Foods to Avoid During Pregnancy—and What to Eat Instead

By Beth W. Orenstein
Reviewed by Alyssa Quimby, M.D.
June 12, 2023
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When you’re expecting, it’s important to make smart choices about your diet, including knowing what foods to avoid during pregnancy and which alternatives are safe and healthy. “Eating a healthy, balanced diet when you’re pregnant helps assure that you and your baby get the nutrients you need,” says Libby Mills, R.D.N., a registered and licensed dietitian-nutritionist in Philadelphia, culinary nutritionist at Villanova University, and spokesperson for the Academy of Nutrition and Dietetics.

A healthy, balanced diet means a variety of nutrient-rich whole foods, including lean meats and/or other proteins, fish and seafood, legumes, low-fat dairy products, fruits, vegetables, whole-grain breads and cereals, nuts, seeds, and healthy oils. “These foods support the growth and development needs of [both you and your baby,]” Mills says.

In a review of studies published in 2021 in the American Journal of Obstetrics and Gynecology, researchers wrote that women who report “health-conscious” eating patterns before and during pregnancy may have fewer complications, and their babies may experience fewer health problems.

An overall healthy diet (with some indulgences here and there) is a good general rule to follow. But there are also some specific dos and don’ts for food safety that promotes a healthy pregnancy and optimal fetal development.

6 Foods to Avoid During Pregnancy

Now that you’re pregnant, your immune system can’t fight off infection as well as it could when you weren’t carrying a baby, Mills says. For this reason, it’s important to avoid or limit certain foods (and drinks).

1. Raw and Undercooked Seafood

Sushi and other raw or undercooked fish and seafood dishes are on the list of foods to avoid during pregnancy. “Fish needs to be cooked,” says Shao-Chun Rose Chang-Jackson, M.D., a board-certified ob-gyn at Austin Regional Clinic in Texas.

Fish and other seafood should be cooked to 145 degrees Fahrenheit (it should be opaque and flake with a fork), Mills says.

That’s because raw and undercooked fish and seafood can carry parasites and bacteria, including a harmful type called listeria, says Anita P. Somani, M.D., a board-certified ob-gyn at OhioHealth in Columbus. Eating food contaminated with Listeria monocytogenes can make pregnant people pretty sick with an infection called listeriosis. It’s rare, but listeriosis can cause stillbirth, preterm labor, sepsis, meningitis, and even death, Somani says.

2. High-Mercury Seafood

While fish can be a healthy source of lean protein and other nutrients, you should be careful about which types and how much you eat. Certain fish have high levels of mercury, a poisonous metallic element that has been associated with birth defects, Chang-Jackson says.

The following are fish to avoid while pregnant because they can have high levels of mercury:

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

You don’t have to avoid seafood altogether, though. Fish provides nutrients like iron, iodine, choline, and omega-3 and omega-6 fats, which are beneficial to brain development. The Food and Drug Administration recommends eating two to three 4-ounce servings of low-mercury fish per week, even during pregnancy.

Low-mercury fish and seafood approved by the FDA include the following:

  • Anchovies
  • Catfish
  • Clams
  • Cod
  • Crab
  • Flounder
  • Haddock
  • Salmon
  • Shrimp
  • Sole
  • Tilapia
  • Trout
  • Canned light tuna

The American College of Obstetrics and Gynecology (ACOG) recommends limiting albacore tuna to no more than 6 ounces a week. Also, check for advisories before you eat seafood caught locally, ACOG advises, since there could be mercury or other contaminations.

Smoked fishes are pretty much a no, too, Chang-Jackson says. The problem with them is the low-temperature cooking process. “It invites parasites,” she says. “You need high enough heat to kill parasites.”

3. Unpasteurized Dairy Products

Unpasteurized cheeses or milk are also foods to avoid during pregnancy. The issue is the same as with raw or undercooked seafood, Somani says. “These foods are at high risk for contamination with listeria,” she says.

If you’re going to eat cheese make sure it’s pasteurized, Chang-Jackson says. Nearly all fresh cheese is pasteurized, including:

  • Mozzarella
  • Fresh goat cheese
  • Ricotta
  • Cottage cheese

However, these cheeses may be unpasteurized, and you should check labels before eating them:

  • Queso fresco
  • Brie
  • Camembert
  • Blue cheese

As for milk, most that’s sold in grocery stores is pasteurized. But be careful if you’re buying from farmers’ markets, food co-ops, or organic food stores. Stay away from raw milk—it hasn't been pasteurized to kill harmful bacteria. A policy statement published in 2014 in the journal Pediatrics reviewed the risk of consuming raw milk products for pregnant women and young children and found the risk of infection to far outweigh any benefits.

