What Not to Eat When Pregnant: Foods to Avoid and Safe Alternatives

01Why

Why some foods are risky in pregnancy

• Listeria: bacteria that can grow in chilled foods, rare but can cause miscarriage, stillbirth or serious illness in newborns.
• Toxoplasmosis: a parasite in undercooked meat, soil and cat faeces that can harm the baby.
• Salmonella: from undercooked eggs and poultry, causing food poisoning.
• Mercury: in some large fish, can affect the baby’s developing nervous system.
• Vitamin A (retinol): very high amounts, found in liver, can cause birth defects.
• Alcohol: can affect the baby’s development at any stage.

02Cheese

Cheese and dairy

• Avoid: unpasteurised milk and dairy products.
• Avoid unless cooked until steaming hot: mould-ripened soft cheeses with a white rind, such as brie, camembert and rinded goat’s cheese; soft blue cheeses such as gorgonzola and Danish blue.
• Usually safe: pasteurised hard cheeses such as cheddar and parmesan, and pasteurised soft cheeses such as mozzarella, cottage cheese, cream cheese, feta, halloumi and paneer.
• UK guidance considers hard cheeses safe even if unpasteurised, while US guidance advises choosing pasteurised products; check local advice.

03Meat

Meat, pâté and deli foods

• Cook all meat and poultry thoroughly, with no pink meat or blood.
• Avoid all types of pâté, including vegetarian pâté, unless it is tinned or shelf-stable.
• Cold cured meats such as salami, chorizo and Parma ham carry a toxoplasmosis risk; cooking them, or following local advice on freezing, reduces the risk.
• US advice recommends heating deli meats and hot dogs until steaming hot because of listeria.
• Avoid liver and liver products, such as liver sausage, because of high vitamin A.
• Avoid game shot with lead pellets.

04Eggs

Eggs

Raw or partly cooked eggs can carry salmonella. In the UK, eggs produced under the British Lion scheme are considered safe to eat runny or raw in pregnancy, as are foods made with them. Other eggs, including non-hen eggs, should be cooked until the whites and yolks are solid. In the US, advice is to cook eggs until both yolk and white are firm and to avoid foods containing raw eggs, such as homemade mayonnaise, mousse or raw cookie dough, unless made with pasteurised eggs.

05Fish

Fish and seafood

• Avoid: shark, swordfish and marlin; US advice also lists king mackerel, orange roughy, bigeye tuna and tilefish from the Gulf of Mexico.
• Limit tuna: UK advice is no more than four medium cans or two fresh tuna steaks a week.
• Oily fish: eat no more than two portions a week, but do include it for omega-3s.
• Raw shellfish: avoid; cooked shellfish is fine.
• Cold-smoked or cured fish such as smoked salmon: cook until steaming hot because of listeria risk.
• Sushi: raw fish is generally considered safe if it has been frozen first; check with the restaurant.
• The FDA recommends 2–3 servings a week of lower-mercury fish such as salmon, sardines, cod and shrimp.

06Drinks

Alcohol, caffeine and drinks

• Alcohol: the safest approach is not to drink at all during pregnancy.
• Caffeine: no more than 200 mg a day, about two mugs of instant coffee or one mug of filter coffee.
• Remember caffeine in tea, cola, energy drinks and chocolate.
• Herbal teas: limit to a few cups a day and check with a midwife or pharmacist.
• Unpasteurised juices: avoid.

07Produce

Fruit, vegetables and sprouts

• Wash fruit, vegetables and salads well to remove soil, which can contain toxoplasma.
• Avoid raw sprouts, such as alfalfa and mung bean, unless cooked until steaming hot, as advised in the US.
• Avoid pre-prepared salads that have been stored for a long time.
• Wear gloves when gardening and wash hands afterwards.

08Supplements

Supplements to avoid and to take

Avoid supplements containing vitamin A (retinol) and fish liver oil supplements. Take folic acid, 400 micrograms a day, before conception and for the first 12 weeks, and vitamin D, 10 micrograms a day, throughout pregnancy, as recommended by the NHS. Some women need higher-dose folic acid or other supplements, so follow your midwife or doctor’s advice.

09Hygiene

Food hygiene tips

• Wash hands before and after handling food.
• Keep raw meat separate from ready-to-eat foods.
• Use separate chopping boards.
• Reheat leftovers until steaming hot, and eat within 24 hours.
• Keep the fridge at 5°C or below.
• Check use-by dates.

10Nausea

Eating well with nausea and cravings

Morning sickness can make it hard to eat a balanced diet. Small, frequent meals, plain carbohydrates and cold foods may be easier to manage; ideas are in our guide to foods for nausea. Constipation is also common, and fibre, fluids and activity help; see high-fiber snacks. Cravings for non-food items such as soil or ice should be discussed with a midwife, as they can be linked to iron deficiency.

11Summary

Key points to remember

• Avoid foods with a higher risk of listeria, toxoplasmosis and salmonella.
• Avoid high-mercury fish, liver and vitamin A supplements.
• Avoid alcohol and limit caffeine to 200 mg a day.
• Guidance differs slightly by country; follow local advice.