On Toxoplasmosis

One of the big topics for pregnant women is Toxoplasmosis. We are warned to avoid our cats, or at the very least, their litter boxes. After years of working in pet hospitals and doing research on the topic for our expectant mother clients, I want to set the record straight.

This topic has utterly annoyed me since my first pregnancy, but now that I'm expecting my second child, I've come in contact with continued frustrations. Two stand out in my mind. The first, when I went into the doctor's office to have an early pregnancy consult with one of their nurses. I was already annoyed at the requirement for this meeting since I felt nothing of value was gained (I merely discussed my family's medical background and got an appointment for the doctor). In discussing my medical background, I was asked if I had pets, which I do - a cat and a dog. The nurse went on to ask if I knew about the litter box. Yes, of course I did, this wasn't my first rodeo. At least, that seemed to be the end of the discussion. A second incidence was with my mother-in-law who came to visit and insisted that she clean out the litter boxes while she was there since my husband was out of town.

Ok, so, why am I annoyed? Those don't sound bad, really. And all things considered, they aren't. I mean, c'mon, I got out of litter box duty. But in my mind, it's the same thing as using my pregnancy as an excuse to avoid housework, work, or activity in general, which is actually more harmful to me as a pregnant woman than doing those things in the first place, but I digress.

The thing is, our poor cats are being accused of transferring Toxoplama gondii (the protozoan that causes Toxoplasmosis) when there is a very high likelihood that they aren't. They are automatically cast as the villains in our pregnancies.

While most of us know that Toxoplasmosis is extremely bad in pregnancy - it can lead to birth defects or loss of the pregnancy - most of us don't know the whole story. We look up what could happen to us if we are infected and hear that we can get it from cleaning out the litter box and that is enough for us to steer clear of our feline friends. This is in error, however, and our cats should not be feared by us while we are pregnant. Let me explain. The information that is most often skipped over is how Toxoplamosis works in cats. That will give us an idea of what our risk really looks like.

Toxoplasmosis occurs in almost all warm blooded animals. The thing that makes cats different is that when they contract it, they can pass it in their feces - no other mammal does this. And this is why cats are called the definitive host for Toxoplasmosis and the reason we fear their litter boxes. There is more to the story though.

Cats typically get Toxoplama gondii by ingesting raw meat - like when they hunt rodents and birds or by coming in contact with contaminated soil or water. About a week after exposure, they begin passing the infective oocysts (kinda like eggs) in their stool - which, I'll be honest, can occur in large numbers. They pass the infective oocysts for up to two weeks. That's it. After that, the develop an immunity. They don't contract it again, they don't spread it. Here's another piece of the puzzle - the oocyst has to be outside the body for at least 24 hours before it truly becomes infective - a litter box that is cleaned out daily poses little to no risk.

So, what does that mean? Our villainous cats are not the big culprits. If your cat has been a happy indoor cat for years, your risk is virtually nil. An outdoor cat is more likely to be suspect, but again, if they are an older cat, most likely, they had it when they were very young and most likely no longer pose a risk.

Here's something else that they don't tell you - the most common way humans contract Toxoplasmosis is from eating raw meat or drinking raw unpasteurized milk. Not from cats. It is more likely to be found in sheep, goat, and pig as opposed to beef or poultry, but it is still possible. Just one more reason to ensure all meats are cooked thoroughly and your milk has been pasteurized. Also, fruits and vegetables should be cleaned thoroughly as contaminated soil on these foods can pose a risk - don't assume if you grew it yourself you are safe since neighborhood strays like to use gardens as litter boxes.

Where your cat is concerned, you can protect him or her by keeping your cat inside and not allowing your cat to hunt. Also, don't feed your cat raw meats or milk. Doing this will protect you as well. If you do have a cat that goes outside, that is a good reason to avoid the litter box or wear gloves when cleaning it out. Even better, if you have an outdoor cat, blood work can be run to check your cat's exposure. Any strays or new adoptions should be regarded cautiously since you don't know their history and exposure possibilities.

