Foods to Avoid in Pregnancy, and What Is Fine
What mainstream guidance says to avoid in pregnancy and why, which foods only need limiting, and which ones are fine despite the rumours you will hear.
Editorial draft: not yet reviewed by a clinician.
NHS guidance advises avoiding mould-ripened and soft blue cheeses unless cooked, unpasteurised dairy, raw or partially cooked eggs not produced under a recognised safety scheme, pâté, liver, raw or undercooked meat, raw shellfish, and shark, swordfish and marlin. Alcohol is best avoided entirely, caffeine is limited to 200mg a day, and oily fish and tuna are limited rather than banned.
The five things guidance is actually worried about
Understanding the reason behind each rule makes the list much easier to remember, and much easier to apply to a food nobody wrote a leaflet about.
- Listeria. A bacterium that pregnancy makes you more susceptible to. It is why soft mould-ripened cheeses, unpasteurised dairy and pâté are on the list, and why cooking them until steaming hot removes the problem.
- Salmonella. The reason raw and partially cooked eggs are restricted unless they come from a recognised food-safety scheme, such as the British Lion mark in the UK.
- Toxoplasma. A parasite found in raw and undercooked meat and in soil, which is why meat should be cooked through and fruit and vegetables washed.
- Mercury. It accumulates in large predatory fish, which is why shark, swordfish and marlin are avoided and tuna is limited.
- Vitamin A. Too much can be harmful in pregnancy, which is why liver and liver products are avoided.
Alcohol and caffeine sit outside those categories and are dealt with separately.
The avoid list
| Food | Why | The exception |
|---|---|---|
| Brie, camembert and other white-rind soft cheeses | Listeria | Fine if cooked until steaming hot |
| Soft blue cheeses: roquefort, gorgonzola, Danish blue | Listeria | Fine if cooked until steaming hot |
| Anything made with unpasteurised milk | Listeria | None |
| Raw or partially cooked eggs not from a recognised scheme | Salmonella | Eggs from a recognised scheme, or eggs cooked through |
| All types of pâté, including vegetable pâté | Listeria | None |
| Liver, liver pâté, liver sausage | Too much vitamin A | None |
| Raw or undercooked meat | Toxoplasma | Cooked through, with no pink meat and clear juices |
| Raw shellfish | Food poisoning risk | Cooked shellfish is fine |
| Shark, swordfish, marlin | Mercury | None |
| Alcohol | No safe level established | None |
The limit list
These are not banned. They come with a ceiling.
- Caffeine: 200mg a day, which NHS guidance describes as about two mugs of instant coffee. Tea, green tea, cola, energy drinks, chocolate and some cold remedies all count towards it.
- Oily fish: no more than two portions a week. Salmon, mackerel, sardines, trout and herring are good things to eat; the limit exists because of pollutants, not because the fish is bad for you.
- Tuna is limited too. NHS guidance gives a weekly limit for tuna separately from other oily fish, so check the current figure on their page rather than assuming it is unlimited.
- Cured meats such as salami and parma ham carry a small toxoplasma risk. NHS guidance notes that freezing them first reduces the risk, and cooking them removes it.
What is fine, despite what you will be told
People will tell you to avoid far more than guidance actually does. These are commonly worried about and are generally considered safe:
- Hard cheeses such as cheddar and parmesan, even unpasteurised
- Pasteurised soft cheeses: mozzarella, feta, cream cheese, cottage cheese, halloumi, paneer, ricotta, and goat’s cheese without a white rind
- Cooked eggs, and runny eggs if they come from a recognised food-safety scheme
- Cooked shellfish, including prawns and mussels
- Pasteurised milk and yoghurt
- Spicy food
- Peanuts and other nuts, unless you are allergic to them
- Honey, which is safe for you, though it should not be given to a baby under one year old
- Most cooked leftovers, provided they were cooled quickly and reheated until steaming hot
Hygiene does as much work as the list
- Wash fruit, vegetables and salad thoroughly, including bagged salad, to remove soil.
- Wash your hands, boards and knives after handling raw meat.
- Cook meat until there is no pink and the juices run clear.
- Reheat leftovers until steaming hot right through, once only.
- Keep raw and cooked food separate in the fridge.
- Wear gloves for gardening and wash your hands afterwards.
When to make a call rather than worry quietly
Contact your midwife or doctor straight away if, after eating something you are now concerned about, you develop a fever, flu-like aches, a severe headache, severe vomiting or diarrhoea, or feel very unwell. Tell them exactly what you ate and when. Contact them immediately, regardless of food, if your baby’s movements slow down, change or stop, if you have any bleeding, or if you have severe abdominal pain. These are not matters for the next appointment.
Keeping the list with you in PreBaby
The problem with food guidance is that you need it in a supermarket aisle, not at home. PreBaby has a shopping list you can build yourself and a questions list for your next appointment, so “is this brand pasteurised” and “how much tuna” become notes you actually ask rather than searches you half-remember. Both work offline, which is useful in a shop with no signal.
Sources
This article is general information, not medical advice. Anything that worries you is a reason to contact your own midwife or doctor.
Questions and answers
Which foods does guidance say to avoid completely in pregnancy?
NHS guidance on foods to avoid in pregnancy lists mould-ripened soft cheeses with a white rind such as brie and camembert, and soft blue cheeses, unless they are cooked until steaming hot; anything made with unpasteurised milk; raw or partially cooked eggs that were not produced under a recognised food-safety scheme; all types of pâté; liver and liver products; raw or undercooked meat; raw shellfish; and the fish with the highest mercury levels, namely shark, swordfish and marlin. The NHS also advises avoiding alcohol altogether, on the basis that no level has been shown to be safe. Guidance differs a little between countries, so follow what your own midwife or doctor tells you.
How much caffeine can I have in pregnancy?
NHS guidance sets a limit of 200mg of caffeine a day in pregnancy, which it describes as roughly two mugs of instant coffee. The figure counts everything, not just coffee: tea, green tea, cola and energy drinks, chocolate, and some cold and flu remedies all contribute, which is how people exceed it without noticing. Filter or espresso-based coffee is generally stronger than instant, so a single large takeaway coffee can use most of the allowance on its own. Decaffeinated drinks are not restricted. If you are unsure how your usual day adds up, it is a good question for a midwife appointment.
Can I eat cheese while pregnant?
Most cheese is fine. Hard cheeses such as cheddar and parmesan are not a concern, even when unpasteurised, and pasteurised soft cheeses including mozzarella, feta, cream cheese, cottage cheese, halloumi, paneer and ricotta are considered safe. What NHS guidance advises against is mould-ripened soft cheese with a white rind, such as brie and camembert, and soft blue cheeses such as roquefort, gorgonzola and Danish blue, because of the risk of listeria. Those become fine if they are cooked until steaming hot all the way through, so a properly baked camembert or a fully cooked blue cheese sauce is not the same as eating them cold.
What should I do if I have already eaten something on the avoid list?
Do not panic, because the risk from a single exposure is generally low, and then take two practical steps. First, stop eating it. Second, watch out for symptoms over the following days and weeks: a fever, flu-like aches, a bad headache, severe vomiting or diarrhoea, or feeling generally very unwell are all reasons to contact your midwife or doctor and to tell them exactly what you ate and when. Also contact them straight away if your baby's movements slow down or change. What you should not do is stay silent out of embarrassment, because the information genuinely helps them assess you.
Sources
This is general information, not medical advice. It does not diagnose or treat, and it does not replace your own midwife or doctor. Anything that worries you is a reason to contact them.