What foods should be avoided during pregnancy and why for each?

Foods to Avoid During Pregnancy

Pregnant women must completely avoid raw or unpasteurized dairy products, all raw or undercooked seafood and shellfish, raw or undercooked meats and eggs, high-mercury fish, unpasteurized soft cheeses, unheated deli meats, and all alcohol due to severe risks of life-threatening infections, fetal loss, and developmental harm.

Raw or Unpasteurized Dairy Products

Complete avoidance is mandatory for all unpasteurized milk and dairy products, including soft cheeses like feta, Brie, Camembert, blue-veined cheeses, and Mexican queso fresco unless clearly labeled as pasteurized 1, 2.

Why This Matters:

• Listeria monocytogenes infection occurs 13-17 times more frequently in pregnant women than the general population 3
• Carries a 20% risk of spontaneous abortion or stillbirth 1, 3
• Two-thirds of infants born to mothers with listeriosis develop neonatal pneumonia, sepsis, or meningitis 1, 3
• Between 17-33% of all invasive Listeria disease cases involve pregnant women, fetuses, or newborns 1, 3
• From 1998-2009, raw dairy consumption caused 93 outbreaks, 1,837 illnesses, 195 hospitalizations, and 2 deaths in the U.S. 1

Raw or Undercooked Seafood and Shellfish

All raw shellfish (oysters, clams, mussels) and undercooked seafood—including sushi, ceviche, poke, or lightly seared fish—must be completely avoided 3, 2.

Why This Matters:

• Raw oysters and clams can transmit Toxoplasma gondii, causing miscarriage and fetal infection 3
• Raw seafood transmits Salmonella, Campylobacter, E. coli, and Listeria 3
• Pregnancy-associated immunologic changes (progesterone-mediated down-regulation of cell-mediated immunity) increase susceptibility to intracellular pathogens found in raw seafood 3

Safe Alternative:

• Cook all fish to an internal temperature of at least 145°F (63°C) 3
• Consume 8-12 ounces of cooked, low-mercury seafood weekly for fetal neurodevelopment 3, 2
• Cooked shrimp, crab, and shellfish are safe when thoroughly prepared 3

High-Mercury Fish

Completely avoid shark, swordfish, king mackerel, and tilefish throughout pregnancy 2.

Why This Matters:

• Mercury crosses the placenta and damages the developing fetal nervous system 2
• Limit white (albacore) tuna to no more than 6 ounces per week 2

Raw or Undercooked Meat, Poultry, and Eggs

All meat must be cooked until well-done with no pink remaining; avoid any undercooked preparation 3, 2.

Why This Matters:

• Undercooked meats pose significant risk of Toxoplasma gondii infection, associated with miscarriage and fetal transmission 3, 4
• Individuals eating raw or undercooked meat have 1.2-1.3 times the risk and 1.7-3.0 times the odds of T. gondii infection 4
• Raw or undercooked products also transmit Salmonella and E. coli 3

Safe Cooking Temperatures:

• Poultry: 165°F internal temperature 2
• Red meats: 160°F internal temperature 2
• When dining out, request only well-done meat 3

Unheated Deli Meats and Ready-to-Eat Foods

Reheat all deli meats, hot dogs, and ready-to-eat foods until steaming hot (165°F/74°C) before consumption 2, 5.

Why This Matters:

• Delicatessen meats and prepared salads are high-risk for both Listeria and Staphylococcus aureus contamination 5
• These foods are often handled by colonized food handlers and stored improperly 5
• Buffet items held at room temperature and foods from street vendors pose additional risks 5

Common Pitfall:

• Reheating destroys bacteria but will not destroy preformed staphylococcal enterotoxin if the food was already contaminated and held at improper temperatures 5

Prepared Salads and Egg-Containing Products

Avoid mayonnaise-based salads, hollandaise sauce, Caesar dressing, and prepared sandwiches from deli counters unless freshly made and properly refrigerated 5.

Why This Matters:

• These are high-risk for staphylococcal food poisoning due to handling and temperature abuse 5
• Egg-containing products can harbor Salmonella if undercooked 2

Alcohol

Complete abstinence from all alcohol throughout pregnancy is mandatory 2.

Why This Matters:

• Alcohol causes fetal alcohol spectrum disorders 2
• No safe level of alcohol consumption has been established during pregnancy 2

Critical Food Safety Practices

Prevent cross-contamination by keeping raw meats separate from other foods and thoroughly washing hands, cutting boards, counters, knives, and utensils after contact with raw products 2, 5.

Additional Precautions:

• Wash all fruits and vegetables thoroughly before consumption 2
• Avoid foods from sources with inadequate temperature control 5
• Never consume foods left at room temperature for extended periods 5, 6