During pregnancy, some common infections like the common cold or a skin infection do not usually cause serious problems. But other infections can be dangerous to you, your baby, or both. Some infections may lead to preterm birth and low birth weight babies. Others can cause serious illness, birth defects, and lifelong disabilities, such as hearing loss or learning problems.

Some of the infections that can be dangerous during pregnancy include

• Bacterial vaginosis (BV)
• Group B strep (GBS)
• Hepatitis
• Sexually transmitted diseases
• Toxoplasmosis
• Urinary tract infections
• Yeast infections
• Zika virus

To try to prevent infections,

• Don't eat raw or undercooked meat
• Don't share food or drinks with other people
• Wash your hands frequently
• Don't empty cat litter. Cats can transmit toxoplasmosis.

If you do get an infection during pregnancy, contact your health care provider about how best to protect you and your baby. Only some medicines are safe during pregnancy.

Pregnant women with BV are more likely to deliver a preterm infant (before 37 weeks of pregnancy) and to have a low birth weight infant (generally, 5.5 pounds or less).

Scientists estimate that each year in the United States, 80,000 preterm births, 4,000 infant deaths, and 4,000 cases of damage to an infant's nervous system are related to pregnant women having BV.

The types of bacteria that cause BV can sometimes infect other parts of the reproductive organs and cause pelvic inflammatory disease (PID).If a woman develops PID because of infection with BV, she is more likely to have an ectopic pregnancy—a pregnancy in which the fetus develops outside of the womb. Fetuses that develop ectopically (outside of the womb) usually do not survive. PID can also increase a woman's chances of becoming infertile.

For these reasons, the Centers for Disease Control and Prevention recommends that any woman who has had a premature delivery or an infant with a low birth weight be screened for BV. Other women who are planning a pregnancy should discuss screening for BV with their health care provider.

Most people have been infected with cytomegalovirus (CMV), but do not have symptoms. If a pregnant woman is infected with CMV, she can pass it to her developing baby. This is called congenital CMV, and it can cause birth defects and other health problems.

For pregnant women

You can pass CMV to your baby

If you are pregnant and have CMV, the virus in your blood can cross through your placenta and infect your developing baby. This is more likely to happen if you have a frst-time CMV infection while pregnant but can also happen if you have a subsequent infection during pregnancy.

You are not likely to be tested for CMV

It is not recommended that doctors routinely test pregnant women for CMV infection. This is because laboratory tests cannot predict which developing babies will become infected with CMV or have long-term health problems.

You may be able to reduce your risk

You may be able to lessen your risk of getting CMV by reducing contact with saliva and urine from babies and young children. The saliva and urine of children with CMV have high amounts of the virus. You can avoid getting a child’s saliva in your mouth by, for example, not sharing food, utensils, or cups with a child. Also, you should wash your hands after changing diapers. These cannot eliminate your risk of getting CMV, but may lessen the chances of getting it.

For parents

About 1 out of every 200 babies is born with congenital CMV. About 1 out of 5 of these babies will have birth defects or other long-term health problems.

Babies with congenital CMV may show signs at birth

Some signs that a baby might have congenital CMV infection when they are born are:

• Small head size
• Seizures
• Rash
• Liver, spleen, and lung problems

Tests on a baby’s saliva, urine, or blood done within two to three weeks after birth can confirm if the baby has congenital CMV.

Early treatment may help

Babies who show signs of congenital CMV at birth may be treated with medicines called antivirals. Antivirals may decrease the severity of health problems and hearing loss but should be used with caution due to side effects.

Long-term health problems may occur

Babies with signs of congenital CMV at birth are more likely to have long-term health problems, such as:

• hearing loss
• intellectual disability
• vision loss
• seizures
• lack of coordination or weakness

Some babies with congenital CMV but without signs of disease at birth may still have or develop hearing loss. Hearing loss may be present at birth or may develop later in babies who passed their newborn hearing test. Sometimes, hearing loss worsens with age.

Hearing checks and therapies are recommended

Children with congenital CMV should have regular hearing checks. Children with hearing loss should receive services such as speech or occupational therapy. These services help ensure they develop language, social, and communication skills.

The earlier your child can get hearing checks and therapies, the more he or she can benefit from them.

Immune system changes in pregnant women place the women themselves, their unborn children, and their newborns at increased risk of foodborne illness. These illnesses can be worse during pregnancy and may lead to miscarriage or premature delivery. Some foodborne illnesses, such as Listeria and Toxoplasma gondii, can infect the fetus even if the mother does not feel sick. This is why doctors provide pregnant women with specific guidelines about foods that they should and should not eat.

Advice Regarding Seafood

Women who are pregnant or may become pregnant—as well as breastfeeding mothers and parents of young children – should make informed choices when it comes to seafood. Fish is one source of high quality protein, minerals, and vitamins that are beneficial to overall health. However, it is important to choose fish that are safe to eat and offer health benefits. Follow FDA and EPA’s advice on eating fish by using this chart and a set of frequently asked questions and answers to choose healthy and safe options.

Cook seafood thoroughly: All seafood dishes should be cooked to 145°F. Raw seafood may contain parasites or bacteria, including Listeria, that can make pregnant women ill and could potentially harm their babies. This means that you should avoid:

• Sushi
• Sashimi
• Raw Oysters
• Raw Clams
• Raw Scallops
• Ceviche

Take care with smoked seafood: Refrigerated smoked seafood presents a very real threat of Listeria. Don’t eat refrigerated smoked seafood unless it’s in a cooked dish, such as a casserole, that reaches an internal temperature of 165°F to kill harmful germs.

