Ob­ste­tri­cian and gy­nae­col­o­gist Dr Sherene Kalloo is hop­ing that the new chair­man of the En­vi­ron­men­tal Man­age­ment Au­thor­i­ty (EMA) Kelvin Ram­nath could im­ple­ment mea­sures to reg­u­late the lev­els of chem­i­cals and tox­ins in food to pro­tect the health of preg­nant women.In an in­ter­view at her of­fice at The St Au­gus­tine Pri­vate Hos­pi­tal this week Kalloo said preg­nant women would ap­pre­ci­ate some more spe­cif­ic guide­lines from The Min­istry of Food Pro­duc­tion, Land and Ma­rine Af­fairs which has the re­spon­si­bil­i­ty to mon­i­tor pes­ti­cides and food safe­ty."The Pes­ti­cides and Tox­ic Chem­i­cals Con­trol Board main­ly de­ter­mines which chem­i­cals are less harm­ful to the en­vi­ron­ment while the In­sti­tute of Ma­rine Af­fairs have pro­to­cols in place to in­ves­ti­gate fish kills and have done bac­te­r­i­al test­ing in cer­tain coastal wa­ters," Kalloo said.

She said the US En­vi­ron­men­tal Pro­tec­tion Agency would give re­gion­al guide­lines and warn­ings of food safe­ty in its ju­ris­dic­tion."Ob­ste­tri­cians de­pend on gen­er­al food cau­tions giv­en by their for­eign as­so­ci­a­tions, but when faced with ques­tions like the safe­ty of eat­ing cas­cadu­ra dur­ing preg­nan­cy, an ob­ste­tri­cian would not know the lev­el of bio-ac­cu­mu­la­tion of heavy met­als in the fish or the amounts of harm­ful bac­te­r­i­al con­tent in the wa­ter it was caught in," Kalloo said.She not­ed that T&T was just 1981 square miles and it should be easy to map the dif­fer­ent wa­ter ways with their dif­fer­ent lev­els of pol­lu­tion."Con­sumer Af­fairs should make it manda­to­ry for fish ven­dors to state the source of their fish and spot checks made on the pes­ti­cide con­tents of veg­eta­bles," Kalloo said."Shark, tu­na, king mack­er­el, sword fish and mar­lin should not be eat­en.

"Fish with a long lifes­pan tend to ac­cu­mu­late mer­cury, which can cause nerve and brain dam­age to the un­born in­fant."As a gen­er­al rule Kalloo pre­ferred ex­pec­tant moth­ers to buy fish caught in Blan­chisseuse, away from the in­dus­tri­alised west coast and south east wa­ters."Fish how­ev­er is an ex­cel­lent source of pro­tein and omega-3 fat­ty acids, es­pe­cial­ly sar­dines and salmon," she said."Fish with short lifes­pans could be con­sumed, but not more than 12 ounces per week, a typ­i­cal serv­ing is three-six ounces."Shrimp, canned light tu­na, pol­lock, salmon and cooked shell­fish can al­so be eat­en.Sushi and raw oys­ters should not be con­sumed Kalloo cau­tioned.She dis­closed that PCB (poly­chlo­ri­nat­ed biphenyls) used in man­u­fac­tur­ing elec­tri­cal equip­ment was found in fresh wa­ter fish in the USA."This chem­i­cal caused mem­o­ry dif­fi­cul­ties and low­er IQ in chil­dren and now it has been banned," she said."Veg­eta­bles should be soaked in wa­ter for some time and peeled deeply.

Wash­ing prop­er­ly would pro­tect against fae­cal con­t­a­m­i­nants like the E Coli bac­te­ria, Campy­lobac­ter and Tox­o­plas­mo­sis bac­te­ria."Tox­o­plas­mo­sis is a par­a­site found in birds and mam­mals. It is com­mon­ly found in cat fae­ces, soil con­t­a­m­i­nat­ed by cat lit­ter is dan­ger­ous. Kalloo ad­vised if a per­son is preg­nant to be ex­tra care­ful of wash­ing up af­ter pet­ting the fam­i­ly cat."Preg­nant women in­fect­ed by tox­o­plas­mo­sis have a 30 per cent chance of pass­ing the germ to the in­fant," she said."This can cause vi­su­al and hear­ing prob­lems, men­tal re­tar­da­tion, cere­bral pal­sy, seizures, jaun­dice, preterm birth and still­birth."Raw meat and eggs may con­tain sal­mo­nel­la which can cause gas­tric-type symp­toms, usu­al­ly 12-72 hours af­ter ex­po­sure and can last for-sev­en days. So no rare steaks and eggnog."

Kalloo said Cae­sar sal­ad dress­ing, Hol­landaise sauce and may­on­naise should be avoid­ed and deli meats such as cold cuts, cured meats, hot dogs, sala­mi and ham may con­tain the Lis­te­ria bac­te­ria."Lis­te­rio­sis or in­fec­tion with this or­gan­ism can cause mis­car­riage and still­birth," she said."In 2010, there were 156 cas­es in Eng­land and Wales, 17 of which af­fect­ed preg­nant women."Twen­ty-two per cent of preg­nan­cy ac­quired Lis­te­rio­sis would re­sult in the death of the ba­by."Kalloo said all cured meats must be heat­ed to 165 de­grees Fahren­heit in­ter­nal tem­per­a­ture be­fore con­sump­tion.Pât&ea­cute;, pre-packed sand­wich­es, smoked salmon should not be con­sumed."Soft cheese, goat cheese, Ro­mano, un­pas­teurised cheeses and bleu cheese may con­tain Lis­te­ria and should be avoid­ed," she said."Hard cheese is al­lowed since they con­tain less wa­ter so there is less chance for bac­te­ria to grow."Un­pas­teurised milk should not be used. Cul­tur­al­ly pa­tients are told by their moth­ers to drink fresh cows milk, if they must do so then the milk must be boiled."Stud­ies have shown that ex­cess caf­feine can cause low birth weight in­fants and mis­car­riages, Kalloo re­vealed.

Some guide­lines al­low not more than 200mg per day, this can trans­late to one and a half-two eight-ounce cups of reg­u­lar cof­fee, two mugs of tea or four 12 ounce cans of co­la."En­er­gy drinks and choco­late al­so have caf­feine," she said."I ad­vise how­ev­er ces­sa­tion of any caf­feine to my pa­tients es­pe­cial­ly in the first trimester."Kalloo said liv­er which has lots of Vi­t­a­min A must not be used. A three-ounce piece of beef liv­er has more than 12 times the rec­om­mend­ed dai­ly dose."Ex­cess Vi­t­a­min A caus­es birth de­fects and liv­er tox­i­c­i­ty," she said."I of­ten have to stop pa­tients who are us­ing cod liv­er oil sup­ple­ments with Vi­t­a­min A in ad­di­tion to their nor­mal an­te­na­tal vi­t­a­mins. Any herbal prepa­ra­tions should be dis­con­tin­ued since their con­tents and safe­ty in preg­nan­cy is ques­tion­able."