Fellow Fodorites,

DH and I are planning a trip to Italy (Rome and Venice - 4 nights in each city) during my second trimester. We would be there towards the end of November. I kept wondering and reading about all the "pregnancy travel" questions and have come to the conclusion that it seems pretty safe to travel during this time.This will be our last Europe trip before the little one arrives in late April next year. I'm pretty sure travel will not be the 'same' anymore although we plan to start again by the time he/she turns 2.

My dilemma (or is it?) - I am a vegetarian! Typically that poses no problems. I love salads and cheese and was always dreaming living on Pizza whenever I made it to Italy. Now all this talk from my doctors and others about pasteurized v. non pasteurized cheese is bothering me. Let me be honest - I don't know much about the whole pasteurizing process. What can I eat when I'm there without the nagging worry about potentially harming the baby?

Thanks in advance. I am pretty sure some of you will have some sort of advice for me.

Have you asked your pediatrician? I think he'd be a more reliable source of information than us strangers!

I don't know about Italy in particular, but most of the cheeses in France are UNpasteurized. It seemed that the better the restaurant, the less chance of cheese being pasteurized b/c most of the delicious cheeses that we associate with France are unpasteurized. There were some supermarket brands that were pasteurized.

Someone will post about Italian cheese, I'm sure. I also have heard that hard cheeses like parmesan, romano are ok, but again, check that out.

My daughter was just beginning her 2nd trimester when we were in France in '02 . She was warned about green salads, also.

I'd think you'd be able to find lots of pasta dishes with "red sauce" w/o meat, and how about just plain garlic and olive oil?

I don't know about Italy in particular, but most of the cheeses in France are UNpasteurized. It seemed that the better the restaurant, the less chance of cheese being pasteurized b/c most of the delicious cheeses that we associate with France are unpasteurized. There were some supermarket brands that were pasteurized: President-brand brie, eg.

Someone will post about Italian cheese, I'm sure. I also have heard that hard cheeses like parmesan, romano are ok, but again, check that out.

My daughter was just beginning her 2nd trimester when we were in France in '02 . She was warned about green salads, also.

I'd think you'd be able to find lots of pasta dishes with "red sauce" w/o meat, and how about just plain garlic and olive oil?

I hope you come up with a plan that you are comfortable with; you will have a wonderful time!

Excuse the double post; must have hit the button by mistake when editing?

The big concern is listeria, which can cause spontaneous miscarriages. It is a bacteria than can be found in unpasteurised cheese, cold cuts, rare meat, etc.

Since you are a vegetarian, you don't have to worry about the meats and sausages. Friends of mine in France were advised to avoid unpasteurised cheeses, but that cheese that was brought up to a certain temperature (ie baked or cooked) was ok. On that logic, cheese on pizza should be ok. If this clashes with information given by your doctor, you can always ask in the restaurant if the cheese is pasturised.

The other thing that some of pregnant friends were told was to avoid salads that had not been rinsed in a vinegar solution (same bacteria). So salad at home was ok, salad out was not.

I am not a doctor, and you should definitely discuss this with your doctor.

I'm not sure which (if any) Italian cheeses are unpasteurized, but be careful with desserts. Definitely no tiramsu, as it contains raw eggs. Some pastas, such as Carbonara, also contain raw egg. And there's been a discussion on this board about pizza with an egg on top.

Don't you think Italians get pregnant?
If whatever cheese/vegetable/fruit the native Italians eat doesn't beget a higher rate of complications than in the USA, then it must be ok for them. If it's ok for them, it's ok for you.

Thanks for the replies everyone. It really helps.

Tomboy - I am not typically this "on the edge". However, this is my first pregnancy. Also, immunity is a big factor in most infections. I am originally from India but have lived in the US for the past 8 years. Every time I visit India, I get sick (sometimes awfully sick) for 5 - 6 days. If I go by that logic, the air, water and food which is "good enough" for Indians should be "good enough" for me especially since I lived there for the first 21 years of my life. Unfortunately, our immune system changes and we do get more susceptible to catch what locals might not.

I just returned from 10 days in Venice and I'm 6.5 mos pregnant and had no problems. My dr. told me to avoid "soft" cheeses as they are the most likely to cause problems. However, anything baked (i.e. pizza) is fine according to my dr. b/c the cooking process kills any bacteria. Margarita pizza was my lifeline for lunch in order to avoid the "cured" meats that seem to rule Italian sandwiches, although I must admit I rolled the dice and ate proscuitto for lunch one day and am living to tell about it! Hard cheeses are apparently fine (i.e. pecorino, parmasean) b/c the aging process does not allow the bacteria to survive. Again, check with your dr. but this is what my dr. told me. Also, make up for the wine you won't be drinking with lots of gelato! I highly recommend Fantasy Gelato off Piazza San Marco in Venice!

Hi life,

Pizza will be OK since the cheese is heated well above its melting temperature, which is high enough to kill the listeria.

Hard cheeses, such as Regiano Parmegiano, are not a problem.

Raw fish can harbor listeria.

Use oil and vinegar dressing or oil and lemon juice dressing.