What about unpasteurized juice? “Unpasteurized juice is fine as long as the fruit was washed before juicing,” Somani says. So, it’s a good idea to avoid it if you didn’t make it yourself to see that it was prepared safely. Always wash the skin of fruit and vegetables in running tap water even if you’ll peel it before eating or juicing it, Somani notes.

4. Processed Meats

Cross processed meats off your grocery list while you’re pregnant. Bacon, sausage, many hot dogs, and many deli meats contain nitrites, which are added to help preserve freshness as part of the curing process. But they can be toxic to you and your baby, Chang-Jackson says.

Pregnant people may be most sensitive to nitrites’ toxicity when they’re 30 weeks or further along, according to the Centers for Disease Control and Prevention.

Another reason that processed meats are among the foods to avoid during pregnancy: Hot dogs and cold cuts are at high risk for contamination with listeria, Somani says.

5. Alcohol

Avoid alcohol while you’re pregnant. It’s known that alcohol in excess is linked to birth defects and developmental delays. And while it potentially could be okay to have a little bit on a special occasion while pregnant, Somani says, even a small amount is not recommended.

That’s because there’s no study that demonstrates whether there’s a certain level of alcohol that could be safe during pregnancy, Chang-Jackson says. Researchers would never conduct a study where some pregnant women drank and others didn’t, she says. It’s simply not worth the risks.

6. And Limit Caffeine

Good news for coffee lovers: 200 milligrams of caffeine per day is considered safe in pregnancy. That’s the equivalent to 1 to 2 cups of coffee (depending on its strength). But don’t have any more caffeine than that.

Caffeine is a stimulant, which means it can raise your blood pressure and heart rate. Caffeine is also a diuretic, which can make you have to urinate even more and leave you dehydrated. In addition, caffeine can affect not only your ability to sleep but also your baby’s.

3 Foods to Eat While Pregnant

If it seems like nothing’s safe, think again. There are many foods you can and should eat for a healthy pregnancy and healthy outcomes.

1. Iron-Rich Foods

Because your blood volume is increased to support your developing fetus, you’ll need 150% of the iron intake that people who aren’t pregnant do, ACOG says. Take a prenatal vitamin with iron—most contain the extra 9 milligrams you’ll need daily—and eat iron-rich foods, such as:

  • Lentils and beans
  • Iron-fortified cereals
  • Beef, turkey, liver, and/or shrimp

It’s also important that you eat vitamin-C-rich foods because they help your body absorb iron. These include:

  • Oranges or orange juice
  • Grapefruit
  • Strawberries
  • Broccoli
  • Peppers

2. Foods with Folate

When shopping for good foods to eat while pregnant, make sure to stock up on those with folate. This B vitamin helps prevent brain and spine birth defects and is important in making red blood cells, Mills says. Eat a variety of fruits, vegetables, and whole grains to get the folate you and your baby need.

The synthetic form of folate is called folic acid. It’s included in most prenatal vitamins, too.

3. Calcium-Rich Foods

You and your baby need calcium, a mineral, to build bones and teeth. Calcium also helps nerves communicate with the brain. The best way to get calcium is by eating and drinking calcium-rich foods and beverages, Mills says.

The most well-known sources of calcium are milk and dairy products, such as cheese and yogurt, but they’re not the only sources. You can also eat the following foods to help you get plenty of calcium:

  • Calcium-fortified cereal, bread, and juice
  • Sardines or anchovies with bones
  • Fortified tofu
  • Almonds and sesame seeds
  • Dark green leafy vegetables

How to Prepare Meals Safely for You and Your Baby

Mills also offers these tips to be sure what you’re eating is safe for you and your baby during pregnancy:

  • Practice safe food handling. Wash your hands often using warm, soapy water for at least 20 seconds before preparing foods. Dry your hands on a clean, dry towel.
  • Refrigerate raw meat, poultry, fish and seafood, and eggs until you’re ready to cook them.
  • Keep kitchen surfaces clean. Use a separate cutting board and utensils for raw proteins than you use for any other food you need to cut. And be sure to wash your cutting boards and knives between uses.
  • Refrigerate any leftovers. Don’t let food sit out for more than two hours so it doesn’t develop bacteria.

Eating safe and healthy foods when you’re pregnant is one of the best things you can do for you and your baby. A healthy diet helps your body with the extra demands on it during this special time. And it helps your baby to get the nutrients they need to start out healthy and happy.

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