Refrigerated smoked seafood, such as salmon, trout, whitefish, cod, tuna, or mackerel, are often labeled as:

• Nova-style
• Lox
• Kippered
• Smoked
• Jerky

It is OK to eat smoked seafood during pregnancy if it is canned, shelf stable or an ingredient in a casserole or other cooked dish.

Don’t Drink Unpasteurized Juice or Cider

Unpasteurized juice, even fresh-squeezed juice, and cider can cause foodborne illness. These beverages have been linked to outbreaks caused by E. coli and other harmful germs. To prevent infection, either choose a pasteurized version or bring unpasteurized juice or cider to a rolling boil and boil for at least 1 minute before drinking.

Avoid Raw Milk, Raw Milk Soft Cheeses, and Other Raw Milk Products

Raw milk is milk from any animal that has not been pasteurized to kill harmful bacteria. Raw milk, also called unpasteurized milk, may contain bacteria such as Campylobacter, E. coli, Listeria, Salmonella or the bacteria that causes tuberculosis. To avoid getting these foodborne illnesses, only consume pasteurized milk and milk products, including cheese.

Don’t eat the soft cheeses listed below unless they’re made with pasteurized milk. Make sure the label says “made with pasteurized milk.”

• Brie
• Feta
• Camembert
• Roquefort
• Queso blanco
• Queso fresco

Cheese made with unpasteurized milk may contain E. coli or Listeria. Instead of eating soft cheese, eat hard cheese such as Cheddar or Swiss.

Pregnant woman should pay particular attention at farmers’ markets to make sure that fresh and soft cheeses are pasteurized.

Cook Eggs Thoroughly

Undercooked eggs may contain Salmonella. Cook eggs until the yolks and whites are firm to kill germs. If you are making a casserole or other dish containing eggs, make sure the dish is cooked to a temperature of 160°F. Make sure that foods that contain raw or lightly cooked eggs are made only with pasteurized eggs. Do not eat foods that may contain raw eggs, such as:

• Homemade eggnog
• Raw batter
• Homemade Caesar salad dressing
• Tiramisu
• Eggs Benedict
• Homemade ice cream
• Freshly made or homemade hollandaise sauce

Don’t Eat Premade Meat or Seafood Salad (Such as Deli Chicken or Tuna Salads)

Don’t buy or eat premade ham salad, chicken salad, or seafood salad which may contain Listeria. These items are commonly found in delis.

Do Not Eat Raw Sprouts

Raw or undercooked sprouts, such as alfalfa, clover, mung bean, and radish may contain E. coli or Salmonella. Cook sprouts thoroughly.

Avoid Undercooked Meat and Poultry

All meat and poultry should be thoroughly cooked before eating. A food thermometer should be used to ensure that the meat has reached the USDA-recommended safe minimum internal temperature. Visit minimum cooking temperatures for specific details.

Following the minimum recommend internal temperature is important because meat and poultry may contain E. coli, Salmonella, Campylobacter, or Toxoplasma gondii.

CDC recommends the following preventive measures to reduce the risk of contracting toxoplasmosis from eating meat:

• Cook meat to the USDA-recommended minimum safe internal temperature.
• Freeze meat for several days at sub-zero (0 °F) temperatures before cooking to greatly reduce chance of infection.
• Wash cutting boards, dishes, counters and utensils with hot, soapy water after contact with raw meat, poultry, seafood, or unwashed fruits or vegetables.
• Wash hands with soap and water.

Reheat Hot Dogs and Luncheon Meats

Reheat these meats to steaming hot or 165°F before eating, even though the label says precooked. These meat items may contain Listeria and are unsafe to eat if they have not been thoroughly reheated.

• Hot dogs
• Luncheon (deli) meats
• Cold cuts
• Fermented or dry sausage
• Any other deli-style meat and poultry

Be Selective with Meat Spreads or Pâté

Do not eat refrigerated pâtés or meat spreads from a deli or meat counter, or from the refrigerated section of a store. They can contain Listeria. Meat spreads and pâté that do not need refrigeration before opening, such as products in cans, jars, or sealed pouches, are a safer choice. Refrigerate these foods after opening.

Don’t Eat Raw Dough

Unbaked (raw) dough or batter can make you sick. Flour hasn’t been treated to kill germs like E. coli. Raw eggs can contain Salmonella. Make sure batter is thoroughly baked or cooked before eating.

FDA and EPA have issued advice regarding eating fish.

This advice can help those who might become or are pregnant or breastfeeding as well as parents and caregivers who are feeding children make informed choices when it comes to the types of fish that are nutritious and safe to eat.

Fish provide key nutrients that support a child’s brain development.

Fish are part of a healthy eating pattern and provide key nutrients during pregnancy, breastfeeding, and/or early childhood to support a child’s brain development:

• Omega-3 (called DHA and EPA) and omega-6 fats
• Iron
• Iodine (during pregnancy)
• Choline

Choline also supports development of the baby’s spinal cord. Fish provide iron and zinc to support children’s immune systems. Fish are a source of other nutrients like protein, vitamin B12, vitamin D, and selenium too.

Eating fish can provide other health benefits too.

Fish intake during pregnancy is recommended because moderate scientific evidence shows it can help your baby’s cognitive development.

Strong evidence shows that eating fish, as part of a healthy eating pattern, may have heart health benefits.

Healthy eating patterns that include fish may have other benefits too. Moderate scientific evidence shows that eating patterns relatively higher in fish but also in other foods, including vegetables, fruits, legumes, whole grains, low- or non-fat dairy, lean meats and poultry, nuts, and unsaturated vegetable oils, and lower in red and processed meats, sugar-sweetened foods and beverages, and refined grains are associated with:

• Promotion of bone health – decreases the risk for hip fractures
• Decreases in the risk of becoming overweight or obese
• Decreases in the risk for colon and rectal cancers

A healthy eating pattern consists of choices across all food groups (vegetables, fruits, grains, dairy, and protein foods, which includes fish), eaten in recommended amounts, and within calorie needs. Healthy eating patterns include foods that provide vitamins, minerals, and other health-promoting components and have no or little added sugars, saturated fat, and sodium.

