Foods to avoid during pregnancy, and what to eat instead

Most food in pregnancy is about adding good things, not fear. But a short list of foods can carry bacteria, parasites, mercury, or too much vitamin A, and those are worth skipping until your baby is here. Here’s the list I give my clients, with the reason for each and what to reach for instead.

High-mercury fish

• Shark
• Swordfish
• King mackerel
• Tilefish
• Marlin
• Orange roughy
• Bigeye tuna

These fish can carry high levels of mercury, which can harm your baby’s developing brain.¹ You don’t need to give up fish. Salmon, shrimp, and canned light tuna are good choices: aim for 2 to 3 servings a week, 4 ounces each, or 1 serving a week of albacore (white) tuna.²

Raw or undercooked seafood and meat

• Sushi with raw fish
• Raw shellfish, like oysters
• Rare steak
• Undercooked chicken
• Refrigerated smoked seafood, like lox, unless it’s cooked into a dish or comes in a sealed can or pouch that doesn’t need the fridge

Raw and undercooked meat and seafood can carry bacteria and parasites like listeria, salmonella, and toxoplasma. These can cause serious infection and raise the risk of miscarriage.¹ Cook meat and poultry all the way through. A food thermometer takes the guessing out of it. Sushi rolls made with cooked fish or vegetables are fine.

Unpasteurized dairy

• Raw milk, and anything made from raw milk
• Soft cheeses made from raw milk, like queso fresco, brie, camembert, and blue cheese

Unpasteurized milk can carry listeria and other bacteria.¹ Choose milk, yogurt, and cheese that say “pasteurized” on the label. Pasteurized soft cheese is fine, or heat soft cheese until it’s steaming hot.¹

Liver and liver products

• Liver
• Foods made with liver, like liver pâté or liverwurst

Liver is very high in vitamin A. Too much vitamin A can be toxic to a developing baby and can cause birth defects.³

Processed, ready-to-eat meat

• Lunch meat and deli meat
• Hot dogs
• Refrigerated pâtés and meat spreads
• Fermented or dry sausages, like salami and pepperoni

These can carry listeria, which can grow even in the fridge.¹ My advice: if you can, wait until your third trimester to eat these, and always heat them to 165°F, or until steaming hot, before you eat them.¹

Raw or runny eggs

• Over-easy eggs, or any egg with a runny yolk
• Raw eggs, and foods made with raw eggs

Raw and undercooked eggs can carry salmonella.¹ Cook eggs until the yolk and the white are both firm.

Unwashed fruit and vegetables

Always wash fruit and vegetables before you eat them, even if you’re going to peel them. Peeling can drag bacteria from the skin onto the part you eat.¹

Skip raw sprouts, like alfalfa and bean sprouts, unless they’re cooked until steaming hot. Washing doesn’t make them safe.¹

Caffeine

Caffeine is fine in moderation: keep it under 200 mg a day, about one 12-ounce cup of coffee.⁴ Tea, soda, energy drinks, and chocolate count too.

Alcohol

Never during pregnancy. There’s no known safe amount of alcohol in pregnancy, and no safe time to drink.⁵

Unpasteurized juice

Fresh-pressed juice and cider that hasn’t been pasteurized can carry bacteria.¹ Choose juice labeled pasteurized.

When to call your provider

If you’ve eaten something on this list, don’t panic: most of the time nothing happens. Call your OB or midwife if you get a fever, chills, muscle aches, vomiting, or diarrhea, especially within a few weeks of eating it, and tell them what you ate.

Your own provider knows your health best, so bring this list to your next appointment and ask what they’d add.

Sources

1. CDC: Safer Food Choices for Pregnant Women ↩ ↩² ↩³ ↩⁴ ↩⁵ ↩⁶ ↩⁷ ↩⁸ ↩⁹ ↩¹⁰

2. FDA: Advice about Eating Fish ↩

3. NHS: Foods to avoid in pregnancy ↩

4. March of Dimes: Caffeine in pregnancy ↩

5. CDC: About Alcohol Use During Pregnancy ↩