HOW TO BATHE A BABY SAFELY: A STEP-BY-STEP GUIDE FOR NEW PARENTS

If you are pregnant, or planning a pregnancy, and you share your home with a cat, you may have been warned about toxoplasmosis. It can sound frightening, and some women even think they must give their cat away. The good news is that, with a few simple precautions, you can keep your cat and protect your baby. This guide explains what toxoplasmosis is, how people really catch it, why it matters in pregnancy, and what you can do to reduce your risk.

What is toxoplasmosis?

Toxoplasmosis is an infection caused by a tiny parasite called Toxoplasma gondii. It is very common worldwide. In most healthy people it causes no symptoms, or only mild, flu-like symptoms, and the person recovers without treatment. But if a woman catches it for the first time during pregnancy, it can sometimes pass to the baby and cause serious problems.

What is the role of cats?

Cats are the only animals in which the parasite completes its life cycle. A cat usually becomes infected when it hunts or eats infected prey, or eats raw or undercooked meat. After a first infection, the cat sheds tiny parasite eggs (oocysts) in its faeces (poo) for a short period, usually a few weeks. After that, most cats rarely shed them again.

An important detail is that the parasite is not infectious straight away. It takes about 1 to 5 days after the cat has passed it before it can infect a person. This is why cleaning the litter tray every day makes such a difference.

How do people actually catch toxoplasmosis?

Many people think that stroking a cat is the main danger. In fact, you are more likely to be infected from other sources than from your own cat. The main routes are:

• Eating raw or undercooked meat (especially pork, lamb, and game), or cured meats such as salami or Parma ham
• Soil contaminated with cat faeces, for example through gardening without gloves
• Unwashed fruit and vegetables that carry traces of soil
• Contaminated water
• Touching infected cat poo, for example when cleaning a litter tray, and then touching your mouth
• Unpasteurised goat's milk and its products, and contact with newborn lambs or pregnant sheep

Cats Protection, a cat welfare charity, points out that people are more likely to pick up toxoplasmosis from their garden or from undercooked meat than from their cat.

Why does it matter in pregnancy?

If you become infected for the first time during pregnancy, the parasite can sometimes cross the placenta to the baby. This is called congenital toxoplasmosis. Depending on when it happens, it can lead to miscarriage or, in some babies, to problems affecting the eyes or brain. Infection earlier in pregnancy is less likely to be passed on, but it can be more serious if it is. Passing it on is rare, and most babies of infected mothers are born healthy, especially when the mother receives treatment.

If you were infected before pregnancy, you generally have some protection, and the risk to your baby is very low. Nobody can tell you for certain whether you have already had toxoplasmosis without a blood test.

Symptoms

Most people have no symptoms. When they appear, they are usually mild and may include:

• Swollen glands, especially in the neck
• A sore throat
• Muscle aches and tiredness
• A raised temperature and flu-like feelings

Because the symptoms are so mild and common, many women do not know that they have had it.

How to protect yourself: practical steps

If you have a cat

• Ask someone else to clean the litter tray while you are pregnant, if you can.
• If you have to do it yourself, wear disposable gloves, use a scoop, and wash your hands thoroughly with soap and water afterwards. Avoid touching your face before you wash them.
• Empty the tray every day. The parasite needs time to become infectious, so fresh poo is much less risky.
• Clean the tray regularly with boiling water or a cat-safe disinfectant.
• Feed your cat commercial dry or tinned food. Never give it raw or undercooked meat.
• Keep your cat indoors if possible, so that it does not hunt birds and small animals.
• Wash your hands after stroking any cat, and keep cats away from food preparation areas.
• Avoid stray cats and kittens, and try not to adopt a new cat while you are pregnant.

In the garden

• Wear gloves when gardening or handling soil or sand, and wash your hands afterwards.
• Cover children's sandpits when they are not in use, so that cats cannot use them as a toilet.

In the kitchen

• Cook meat thoroughly until there is no pink, and the juices run clear. Do not eat rare or undercooked meat during pregnancy.
• Avoid cured meats such as salami, chorizo, and Parma ham, unless they have been cooked.
• Wash fruit and vegetables well, to remove traces of soil, or peel them.
• Wash hands, knives, and chopping boards thoroughly after handling raw meat.
• Avoid unpasteurised goat's milk and any products made from it.
• Avoid raw or undercooked eggs.

On farms and with animals

• Avoid contact with sheep and newborn lambs at lambing time.

Do I have to give up my cat?

No. There is no need to give your cat away. The risk from a healthy indoor cat that eats cooked or commercial food is very small, especially if you follow good hygiene. Many pregnant women live safely with their cats.

Testing and treatment

• In many countries, a test for toxoplasmosis is not part of routine antenatal care. Policies differ from country to country, so ask your doctor or midwife what applies where you live.
• If you think you may have been exposed, or you have symptoms, talk to your doctor. A blood test can show whether you have been infected, and whether it is recent.
• If you test positive during pregnancy, you can be referred for more tests to check whether your baby has been affected. This is uncommon.
• If infection is confirmed or suspected in pregnancy, there are antibiotic treatments that can reduce the chance of the infection passing to the baby, or lessen its effects. Mother and baby are monitored closely, and the baby is checked after birth.

Never take any medicine for toxoplasmosis without a doctor's advice.

When to see a doctor

• You are pregnant and think you may have been exposed to toxoplasmosis
• You have swollen glands or flu-like symptoms that do not go away
• You have a weakened immune system and you have been exposed
• You are worried about your baby's health

Frequently asked questions

Can I stroke my cat while pregnant?

Yes. Stroking a cat is not a significant risk. Just wash your hands afterwards, and do not touch your face or mouth before you do.

Can toxoplasmosis harm my baby if I had it before pregnancy?

If you were infected before you became pregnant, the risk to your baby is generally very low, because you have built up immunity.

Can I get it from my indoor cat?

The risk is low. An indoor cat that is not fed raw meat and does not hunt rarely carries the parasite.

Is it safe to eat meat in pregnancy?

Yes, as long as it is cooked thoroughly. Avoid rare or undercooked meat and cured meats.

Do I need a test?

It is not routine in many places. Ask your doctor if you are concerned or have been exposed.

Sources and further reading

• NHS, What are the risks of toxoplasmosis during pregnancy?
• NHS 111 Wales, Toxoplasmosis
• HSE (Ireland), Toxoplasmosis in pregnancy (leaflet)
• Cats Protection, Toxoplasmosis

This article is for general education and does not replace advice from your doctor or midwife. If you are pregnant and worried about toxoplasmosis, contact a healthcare professional. See our Disclaimer.

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