The Dietary Guidelines for Americans recommends eating fish as part of a healthy eating pattern.

The Dietary Guidelines for Americans recommends:

• At least 8 ounces of seafood (less for children) per week based on a 2,000 calorie diet.
• Those who are pregnant or breastfeeding consume between 8 and 12 ounces per week of a variety of seafood from choices that are lower in mercury.

Choose a variety of fish that are lower in mercury.

While it is important to limit mercury in the diets of those who are pregnant or breastfeeding and children, many types of fish are both nutritious and lower in mercury.

This chart can help you choose which fish to eat, and how often to eat them, based on their mercury levels.

What is a serving? As a guide, use the palm of your hand.

Pregnancy and breastfeeding:

• 1 serving is 4 ounces

Eat 2 to 3 servings a week from the "Best Choices" list
(OR 1 serving from the "Good Choices" list).

Childhood:
On average, a serving is about:

• 1 ounce at age 1 to 3
• 2 ounces at age 4 to 7
• 3 ounces at age 8 to 10
• 4 ounces at age 11

Eat 2 servings a week from the “Best Choices” list.

Anyone can get group B strep (GBS) disease, but some people are at greater risk for disease than others. Being a certain age or having certain medical conditions can put you at increased risk for GBS disease.

People at Increased Risk

About 1 in every 4 pregnant women carry GBS bacteria in their body.

GBS disease is most common in newborns. There are factors that can increase a pregnant woman’s risk of having a baby who will develop GBS disease, including:

• Testing positive for GBS bacteria late in pregnancy
• Developing a fever during labor
• Having 18 hours or more pass between when their water breaks and when their baby is born

Talk to your doctor or midwife to learn more and find out if you are at risk.

In adults, most cases of GBS disease are among those who have other medical conditions. Other medical conditions that put adults at increased risk include:

• Diabetes
• Heart disease
• Congestive heart failure
• Cancer or history of cancer
• Obesity

Risk for serious GBS disease increases as people get older. Adults 65 years or older are at increased risk compared to adults younger than 65 years old.

How It Spreads

GBS bacteria commonly live in people’s gastrointestinal and genital tracts. The gastrointestinal tract is the part of the body that digests food and includes the stomach and intestines. The genital tract is the part of the body involved in reproduction and includes the vagina in women.

The bacteria do not spread through food, water, or anything that people might have come into contact with. How people get these bacteria or spread them to others is generally unknown.

However, experts know that pregnant women can pass the bacteria to their babies during delivery. Most babies who get GBS disease in the first week of life (early-onset) are exposed to the bacteria this way. Babies who develop GBS disease from the first week through three months of life have late-onset disease. It can be hard to figure out how babies who develop late-onset GBS disease got the bacteria. The bacteria may have come from the mother during birth or from another source.

Other people that live with someone who has GBS bacteria, including other children, are not at risk of getting sick.

Influenza (flu) is more likely to cause severe illness in pregnant people than in people of reproductive age who are not pregnant. Changes in the immune system, heart, and lungs during pregnancy may make pregnant people (and people up to two weeks postpartum) more prone to severe illness from flu, including illness resulting in hospitalization. Flu also may be harmful for a pregnant person’s developing baby. A common flu symptom is fever, which may be associated with neural tube defects and other adverse outcomes for a developing baby. Getting vaccinated during pregnancy also can help protect a baby from flu during the first several months after birth (the pregnant parent passes antibodies on to the developing baby during pregnancy).

Listeria: Frequently Asked Questions

"What is Listeria monocytogenes?"

It's a harmful bacterium that can be found in refrigerated, ready-to-eat foods (meat, poultry, seafood, and dairy - unpasteurized milk and milk products or foods made with unpasteurized milk), and produce harvested from soil contaminated with L. monocytogenes. Many animals can carry this bacterium without appearing ill, and thus, it can be found in foods made from animals. L. monocytogenes is unusual because it can grow at refrigerator temperatures where most other foodborne bacteria do not. When eaten, it may cause listeriosis, an illness to which pregnant women and their unborn children are very susceptible.

"How could I get listeriosis?"

By eating ready-to-eat meats, poultry, seafood, and dairy products that are contaminated with L. monocytogenes. You can also get listeriosis by eating contaminated foods processed or packaged in unsanitary conditions or by eating fruits and vegetables that are contaminated from the soil or from manure used as fertilizer.

"How could listeriosis affect me?"

The symptoms can take a few days or even weeks to appear and may include fever, chills, muscle aches, diarrhea or upset stomach, headache, stiff neck, confusion, and loss of balance. In more serious cases, listeriosis could also lead to the mother's death.

Most of the time, pregnant women who are infected with listeriosis don't feel sick. However, they can pass the infection to their unborn babies without even knowing it. That's why prevention of listeriosis is very important. In any case, if you experience any of the above symptoms, see your doctor or healthcare provider immediately.

Facts

• Pregnant women are about 10 times more likely to get listeriosis than other healthy adults.
• An estimated 1/6 of all Listeria cases occur in pregnant women.

(Centers for Disease Control and Prevention)

"How could listeriosis affect my baby?"

