What foods should be avoided during pregnancy?

Foods to Avoid During Pregnancy

Pregnant women must completely avoid raw or undercooked seafood, raw or undercooked meats, unpasteurized dairy products, high-mercury fish, and all alcohol to prevent serious maternal and fetal complications including miscarriage, stillbirth, and severe neonatal infections. 1, 2

High-Risk Foods That Must Be Completely Eliminated

Raw and Undercooked Seafood

• All raw shellfish (oysters, clams, mussels) must be avoided because they carry the highest infectious risk, including Listeria monocytogenes (which occurs 13-17 times more frequently in pregnant women and carries ~20% risk of spontaneous abortion or stillbirth), Toxoplasma gondii (linked to miscarriage and fetal transmission), and other pathogens. 1
• All forms of raw or undercooked seafood—including sushi, ceviche, poke, or lightly seared fish—are prohibited during pregnancy. 1
• Pregnancy-associated immunologic changes (progesterone-mediated down-regulation of cell-mediated immunity) increase susceptibility to intracellular pathogens commonly found in raw seafood, making these restrictions biologically necessary. 1, 3

High-Mercury Fish

• Completely eliminate shark, swordfish, king mackerel, and Gulf of Mexico tilefish because mercury crosses the placenta and damages the developing fetal nervous system. 2, 4
• Limit white (albacore) tuna to no more than 6 ounces per week due to moderate mercury content. 2, 4

Raw or Undercooked Meats

• All undercooked meats must be avoided due to significant risk of Toxoplasma gondii infection, which is associated with miscarriage and fetal transmission. 1, 2
• Cook all meat until well-done: 165°F for poultry and 160°F for red meats to effectively inactivate food-borne pathogens. 1, 2

Unpasteurized Dairy Products

• Avoid all unpasteurized (raw) milk and dairy products, including soft cheeses like feta, Brie, Camembert, blue-veined cheeses, and Mexican queso fresco unless clearly labeled as made with pasteurized milk. 2
• Raw milk products carry Listeria risk, and approximately two-thirds of infants born to mothers with listeriosis develop neonatal infection (pneumonia, sepsis, or meningitis). 1

Alcohol

• Completely avoid all alcohol during pregnancy as it can cause fetal alcohol spectrum disorders. 2

Safe Alternatives and Proper Food Handling

Safe Seafood Consumption

• Consume 8-12 ounces per week of low-mercury fish such as salmon, sardines, cod, pollock, canned light tuna (not albacore), shrimp, and catfish to provide omega-3 fatty acids beneficial for fetal neurodevelopment. 1, 4
• Cook all seafood to an internal temperature of at least 145°F (63°C) to eliminate pathogenic organisms. 1
• Cooked shrimp, crab, and other shellfish are safe when prepared thoroughly. 1

Food Safety Practices

• Wash hands, cutting boards, counters, knives, and utensils thoroughly after contact with raw foods to prevent cross-contamination. 1, 2
• Keep uncooked meats separate from other foods to prevent cross-contamination. 2
• Wash all fruits and vegetables thoroughly before consumption. 2

Critical Pitfalls to Avoid

• Do not conflate dietary restrictions with allergy prevention: There is currently no evidence supporting avoidance of any particular food during pregnancy or breastfeeding to prevent food allergy development in the child. 5
• Avoid extreme dietary patterns: Severely restrictive diets including ketogenic (lacks carbohydrates), Paleo (dairy restriction), or diets with excess saturated fats should be avoided during pregnancy. 5
• Be cautious with seaweed products: Some seaweed varieties contain excess iodine (11-6118 µg/g) and could exceed the tolerable upper limit of 600 µg daily; select iodine-appropriate options. 1, 4
• Knowledge gaps are common: Research shows 83% of pregnant women incorrectly identify at least one unsafe food as safe to consume, highlighting the need for clear guidance from healthcare providers. 6