Pregnant women often receive a great deal of advice about what to eat. Family, friends, even well-meaning strangers may tell you what they think you should and shouldn’t eat to keep your little one safe and growing strong. It may be hard to untangle all of that advice. Luckily, we’re here to help, and can hopefully give a little more clarity on foods to avoid during pregnancy than your hairdresser or mail carrier.
Why Do I Have to Avoid Certain Foods During Pregnancy?
During pregnancy, your immune system naturally undergoes changes to help maintain the pregnancy. Some of these changes can make you more susceptible to foodborne illnesses (1). Because you are more vulnerable to infections when pregnant (2), and because your baby can be harmed by bacteria or substances in certain types of food, you need to take care when choosing what foods you eat. Still, it’s important to note that the chances of complications from food are very low (2), so there’s no need to worry excessively.
The good news is that the list of foods mom should not eat is far from restrictive. Most of the things you’re asked to avoid have easy substitutions that are likely similar enough to still satisfy your cravings. As we take a look through foods to avoid during pregnancy, we’ll offer alternative suggestions for safer foods.
Foods to Avoid During Pregnancy
Raw fish is more likely to contain parasites or bacteria than fish that has been cooked (3), because cooking kills most of the bacteria or parasites that may have been present. You should avoid all raw fish during pregnancy.
Alternative option: You can eat sushi that contains cooked seafood/meat or vegetarian sushi. There are cooked rolls with things like shrimp tempura, cooked eel, or steamed crab. Or you can find delicious vegetarian rolls filled with a variety of vegetables, pasteurized cream cheese, avocado, and more.
Raw or Undercooked Meat
You probably don’t eat a lot of raw meat (though some of you might enjoy a nice steak tartare now and then.) However, many people do like to eat meat cooked “rare,” or don’t pay close attention to internal temperature when cooking meat. It is recommended that you use a meat thermometer, and always make sure that meat is cooked to a safe temperature.
Alternative option: In this case, no alternative is needed — you can eat the meats you enjoy. Just make sure they’ve been cooked to a high enough temperature to kill bacteria and parasites.
Cold Cuts and Processed Meats
Cold cuts — also called lunch meat, luncheon meat, or deli meat — can contain harmful bacteria called listeria. The illness it can cause, listeriosis, is rare but potentially serious (4). Listeria, unlike most other types of foodborne bacteria, can grow at refrigerator temperatures, which is why processed meats like deli meat and hot dogs are at risk.
Alternative option: The good news is that you can eat deli meats and hot dogs, you just have to be sure that they’re heated until steaming hot, or 165 degrees (5). So that ham and cheese sandwich you’re craving isn’t necessarily off the table; it just needs to be a hot ham and cheese sandwich.
Most pregnant moms aren’t drinking raw eggs, like Rocky. However, you need to be careful not to do things like eat cookie dough with raw eggs in it. Furthermore, you should be sure to cook your eggs until both the whites and yolks are solid (4). Pregnancy isn’t the time to eat your eggs over easy or sunny side up.
Alternative option: There has been a recent trend in cookie dough that is meant to be eaten rather than baked. There are commercial cookie doughs on the market that do not contain raw eggs and are made to be eaten raw. As for eggs, you can still have them in ways that don’t leave the yolks runny. Embrace scrambled, fried to a firm yolk, boiled, etc.
Unpasteurized (Raw) Cheese or Dairy Products
Pasteurization is a process of heating food to kill organisms that could be harmful. All milk in the U.S. is pasteurized unless you specifically buy raw milk from an individual or farm. Cheeses, particularly soft imported cheeses, are not always made with pasteurized milk. You can eat hard cheeses like cheddar and swiss and hard blue cheeses (2). You need to check the label to make sure pasteurized milk was used before eating soft cheeses like brie, feta, camembert, roquefort, gorgonzola, queso blanco, and queso fresco (1). Also avoid unpasteurized juices.
Alternative option: You can drink milk and eat cheese and other dairy products, you just have to be sure they’re pasteurized. Also check the label on your juice before drinking.
We are definitely not here to tell you not to eat fruits and vegetables. We encourage you to eat a wide variety of both! However, the soil that they’re grown in may contain bacteria or parasites that could make you sick or even harm your baby. Make sure that you wash all of your produce before eating it.