During the first trimester of pregnancy, listeriosis may cause miscarriage. As the pregnancy progresses to third trimester, the mother is more at risk. Listeriosis can also lead to premature labor, the delivery of a low-birth-weight infant, or infant death. Fetuses who have a late infection may develop a wide range of health problems, including intellectual disability, paralysis, seizures, blindness, or impairments of the brain, heart, or kidney. In newborns, L. monocytogenes can cause blood infections and meningitis.

Listeriosis & Pregnant Hispanic Women

Studies show that pregnant Hispanic women may have a higher incidence of listeriosis than pregnant non-Hispanic women. This is most likely because they might make and eat homemade soft cheese and other traditional foods made from unpasteurized milk. "Queso fresco"- a traditional homemade cheese, prepared from unpasteurized milk and widely consumed by Hispanics - has led to miscarriages, death of newborns, and premature delivery caused by L. monocytogenes.

To prevent the risk of listeriosis, Hispanic pregnant women should not eat homemade soft cheeses and other traditional foods made from unpasteurized milk. Like all other pregnant women, they should follow the food safety precautions outlined below.

"How can I prevent listeriosis?"

The good news is that listeriosis can be prevented! Here's how...

Time to Chill

• Your refrigerator should register at 40° F (4° C) or below and the freezer at 0° F (-18° C). Place a refrigerator thermometer in the refrigerator, and check the temperature periodically. During the automatic defrost cycle, the temperature may temporarily register slightly higher than 40° F. This is okay.
• Refrigerate or freeze perishables, prepared food, and leftovers within two hours of eating or preparation. Follow the 2-Hour Rule: Discard food that's left out at room temperature for longer than 2 hours. When temperatures are above 90° F (32° C), discard food after 1 hour.
• Use ready-to-eat, perishable foods, such as dairy, meat, poultry, seafood, and produce, as soon as possible.

Fridge TIPS

• Clean your refrigerator regularly.
• Wipe up spills immediately.
• Clean the inside walls and shelves with hot water and a mild liquid dishwashing detergent; then rinse.
• Once a week, check expiration and "use by" dates, and throw out foods if the date has passed. Follow the recommended storage times for foods.

To Eat or Not to Eat?

Don't eat:

• Hot dogs, deli meats, and luncheon meats - unless they're reheated until steaming hot.
• Soft cheeses like Feta, Brie, and Camembert, "blue-veined cheeses," or "queso blanco," "queso fresco," or Panela - unless they're made with pasteurized milk. Make sure the label says, "made with pasteurized milk."
• Refrigerated pâtés or meat spreads.
• Refrigerated smoked seafood - unless it's in a cooked dish, such as a casserole. (Refrigerated smoked seafood, such as salmon, trout, whitefish, cod, tuna, or mackerel is most often labeled as "nova-style," "lox," "kippered," "smoked," or "jerky." These types of fish are found in the refrigerator section or sold at deli counters of grocery stores and delicatessens.)
• Raw (unpasteurized) milk or foods that contain unpasteurized milk.

It's okay to eat:

• Canned or shelf-stable (able to be stored unrefrigerated on the shelf) pâtés and meat spreads.
• Canned or shelf-stable smoked seafood.
• Pasteurized milk or foods that contain pasteurized milk.

Note: See your doctor or healthcare provider if you have questions about listeriosis.

If a pregnant woman is infected with a non-polio enterovirus shortly before delivery, there is a chance she can pass the virus to her baby. These babies usually have only mild illness, but in rare cases they may have severe infection.

Non-polio enteroviruses are very common, so a pregnant woman is likely to be exposed at some point in her pregnancy to someone who is infected, especially in the summer and fall. But most pregnant women, like other adults, have immunity (protection) from previous exposures to non-polio enteroviruses. If she does get infected, she will likely not have symptoms or will only have mild illness. Pregnant women without immunity to non-polio enteroviruses have a greater chance of getting infected and having symptoms.

There is no clear evidence that non-polio enterovirus infection during pregnancy increases the risk of severe complications like miscarriage, stillbirth, or congenital defects.

Rubella is very dangerous for a pregnant woman and her developing baby. Anyone who is not vaccinated against rubella is at risk of getting the disease. Although rubella was declared eliminated from the U.S. in 2004, cases can occur when unvaccinated people are exposed to infected people, mostly through international travel. Women should make sure they are protected from rubella before they get pregnant.

Infection with rubella virus causes the most severe damage when the mother is infected early in pregnancy, especially in the first 12 weeks (first trimester). During 2005-2015, eight babies with CRS have been reported in the United States.

Congenital Rubella Syndrome (CRS)

Congenital rubella syndrome (CRS) is a condition that occurs in a developing baby in the womb whose mother is infected with the rubella virus. Pregnant women who contract rubella are at risk for miscarriage or stillbirth, and their developing babies are at risk for severe birth defects with devastating, lifelong consequences. CRS can affect almost everything in the developing baby’s body.

The most common birth defects from CRS can include:

• Deafness
• Cataracts
• Heart defects
• Intellectual disabilities
• Liver and spleen damage
• Low birth weight
• Skin rash at birth

Less common complications from CRS can include:

• Glaucoma
• Brain damage
• Thyroid and other hormone problems
• Inflammation of the lungs

Although specific symptoms can be treated, there is no cure for CRS. Since there is no cure, it is important for women to get vaccinated before they get pregnant.

Vaccine Recommendations

Women who are planning to become pregnant should check with their doctor to make sure they are vaccinated before they get pregnant. Because MMR vaccine is an attenuated (weakened) live virus vaccine, pregnant women who are not vaccinated should wait to get MMR vaccine until after they have given birth. Adult women of childbearing age should avoid getting pregnant for at least four weeks after receiving MMR vaccine.

Pregnant women should NOT get MMR vaccine.

If you get rubella or are exposed to rubella while you’re pregnant, contact your doctor immediately.

