Cottage Cheese Safety During Pregnancy
Cottage cheese made from pasteurized milk is safe for consumption during pregnancy and should be the only type consumed, while any unpasteurized dairy products must be completely avoided due to severe risks of life-threatening infections including Listeria, which causes spontaneous abortion, stillbirth, and neonatal death. 1, 2, 3
Pasteurized Cottage Cheese: Safe for Pregnancy
Pasteurized dairy products, including cottage cheese, are safe and recommended for pregnant women because the pasteurization process (heating to at least 161°F for more than 15 seconds) effectively eliminates dangerous pathogens while maintaining full nutritional value. 1
Scientific analyses confirm that pasteurized milk products contain equivalent levels of proteins, carbohydrates, calcium, vitamins, and enzymes compared to raw products, debunking claims that pasteurization destroys nutrients. 1
Critical Risks of Unpasteurized Dairy Products
Listeria: The Primary Threat to Pregnancy
Listeria monocytogenes poses a 20% risk of spontaneous abortion or stillbirth when pregnant women consume contaminated raw milk or cheese, making it the most dangerous pathogen for this population. 2
Listeria causes invasive disease in newborns, resulting in pneumonia, sepsis, or meningitis in two-thirds of infected neonates. 2
Even pasteurized soft cheeses can become contaminated through post-pasteurization handling, as demonstrated by a multistate outbreak where Mexican-style cheese made from pasteurized milk caused listeriosis in pregnant Hispanic women. 4
Additional Pathogens in Unpasteurized Dairy
E. coli O157 causes hemolytic uremic syndrome in 60% of infected patients, predominantly affecting young children, which is relevant for pregnant women planning for their child's future dairy consumption. 2
Other serious infections from raw dairy include Campylobacter gastroenteritis, Salmonella infections, brucellosis, and tuberculosis. 1, 2, 3
Parasitic (Giardia) and viral (Norovirus) pathogens also contaminate unpasteurized products. 2, 3
Evidence-Based Epidemiology
From 1998-2009, raw milk consumption in the United States resulted in 93 outbreaks, 1,837 illnesses, 195 hospitalizations, and 2 deaths, with 79% of outbreaks involving someone under age 20. 1, 2, 3
A more recent systematic review (2007-2020) found that unpasteurized dairy products caused 449 confirmed illnesses, 124 hospitalizations, and 5 deaths across 20 outbreaks in North America. 5
Pasteurized products caused fewer but more severe outcomes when contamination occurred post-pasteurization: 174 cases, 134 hospitalizations, 17 deaths, and 7 fetal losses, with Listeria accounting for 10 of 12 outbreaks. 5
Practical Guidance for Pregnant Women
What to Consume Safely
All cottage cheese and dairy products must be clearly labeled as made from pasteurized milk before consumption during pregnancy. 1, 3
Hard cheeses like Cheddar, Swiss, Parmesan, Romano, and Provolone have the lowest risk profile even when pasteurized. 6
What to Avoid Completely
Soft surface-ripened cheeses (Camembert, Brie) carry significantly greater risk of pathogen transmission and should be avoided or consumed with extreme caution even when pasteurized. 6
Fresh, unripened cheeses made from raw milk pose the highest contamination risk. 7
Any cheese labeled as "raw milk," "unpasteurized," or aged less than 60 days from raw milk must be completely avoided. 1
Common Pitfalls to Avoid
Do not trust claims that raw milk is healthier or more nutritious—these assertions are based on anecdotes and testimonials, not scientific evidence, and pasteurization does not alter nutritional value. 1, 3
Be aware that even cheeses made from pasteurized milk can become contaminated during cutting, handling, or storage, particularly at temperatures above 8°C (46°F). 7
Pregnant women shopping at specialty cheese shops or delicatessens should specifically verify pasteurization status, as these venues had higher rates of unsatisfactory quality products in surveillance studies. 7
The FDA allows an exception for raw milk cheese aged minimum 60 days for interstate commerce, but E. coli can survive even after this aging period, making these products unsafe for pregnancy. 1