directly cross the placenta and cause harm. You should see your doctor quickly if you have more severe symptoms such as fever, bloody diarrhea, dehydration, or any changes in fetal movement.
Fortunately, those more severe cases are not common, and most pregnant women can get through those uncomfortable days with simple home remedies and foods, as well as a few safe over-the-counter (“OTC”) medicines. The most important goal is to stay hydrated, as you can quickly lose a lot of water from vomiting and diarrhea. You shouldn’t only drink water because it doesn’t really replenish your body’s needed salt and sugars, which is why the best options are the Oral Rehydration Salt packages available in local clinics and pharmacies. Those of you who are nauseous and throwing up can try the usual safe pregnancy options for nausea, such as ginger and vitamin B6. If you start to feel too dehydrated, or especially if you feel a change in your baby’s movements, you should immediately see your doctor.
The OTC medicine that most people commonly use to stop diarrhea — loperamide, AKA immodium — isn’t recommended for pregnancy, especially if you have bloody diarrhea. Some safer OTC items to slow down diarrhea include Medilac-S, which is a capsule of “good” bacteria; and Smecta, a charcoal-based powder which can also clear infections more quickly and is not absorbed in your body.
Of course, it’s better not to get gastro in the first place, so pregnant women should take special care with food hygiene. Specific recommendations include:
- not allowing frozen food from the shop to defrost on the way home;
- cooking all meats and eggs fully;
- thorough washing of vegetables;
- separating cooked and raw foods on different cutting boards;
- not reheating foods more than once;
- and washing hands frequently while preparing food.
To prevent the more serious listeria infection, specific foods to avoid include:
- refrigerated pate;
- processed and cold meats including hot dogs unless reheated to steaming hot;
- unpasteurized dairy foods and soft cheeses;
- and cold, raw or smoked seafood.
Those of you with an ayi should make sure that she understands the Five Keys to safer food; the World Health Organization has a great handout in Chinese which you can print or read to her. It is available at http://www.who.int/foodsafety/publications/consumer/5keys/en/
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