Sexually transmitted infections (STIs) are also called sexually transmitted diseases, or STDs. STIs include chlamydia, gonorrhea, trichomoniasis, genital herpes, genital warts, HIV, and syphilis. Some STIs can pass from mother to baby during pregnancy and through breastfeeding.

How do STIs affect pregnant women?

STIs can cause many of the same health problems in pregnant women as in women who are not pregnant. But having an STI also can hurt the unborn baby's health.

Having an STI during pregnancy can cause:

• Premature labor (labor before 37 weeks of pregnancy). Early (preterm) birth is the number one cause of infant death and can lead to long-term developmental and health problems in children.
• Infection in the uterus (womb) after birth

Can I pass an STI to my baby?

Yes. Some STIs can be passed from a pregnant woman to the baby before and during the baby's birth.

• Some STIs, such as syphilis, cross the placenta and infect the baby in the womb.
• Other STIs, like gonorrhea, chlamydia, hepatitis B, and genital herpes, can pass from the mother to the baby as the baby passes through the birth canal.
• HIV can cross the placenta during pregnancy and infect the baby during delivery.

What are the harmful effects of passing an STI to a baby?

The harmful effects to babies may include:

• Low birth weight (less than 5 pounds)
• Eye infection
• Pneumonia
• Infection in the baby's blood
• Brain damage
• Lack of coordination in body movements
• Blindness
• Deafness
• Acute hepatitis
• Meningitis
• Chronic liver disease, which can lead to scarring of the liver (cirrhosis)
• Stillbirth

I'm pregnant. What can I do to prevent problems from STIs?

You can prevent some of the health problems caused by STIs and pregnancy with regular prenatal care. Your doctor will test you for STIs early in your pregnancy and again closer to childbirth, if needed.

• STIs caused by bacteria, such as chlamydia and gonorrhea, can be cured with antibiotics. Some antibiotics are safe to take during pregnancy. Your doctor can prescribe antibiotics for chlamydia, gonorrhea, syphilis, and trichomoniasis during pregnancy.
• STIs caused by viruses, such as genital herpes and HIV, have no cure.
  • If you have herpes, antiviral medicine may help reduce symptoms. If you have symptoms of herpes or active genital herpes sores at the start of labor, you may need a cesarean section (C-section). This can help lower the risk of passing the infection to your baby.
  • If you have HIV, antiviral medicines can lower the risk of giving HIV to your baby to less than 1%. You also may need to have a C-section.

You also can take steps to lower your risk of getting an STI during pregnancy.

Can I breastfeed if I have an STI?

Maybe. Some STIs affect breastfeeding, and some don't. The following are some general guidelines, but talk to your doctor, nurse, or a lactation consultant about the risk of passing the STI to your baby while breastfeeding:

• If you have HIV, do not breastfeed. You can pass the virus to your baby. In countries like the United States where clean water is available, using a breastmilk substitute like formula is recommended.
• If you have chlamydia, gonorrhea, or HPV, you can breastfeed your baby.
• If you have trichomoniasis, you can take the antibiotic metronidazole if you are breastfeeding. You may need to wait 12 to 24 hours after taking the medicine to breastfeed.
• If you have syphilis or herpes, you can breastfeed as long as your baby or pumping equipment does not touch a sore. It is possible to spread syphilis or herpes to any part of your breast, including your nipple and areola. If you have sores on your breast, pump or hand-express your milk until the sores heal. Pumping will help keep up your milk supply and prevent your breast from getting overly full and painful. You can store your milk to give to your baby in a bottle for another feeding. But if parts of your breast pump also touch the sore(s) while pumping, you should throw the milk away.

Are STI treatments safe to use while breastfeeding?

If you are being treated for an STI, ask your doctor about the possible effects of the medicine on your breastfeeding baby. Most treatments for STIs are safe to take while breastfeeding.

As a soon-to-be mom, you are constantly being reminded of the things you should or shouldn’t do and what you should and shouldn’t worry about when it comes to protecting the health of your developing baby. While pregnancy fears are normal, the best way to handle them is by being informed and prepared. If you’ve already had your first prenatal visit, your doctor likely discussed syphilis testing with you. If not, read on to find out the most important facts about this disease, how it can affect your baby, and actions you can take to improve your chances of a healthy pregnancy and baby.

What is it?

Syphilis is a sexually transmitted disease that can cause very serious health problems if not treated. However, it is simple to prevent and can be cured with the antibiotic penicillin. When syphilis is not treated, it can eventually spread to the brain and nervous system or to the eye. This can cause problems like hearing loss, stroke, and blindness. Having syphilis can also increase a person’s risk for getting HIV or giving it to others. Syphilis can also be passed on to an unborn baby during pregnancy.

Congenital syphilis is the disease that occurs when a mother with syphilis passes the infection on to her baby during pregnancy.

How Congenital Syphilis Can Affect Your Baby’s Health

Up to 40% of babies born to women with untreated syphilis may be stillborn (a baby born dead) or die from the infection as a newborn. Infants born with congenital syphilis might have health problems like skin rashes, yellowing of the skin or whites of the eyes (jaundice), enlarged liver and spleen, or severe anemia (low blood count). Untreated babies that survive the newborn period can develop problems later on. They may be developmentally delayed or have seizures.

How concerned do I truly need to be?

Congenital syphilis should be on your radar because there has been a sharp increase in the number of babies born with the disease in the United States. In fact, cases of congenital syphilis have nearly quadrupled between 2015 and 2019. Public health professionals across the country are very concerned about this growing number of congenital syphilis cases.

What can I do to make sure my baby doesn’t get congenital syphilis?