Don't drink the water from the fountains. It is potable, but ....

Have a great visit.

Thanks a bunch everyone. I'll post a trip report once we get back.

Bon voyage, lifetravel and enjoy the trip. Because being pregnant for the first time seems to mean open season on giving the poor mother-to-be advice, I usually keep mine to just one thing: GO AWAY with your husband before you deliver. It'll be the last time in your life when you won't have your mind at least a little with your child/children, so it's kind of the best kind of honeymoon -- all about you and your husband, but with the happy anticipation of a child in your future. You'll never, ever forget this trip, so enjoy enjoy!

And I think you've gotten some perfectly good advice here (things, I might add, that many OBs just don't know anything about since med school's are really thin on nutrition and food issues). One last comment -- watch out for unpasteurized honey, if you can. There are documented cases of problems with contaminated honey, and it's often served with yogurt, so be aware.

Wow! They just tell us expectant mothers here in Europe not to smoke or drink and don't eat for two. No one has ever mentioned soft cheese. Interesting.

An aside regarding traveling with a two-year-old... ask other parents, but we sure found it easier to travel with a baby than with a toddler, when they aren't mobile, for obvious reasons. Also easier before our baby was eating table food (i.e. nursing), since having the right snack or food whenever the baby was hungry or fussy was never a problem. My two cents' worth (not that you asked) is the younger the better! My babies loved the front pack and away we'd go.

It's all a matter of risk/reward (or risk/punishment) ratio. Because western Europe has very high sanitation and health standards, the likelihood of having severe consequences from such foods is very, very low. BUT the possibility, however low, is there.

The frequency of risk is extremely low, but the magnitude of the impact of that extremely low risk should it happen to you is very high--and potentially life-changing.

Here's a concrete example: For some reason, you have to choose between being injected with two viruses.

The first is a cold virus that has a 99% chance of giving you a bad cold that will last a week or two. You will be miserable, but you won't die. High risk factor, but low impact.

The second is a new strain of the ebola virus that has only a 0.1% chance of infecting you, but if you are infected, has a 99% death rate. Low risk factor, but high impact.

I wouldn't take the ebola virus.

It is not a matter of sanitation, but one of resistance to certain bacteria. Europeans are less threatened by raw cheeses because they eat them all the time. Americans likely have no reisitance to the organisms because they've never had a chance to develop the tolerance.

<<Europeans are less threatened by raw cheeses because they eat them all the time...>>

In the matter of listeria (which is a VERY, very low - - but real - - risk in pregnancy), I don't think that a lifetime of eating raw cheeses provides protection, as 99.9% of cheeses will not harbor listeria. Listeria infections have been linked to handling problems with cold cuts (especially turkey) in the US, and perhaps other countries as well. Again, very rare - - but I don't think that eating bologna every day for decades will protect a person from the (highly improbable) risk of contracting listeriosis if the foods ingested are "culprit".

I think you have two choices: don't worry about a very, very low risk - - or screen carefully raw items (not just cheeses), and stick primarily to cooked foods.

An obstetrician, especially one with connections to an academic medical center where a colleague may have a specific interest in pregnancy and international travel/health - - will likely provide as good, if not better info on this subject... as a pediatrician (unless it is a special interest for that pediatrician).

Best wishes,

Rex Bickers, M.D.
Fellow, American Academy of Pediatrics

Exerpt from recent article about honey 'problem' in The Guardian - so eat and enjoy!

"In 1976 the rare syndrome infant botulism was diagnosed for the first time in sick babies in California, US, after traces of botulinum spores were found in their stools. In 1978 a Californian study tested more than 550 samples of food, drugs and miscellaneous environmental substances for botulism. Clostridium botulinum was found in five samples of soil, one of dust from a vacuum cleaner and nine of honey. Honey was the only one of these variables that could be controlled, and it became officially recognised as a danger for infants.

However, as the author points out, honey and soil from California have a higher incidence of botulinum spores than elsewhere, and even in California only 10 - 13% of honey contains botulinum spores. In the UK there have only ever been six cases of infant botulism, none of which implicated British honey. The most recent UK case was due to contaminated milk formula. She also notes that infant botulism almost exclusively affects those under six months old, most of whom would still be consuming milk."

How wonderful that you can get away together before your lives completely change! The 2nd trimester is a good time to travel, as I always felt my best during that trimester -- no more nausea, and you don't feel like a whale... you should have a fantastic time!!

You've gotten some good advice... just remember that your doctor KNOWS YOU BEST, and it should be his/her advice which you ultimately should follow. I'm sure you already advised him/her of your trip -- he/she might have some additional information specifically towards European or Italian food.

With my own 2 pregnancies, I travelled internationally with my husband during the 2nd trimester. One concern which my doctor did express before my trips was regarding the flight... she advised that I get up and move around frequently for circulation.

I just wanted to add that I agree with MareenB... it is SO much easier to travel with a baby than a 2 y.o. We have done both -- a baby requires more luggage BUT they are much easier. You can go to museums, restaurants without too much hassle... it's a WHOLE different story when traveling with a 2-5 y.o.