Above all, don't forget basic hygiene. A good hand washing is always recommended after handling raw foods or cleaning the litter box.

So, go on. Don't be afraid to give your cat a hug.

For more information check out: American Veterinary Medical Association and Cornell Feline Health Center

On Car Seat Safety

Safety is the only reason you need.

Ok, let me explain. But, before I do, I'm sorry if I offend anyone with this post, but there are a few things I had to get off of my chest.

My little boy recently turned one. So did many of the babies in my mom group and several of the other babies I know have recently turned one or soon will. The topic of car seats seems to be coming up more and more frequently in general conversations I have had, on websites I've visited, and in various forum discussions. Needless to say, not from a single source, but many, I'm inundated with tons of comments and opinions about car seats, in particular, turning babies forward facing when they reach the age of one since many of them are 20 lbs by then, and this is the legal age at which they can be turned forward facing.

Like many other parenting topics this generates some very strong opinions, arguments, judgments (forgive me, because I'm contributing to this), and excuses. The thing that has really gotten me thinking lately on this particular topic, unlike many other parenting issues, is that car seat safety is not a topic that should generate this sort of discussion. I'm not saying we shouldn't talk about it, but what I'm saying is that unlike whether or not you vaccinate, bottle or breast feed, circumcise or leave in tact, attachment parent or practice Baby Wise, etc. the issue of car seat safety is black and white. Many other issues that generate such strong opinions are surrounded with facts, circumstantial evidence, and anecdotal tales that offer two or more sides in many cases that may or may not affect the child's future, their intelligence, their over all health, their mental stability, etc. Car seat safety? That's a whole different ball game.

I think when we hear the word "safety" or "safer", we understand, but the concept does not sink in. That factor is given as much thought as many others. I hear tons of other factors to consider when selecting car seats for young ones and whether or not to forward or rear face. Here are some:

My spouse wants to forward face our one-year-old.
My child prefers to face forward.
I want to be able to see my child and can't when they rear-face.
I was given a forward facing seat.
My child is too big to rear-face.
Harnesses are not available for larger/older kids.

I've seen all of these comments in more than one place, multiple times. These are things that you hear especially when an individual is faced with someone commenting that rear-facing is safer. And then an argument and not so nice words are exchanged repeatedly among strangers on a public forum. It gets ugly. And this is all despite the fact that the AAP has updated it's recommendations and now recommends rear-facing at least until the age of 2 and TxDPS (for those that live in Texas) has changed it's recommendations that children stay rear-facing as long as possible and to the upper limit allowed by the seat.

Here is the thing though (and here is where I get all judgey and get up on my soap box): Safety is the only factor that needs to be considered. No other reason has the right to be factored in when it goes against safety. Let's put it another way. When your child's life is on the line, why are there other considerations? It sounds drastic, but that is the reality. We are told that rear-facing is 5 times safer than forward facing. So, let's put that in terms that may sink in more: when forward facing, a child is 5 times more likely to die in a car accident than when rear-facing. Yes, it sounds harsh, but that is the cold hard truth. Automobile accidents are the number one cause of death in children. I don't know that they have statistics about proper vs. improper use of seats/harnesses, forward vs. rear-facing, harnessed vs. not harnessed, correct installations vs. faulty ones, etc. related with that little tidbit of information, but they do know that car accidents are the number one cause of death in children.

We are in our cars on a daily basis, often many times a day, and don't think about getting in an accident because most of the time we arrive at our destination safely. Think of all the near misses we encounter - someone cutting us off, another driver trying to come into our lane who didn't see us in their blind spot, the line of cars slamming on their brakes in the middle of the highway - it goes on and on. It only takes one time for it to be fatal to us or our child.

So please, really consider it. Too many parents have had to suffer the loss of a child. This is one argument that the proverbial in-laws shouldn't win (I apologize to all in-laws that may find offense - I do not mean to insinuate that all in-laws do not have the child's best interest at heart). Rear-face as long as possible, use the seat you have correctly, read all of the instructions that are included, etc. When you are faced with the fact that a hasty car seat decision could mean your child's life, safety is the first and most important factor to consider.