If you are pregnant, here’s what you can do:

• Go to Your Doctor. If you think you may be pregnant, see a health care provider as soon as possible to be sure that you and your baby are healthy during your pregnancy. Prenatal care is important for every pregnancy. Even if you’ve been pregnant before, it’s important to ensure that THIS pregnancy is healthy. All pregnant women should be tested for syphilis, ideally at their first doctor visit. Make sure to ask your doctor about getting tested at your first visit.
• Ask for the Results of Your Syphilis Test. And if you test positive for syphilis during pregnancy, be sure to get treatment right away. Your doctor can treat you with medicine that is safe for both you and your unborn baby.
• Complete Follow-Up Visits with Your Doctor. Continue to visit your doctor regularly during your pregnancy to be sure that you and your baby stay healthy. If you learn that one of your sexual partners has or may have syphilis, tell your doctor right away so you and your partner can be treated, and your baby can be protected. Your doctor may need to retest you for syphilis at the beginning of your third trimester and at delivery, depending on how common syphilis infections are in the area that you live in. Ask your doctor if you should be retested during your pregnancy and at delivery.

When should I be concerned about toxoplasmosis?

Generally, if you were infected with Toxoplasma before becoming pregnant your unborn child is protected by your immunity. Some experts suggest waiting for 6 months after a recent infection to become pregnant.

How do I know if I have been infected with Toxoplasma?

Your health care provider may suggest one or more varieties of blood tests to check for antibodies to Toxoplasma.

How can Toxoplasma affect my unborn child?

If you are newly infected with Toxoplasma while you are pregnant, or just before pregnancy, then you can pass the infection on to your baby. You may not have any symptoms from the infection. Most infected infants do not have symptoms at birth but can develop serious symptoms later in life, such as blindness or mental disability. Occasionally, infected newborns have serious eye or brain damage at birth.

How is toxoplasmosis spread?

Cats play an important role in the spread of toxoplasmosis.

Cats play an important role in the spread of toxoplasmosis. They become infected by eating infected rodents, birds, or other small animals. The parasite is then passed in the cat’s feces. Kittens and cats can shed millions of parasites in their feces for as long as 3 weeks after infection. Mature cats are less likely to shed Toxoplasma if they have been previously infected. Cats and kittens prefer litter boxes, garden soils, and sandboxes for elimination, and you may be exposed unintentionally by touching your mouth after changing a litter box, or after gardening without gloves. Fruits and vegetables may have contact with contaminated soil or water also, and you can be infected by eating fruits and vegetables if they are not cooked, washed, or peeled.

Do I have to give up my cat if I’m pregnant or planning on becoming pregnant?

No. You should follow these helpful tips to reduce your risk of environmental exposure to Toxoplasma:

• Avoid changing cat litter if possible. If no one else can perform the task, wear disposable gloves and wash your hands with soap and water afterwards.
• Ensure that the cat litter box is changed daily. The Toxoplasma parasite does not become infectious until 1 to 5 days after it is shed in a cat’s feces.
• Feed your cat commercial dry or canned food, not raw or undercooked meats.
• Keep cats indoors.
• Avoid stray cats, especially kittens. Do not get a new cat while you are pregnant.
• Keep outdoor sandboxes covered.
• Wear gloves when gardening and during contact with soil or sand because it might be contaminated with cat feces that contain Toxoplasma. Wash hands with soap and water after gardening or contact with soil or sand.

Is there treatment available for toxoplasmosis?

If you are infected during pregnancy, medication is available. You and your baby should be closely monitored during your pregnancy and after your baby is born.

What are the best ways to protect myself or my unborn child against toxoplasmosis?

Cat owners and women who are exposed to cats should follow these tips to reduce exposure to Toxoplasma.

• Avoid changing cat litter if possible. If no one else can perform the task, wear disposable gloves and wash your hands with soap and water afterwards.
• Ensure that the cat litter box is changed daily. The Toxoplasma parasite does not become infectious until 1 to 5 days after it is shed in a cat’s feces.
• Feed your cat commercial dry or canned food, not raw or undercooked meats.
• Keep cats indoors.
• Avoid stray cats, especially kittens. Do not get a new cat while you are pregnant.
• Keep outdoor sandboxes covered.
• Wear gloves when gardening and during contact with soil or sand because it might be contaminated with cat feces that contain Toxoplasma. Wash hands with soap and water after gardening or contact with soil or sand.

You should also:

Cook food to safe temperatures. A food thermometer should be used to measure the internal temperature of cooked meat. Color is not a reliable indicator that meat has been cooked to a temperature high enough to kill harmful pathogens like Toxoplasma. Do not sample meat until it is cooked. USDA recommends the following for meat preparation:

For Whole Cuts of Meat (excluding poultry)
Cook to at least 145° F (63° C) as measured with a food thermometer placed in the thickest part of the meat, then allow the meat to rest for three minutes before carving or consuming. *According to USDA, “A ‘rest time’ is the amount of time the product remains at the final temperature, after it has been removed from a grill, oven, or other heat source. During the three minutes after meat is removed from the heat source, its temperature remains constant or continues to rise, which destroys pathogens.”

For Ground Meat (excluding poultry)
Cook to at least 160° F (71° C); ground meats do not require a rest time.

For All Poultry (whole cuts and ground)
Cook to at least 165° F (74° C). The internal temperature should be checked in the innermost part of the thigh, innermost part of the wing, and the thickest part of the breast. Poultry do not require a rest time.