It’s well known that you should never drink alcohol while pregnant. Alcohol crosses the placenta, so any alcohol you drink when pregnant can get into your baby’s system. The liver is one of the last organs to develop, meaning that your baby cannot detoxify the effects of alcohol and the rising concentration of alcohol in the blood can starve him or her of oxygen. Babies exposed to alcohol while in the womb may be at risk for premature birth, have low birth weight, or have fetal alcohol syndrome. (FAS can cause facial malformities, learning difficulties, and kidney and heart defects) (2, 6).
Alternative option: Use this time to explore other fun drinks — juices, smoothies, non-alcoholic mixed drinks, etc. (Of course you should start by drinking plenty of water, and make sure you’re not consuming too much sugar and empty calories in “fun” drinks.)
Foods to be Careful with During Pregnancy
Fish is a great source of protein and omega-3 fatty acids, and in general, fish is good for you. However, because of human-caused pollution, mercury has made its way into the oceans and some fish have a higher chance than others of containing high levels of mercury. Larger fish that live longer have the highest levels of mercury because they’ve had a longer time for it to accumulate in their systems (7). For this reason, the levels are higher in fish like shark, swordfish, king mackerel, tilefish, orange roughy, marlin, and bigeye tuna (4, 6). (Bigeye is not the type used for canned tuna.)
Alternative option: Don’t be afraid of fish, though. As mentioned above, it is generally a healthy choice. As long as you steer clear of the high-mercury types, fish is not a food you need to avoid during pregnancy. Experts recommend that pregnant women limit their fish and shellfish intake to no more than 12 ounces a week (7). This is about two or three average servings. If you like canned tuna, chunk light is a better choice than solid white. If you choose to eat solid white tuna, it is recommended that you limit it to no more than six ounces a week (4).
There isn’t an overwhelming consensus among professionals that caffeine must be avoided entirely, but some studies have shown that large amounts of caffeine may cause problems for your pregnancy or your baby. These problems could include miscarriage, premature birth, low birth weight, raised heart rate, raised blood pressure, and withdrawal symptoms in newborns (6). If you choose not to cut caffeine out entirely, you should limit your intake to no more than 200 mg a day.
To give you an idea of what 200 mg of caffeine looks like:
- An 8-ounce cup of coffee contains about 95 mg
- An 8-ounce cup of tea contains about 47 mg,
- A 12-ounce can of caffeinated cola contains about 33 mg (4)
Alternative option: If you don’t want to cut these things out entirely, try switching to decaffeinated coffee or tea or chose sodas that don’t contain caffeine.
Herbal teas aren’t regulated by the Food and Drug Administration (FDA), and there isn’t a lot of research on how many herbs effect a developing baby. You’re safer sticking to black tea. (Decaffeinated black tea is even better.) There are fruit and ginger teas out there, but if you’d like to try them, carefully read the ingredients to ensure that there aren’t any additional herbs in them. Also limit green tea, since there’s some evidence that it may interfere with fetal growth (2).
Want to learn more? Read Pregnancy Questions & Answers: From Sushi to Hair Dye.
A Handy Reference
While not as detailed as what you’ve just read, here is a really great informational resource that you can print and hang in your kitchen or reference easily at a glance. Follow these simple guidelines to help keep both you and baby safe from foodborne illness.
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1. Assistant Secretary for Public Affairs (ASPA). (2019, November 21). People at Risk: Pregnant Women. Retrieved July 26, 2020, from https://www.foodsafety.gov/people-at-risk/pregnant-women
2. Barratt, J., Cross, C., Steel, S., & Biswas, C. (2016). The pregnancy encyclopedia: All your questions answered. London: Dorling Kindersley Limited.
3. American College of Obstetricians and Gynecologists. (2021). YOUR PREGNANCY AND CHILDBIRTH: Month to month.
4. Do you know which foods to avoid when you’re pregnant? (2019, December 31). Retrieved July 26, 2020, from https://www.mayoclinic.org/healthy-lifestyle/pregnancy-week-by-week/in-depth/pregnancy-nutrition/art-20043844
5. Center for Food Safety and Applied Nutrition. (n.d.). Listseria from Food Safety for Moms to Be. Retrieved July 26, 2020, from https://www.fda.gov/food/health-educators/listeria-food-safety-moms-be
6. Foods to Avoid When Pregnant. (2020, May 13). Retrieved July 27, 2020, from https://americanpregnancy.org/pregnancy-health/foods-to-avoid-during-pregnancy/
7. Curtis, G. B., & Schuler, J. (2016). Your pregnancy week by week. Cambridge, MA, MA: Da Capo Life Long.