Cheese and the Pregnant Pause

A question came up recently; actually this question comes up almost daily:

“Is it okay to eat cheese when you are pregnant”?

The short answer is: Yes, same as it is for everyone else, except that it is not only okay; it is imperative that you eat cheese when you are pregnant.

The questions are frequently centered on raw milk cheeses.

“Which cheeses should I avoid while I am pregnant”? The underlying question is which ones are made from unpasteurized milk?

We do not advise you to ignore your obstetrician of course, yet as I mentioned in a recent post: cheese is not taught in medical school. Obstetricians should certainly know a lot about nutrition, and I am certain that most of them do. My fear is that some of the diet guidelines recommended may be based on incomplete or imprecise science.

One of the pitfalls I encounter with the assumption that pregnant women should only eat pasteurized cheeses is that this gives a false sense of security, as though pasteurization is an absolute, that the cheese is squeaky clean so there should be no concern whatsoever.

I have been asked these questions hundreds of times so I wanted to get to the bottom of it. I also happen to be a parent.

Part of the problem with this issue is one of nomenclature. To hear that a cheese is made with raw milk sounds a bit sinister. The “raw” word is associated with things that are unclean: raw sewage, or for the more puritanical in us, raw sex. This is why I prefer to call the cheeses made with unpasteurized milk (which also suggests “unclean”) as uncompromised cheeses.

Besides diminished aroma and flavors, cheeses that are crafted from pasteurized milk have altered textures; more importantly: some of their nutritional values are reduced, especially the fat-soluble vitamins and some of the minerals chelated to denatured proteins, denatured by the heat of pasteurization.

The premise of pasteurization is that it eliminates the bad bugs, which it does, to an extent. It kills most of the bad bugs in milk, but it also kills a large population of the “good” bugs. For anyone that does not realize that we are surrounded by good and bad bugs (that an entire civilization of each kind resides in our alimentary canal) they should know that it is okay not to know this because we can count on those “good” bugs; they outnumber the “bad” ones. If it were the other way around we would not be here. Bad bugs can be more serious when they have their brethren around; in other words, they fight like bullies.

Yet we want to know that the environment where the fetus is growing is clean, and that the mother is providing “clean” nutrients all along. Of course we don’t want the mother to consume foods that are riddled with pathogens: harmful to the fetus and potentially harmful to the mother too. Expectant mothers have been consuming raw milk cheese for millennia. Of the rare cheese contamination problems, the majority of those few problems have occurred with the pasteurized varieties. It is important to remember this: that cheese continues to enjoy an excellent track record for food safety, far safer than fruits and vegetables, safer than most of the foods we find in our grocery stores. Sad. Yet in a way, this is good for cheese.

Again, pasteurization does eliminate most of the pathogens that get into milk. Rarely are these pathogens present in the dairy animal’s milk to begin with. The contamination, when it does occur, happens post-production, regardless of whether or not the milk used in the cheese production has been pasteurized. The relative importance and strength of the good bugs should be preserved, for their presence should be better able to defend the cheese from pathogenic contamination. Without those lines of defense, the pasteurized cheeses are more susceptible and potentially more inviting to contamination.

The serious pathogen a mother should be concerned with is listeria monocytogenes. This particularly tenacious bacterium can cause miscarriages and meningitis in newborns. However it should be pointed out that the incidences of contamination in cheese are few and far between. Food borne illnesses attributed to cheese are far fewer than those derived from other foods. Fewer illnesses have been caused by cheese than have been caused by bread and baked goods, by fruits and vegetables, by eggs and egg dishes, by multiple-ingredient foods, by juices and other beverages, by poultry, pork, beef, and far fewer have been attributed to cheese than have been caused by seafood.

So what should the expectant mother include in her diet?

Cheese supplies all those nutrients that the fetus and the mother require, including the best source of bio-available calcium, all of those nutrients except for vitamin C and fiber. If any doubts remain regarding which types of cheese to avoid, I recommend that the mother avoid the softer cheeses. The softer cheeses with their higher water contents are more hospitable to listeria monocytogenes. Stick to the drier cheeses.

Max McCalman

Spread the curd!
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