• Freeze meat for several days at sub-zero (below 0° F) temperatures before cooking to greatly reduce chance of infection. *Freezing does not reliably kill other parasites that may be found in meat (like certain species of Trichinella) or harmful bacteria. Cooking meat to USDA recommended internal temperatures is the safest method to destroy all parasites and other pathogens.
• Peel or wash fruits and vegetables thoroughly before eating.
• Wash cutting boards, dishes, counters, utensils, and hands with soapy water after contact with raw meat, poultry, seafood, or unwashed fruits or vegetables.
• Avoid drinking untreated water.
• Do not drink unpasteurized goat’s milk.
• Do not eat raw or undercooked oysters, mussels, or clams (these may be contaminated with Toxoplasma that has washed into seawater).

Should a woman breastfeed her infant if she had contracted a Toxoplasma infection during her pregnancy?

Yes. Among healthy women, the possibility of breast milk transmission of Toxoplasma infection is not likely. While Toxoplasma infection has been associated with infants who consumed unpasteurized goat’s milk, there are no studies documenting breast milk transmission of Toxoplasma gondii in humans. In the event that a nursing woman experiences cracked and bleeding nipples or breast inflammation within several weeks immediately following an acute Toxoplasma infection (when the organism is still circulating in her bloodstream), it is theoretically possible that she could transmit Toxoplasma gondii to the infant through her breast milk. Immune suppressed women could have circulating Toxoplasma for even longer periods of time. However, the likelihood of human milk transmission is very small.

Urinary tract infections (UTIs) are most often caused by bacteria (germs) that get into the bladder, which is part of the urinary tract. UTIs are also called bladder infections. UTIs are common, especially in women. More than half of women will have at least one UTI at some point in life. UTIs are serious and often painful. But most UTIs are easy to treat with antibiotics.

What is a urinary tract infection (UTI)?

UTIs can happen anywhere in the urinary system (which includes the kidneys, ureters, bladder, and urethra). UTIs are most common in the bladder. A UTI in the bladder is called cystitis. Infections in the bladder can spread to the upper part of the urinary tract or the kidneys. A UTI in the kidneys is called pyelonephritis or "pyelo."

Who gets UTIs?

Women get UTIs up to 30 times more often than men do. Also, as many as 4 in 10 women who get a UTI will get at least one more within six months.

Women get UTIs more often because a woman's urethra (the tube from the bladder to where the urine comes out of the body) is shorter than a man's. This makes it easier for bacteria to get into the bladder. A woman's urethral opening is also closer to both the vagina and the anus, the main source of germs such as Escherichia coli (E. coli) that cause UTIs.

Are some women more at risk for UTIs?

Yes. You may be at greater risk for a UTI if you:

• Are sexually active. Sexual activity can move germs that cause UTIs from other areas, such as the vagina, to the urethra.
• Use a diaphragm for birth control or use spermicides (creams that kill sperm) with a diaphragm or with condoms. Spermicides can kill good bacteria that protect you from UTIs.
• Are pregnant. Pregnancy hormones can change the bacteria in the urinary tract, making UTIs more likely. Also, many pregnant women have trouble completely emptying the bladder, because the uterus (womb) with the developing baby sits on top of the bladder during pregnancy. Leftover urine with bacteria in it can cause a UTI.
• Have gone through menopause. After menopause, loss of the hormone estrogen causes vaginal tissue to become thin and dry. This can make it easier for harmful bacteria to grow and cause a UTI.
• Have diabetes, which can lower your immune (defense) system and cause nerve damage that makes it hard to completely empty your bladder
• Have any condition, like a kidney stone, that may block the flow of urine between your kidneys and bladder
• Have or recently had a catheter in place. A catheter is a thin tube put through the urethra into the bladder. Catheters drain urine when you cannot pass urine on your own, such as during surgery.

What are the symptoms of a UTI?

If you have a UTI, you may have some or all of these symptoms:

• Pain or burning when urinating
• An urge to urinate often, but not much comes out when you go
• Pressure in your lower abdomen
• Urine that smells bad or looks milky or cloudy
• Blood in the urine. This is more common in younger women. If you see blood in your urine, tell a doctor or nurse right away.
• Feeling tired, shaky, confused, or weak. This is more common in older women.
• Having a fever, which may mean the infection has reached your kidneys

What causes UTIs?

UTIs are caused by bacteria or, rarely, yeast getting into your urinary tract. Once there, they multiply and cause inflammation (swelling) and pain. You can help prevent UTIs by wiping from front to back after using the bathroom.

How is a UTI diagnosed?

To find out whether you have a UTI, your doctor or nurse will test a clean sample of your urine. This means you will first wipe your genital area with a special wipe. Then you will collect your urine in midstream in a cup. Your doctor or nurse may then test your urine for bacteria to see whether you have a UTI, which can take a few days.

If you have had a UTI before, your doctor may order more tests to rule out other problems. These tests may include:

• A cystogram. This is a special type of x-ray of your urinary tract. These x-rays can show any problems, including swelling or kidney stones.
• A cystoscopic exam. The cystoscope is a small tube the doctor puts into the urethra to see inside of the urethra and bladder for any problems.

How is a UTI treated?

UTIs are treated with antibiotics prescribed by your doctor. You may feel better in one or two days. Make sure to finish taking all of the antibiotics as prescribed, even if you feel better after a day or two.

What can happen if a UTI is not treated?

If treated right away, a UTI is not likely to damage your urinary tract. But if your UTI is not treated, the infection can spread to the kidneys and other parts of your body. The most common symptoms of kidney infection are fever and pain in the back where the kidneys are located. Antibiotics can also treat kidney infections.

Sometimes the infection can get in the bloodstream. This is rare but life-threatening.

How do UTIs affect pregnancy?

Changes in hormone levels during pregnancy raise your risk for UTIs. UTIs during pregnancy are more likely to spread to the kidneys.

If you're pregnant and have symptoms of a UTI, see your doctor or nurse right away. Your doctor will give you an antibiotic that is safe to take during pregnancy.

If left untreated, UTIs could lead to kidney infections and problems during pregnancy, including:

• Premature birth (birth of the baby before 39 to 40 weeks)
• Low birth weight (smaller than 5 1/2 pounds at birth)
• High blood pressure, which can lead to a more serious condition called preeclampsia

How can I prevent UTIs?

You can take steps to help prevent a UTI. But you may follow these steps and still get a UTI.

• Urinate when you need to. Don't go without urinating for longer than three or four hours. The longer urine stays in the bladder, the more time bacteria have to grow.
• Try to urinate before and after sex.
• Always wipe from front to back.
• Try to drink six to eight glasses of fluid per day.
• Clean the anus and the outer lips of your genitals each day.
• Do not douche or use feminine hygiene sprays.
• If you get a lot of UTIs and use creams that kill sperm (spermicides), talk to your doctor or nurse about using a different form of birth control instead.
• Wear underpants with a cotton crotch. Avoid tight-fitting pants, which trap moisture, and change out of wet bathing suits and workout clothes quickly.
• Take showers, or limit baths to 30 minutes or less.

Can cranberry juice help prevent UTIs?

Maybe. Studies on whether cranberry juice or products prevent or treat UTIs show mixed results.

Cranberries may help prevent bacteria from attaching to cells in the wall of the urinary tract and causing infection. If you get recurrent UTIs, talk to your doctor or nurse about taking cranberry products to prevent UTIs.

What should I do if I keep getting UTIs?

Women who get two UTIs in six months or three in a year have recurrent UTIs. Your doctor or nurse might do tests to find out why. If the test results are normal, you may need to take a small dose of antibiotics every day to prevent infection. Your doctor may also give you a supply of antibiotics to take after sex or at the first sign of infection.

Some infections before and during pregnancy can hurt both you and your developing fetus. They can cause serious illness, birth defects, and lifelong disabilities, such as hearing loss or learning problems. Here are 10 tips to help prevent infections before and during pregnancy:

1. Protect yourself from Zika virus.
   Zika virus can be passed from a pregnant woman to her fetus during pregnancy or to her baby around the time of birth. Zika virus infection during pregnancy can cause microcephaly (a birth defect where a baby’s head and brain are smaller than babies of the same age and sex) and other severe brain defects.
   • If you are pregnant, do not travel to areas with Zika.
     • If you must travel to an area with Zika, talk to your doctor or other healthcare provider first and strictly follow steps to prevent mosquito bites during the trip.
     • If you have a partner who lives in or has traveled to an area with Zika, use condoms from start to finish, every time you have sex (vaginal, anal, or oral) to protect against infection or do not have sex during the pregnancy.
   • If you are trying to become pregnant
     • Talk with your healthcare provider before traveling to areas with Zika and strictly follow steps to prevent mosquito bites during the trip.

1. Wash your hands with soap and water after the following:
   • Using the bathroom
   • Touching raw meat, raw eggs, or unwashed vegetables
   • Preparing food and eating
   • Gardening or touching dirt or soil
   • Handling pets
   • Being around people who are sick
   • Getting saliva (spit) on your hands
   • Caring for and playing with children
   • Changing diapers
      
2. Reduce contact with saliva and urine from babies and young children
   A common virus called cytomegalovirus (CMV) can cause problems for some babies, including microcephaly and hearing loss. A woman who is infected with CMV can pass the virus to her developing baby during pregnancy. Women may be able to lessen their risk of getting CMV by reducing contact with saliva and urine from babies and young children. Some ways to do this are by not sharing food and utensils with babies and young children, and washing hands after changing diapers. These actions can’t eliminate your risk of getting CMV, but may lessen your chances of getting it.
3. Avoid unpasteurized (raw) milk and foods made from it.
   Do not eat soft cheeses, such as feta, brie, and queso fresco, unless they have labels that say they are pasteurized. Unpasteurized products can contain harmful bacteria. 
4. Do not touch or change dirty cat litter.
   Have someone else do it. If you must change the cat litter yourself, be sure to wear gloves and wash your hands afterwards. Dirty cat litter might contain a harmful parasite. 
5. Stay away from wild or pet rodents and their droppings.
   Have a pest control professional get rid of pests in or around your home. If you have a pet rodent, like a hamster or guinea pig, have someone else care for it until after your baby arrives. Some rodents might carry a harmful virus.
6. Get tested for sexually transmitted diseases (STDs), such as HIV and hepatitis B, and protect yourself from them.
   Some people that have HIV, hepatitis B, or an STD do not feel sick. Knowing if you have one of these diseases is important. If you do, talk to your healthcare provider about reducing the chance that your baby will become sick.
7. Talk to your healthcare provider about vaccinations (shots).
   Some vaccinations are recommended before you become pregnant, during pregnancy, or right after delivery. Having the right vaccinations at the right time can help keep you healthy and help keep your baby from getting very sick or having life-long health problems. 
8. Avoid people who have an infection.
   If you have not yet had or did not have the vaccine before pregnancy, stay away from people who you know have infections, such as chickenpox or rubella. 
9. Ask your doctor about group B strep.
   About 1 in 4 women carry this type of bacteria, but do not feel sick. An easy swab test near the end of pregnancy will show if you have this type of bacteria. If you do have group B strep, talk to your healthcare provider about how to protect your baby during labor. 

These tips can help you prevent infections that could harm you and your developing baby. You will not always know if you have an infection and sometimes you will not feel sick. If you think you might have an infection or think you are at risk, see your healthcare provider. Be sure to talk with your healthcare provider to learn more about safe food preparation, wearing insect repellent when outside, taking medicine, and other important topics.