Foods to Avoid During Pregnancy: Evidence-Based List

During pregnancy, changes in your immune system make you more susceptible to certain foodborne illnesses. Some substances also cross the placenta and can directly affect fetal development. The following guidance is based on recommendations from the FDA, ACOG, WHO, CDC, and NHS.

1. High-Mercury Fish

Avoid entirely: Shark, swordfish, king mackerel, tilefish, bigeye tuna, marlin, and orange roughy.

Why: Mercury (specifically methylmercury) is a neurotoxin. It crosses the placenta and can damage the developing fetal brain and nervous system. The FDA and EPA jointly maintain a specific list of fish to avoid during pregnancy.

Safe alternatives: Salmon, sardines, anchovies, herring, trout, tilapia, shrimp, pollock, and catfish are all low-mercury options. The FDA recommends 2-3 servings (8-12 ounces) of low-mercury fish per week during pregnancy for the omega-3 benefits, which are important for fetal brain development.

2. Raw or Undercooked Meat

Avoid: Rare or medium-rare steak, raw meat dishes (tartare, carpaccio), undercooked ground meat, and undercooked poultry.

Why: Risk of Toxoplasma gondii (causing toxoplasmosis) — a parasite that can cause severe brain damage or blindness in the fetus. There is also risk of Salmonella and E. coli infections.

Safe practice: Cook all meat to safe internal temperatures. The USDA recommends: 165°F (74°C) for poultry, 160°F (71°C) for ground meats, and 145°F (63°C) with a 3-minute rest for whole cuts of beef, pork, and lamb.

3. Raw or Undercooked Eggs

Avoid: Runny or soft-boiled eggs, homemade mayonnaise, raw cookie dough, homemade salad dressings with raw egg, tiramisu, mousse, and hollandaise sauce.

Why: Risk of Salmonella infection, which can cause severe dehydration and, in rare cases, intrauterine infection. Both the NHS and FDA recommend fully cooking eggs during pregnancy.

Safe practice: Cook eggs until both the white and yolk are firm. Pasteurized eggs are a safe alternative for recipes that call for raw eggs.

4. Unpasteurized Dairy and Juice

Avoid: Raw milk, soft cheeses made with unpasteurized milk (traditional feta, brie, camembert, queso fresco, and blue-veined cheeses), and unpasteurized fruit juice or cider.

Why: Risk of Listeria monocytogenes. According to the CDC, pregnant women are approximately 10 times more likely to get listeriosis than the general population. Listeriosis during pregnancy can cause miscarriage, stillbirth, preterm labor, and life-threatening infection in newborns.

Safe practice: Choose pasteurized dairy products. Hard cheeses (cheddar, Swiss, Parmesan) and soft cheeses made from pasteurized milk are safe.

5. Deli Meats and Ready-to-Eat Processed Meats

Avoid or heat first: Deli/lunch meats, hot dogs, paté, meat spreads, and smoked seafood (unless in a cooked dish).

Why: Listeria can grow at refrigerator temperatures, unlike most bacteria. ACOG and the FDA recommend heating deli meats to steaming hot (165°F / 74°C) before eating during pregnancy.

Safe practice: If you choose to eat deli meat, heat it until steaming. Freshly cooked meat sliced at home is a safer alternative.

6. Raw Sprouts

Avoid: Raw alfalfa, clover, mung bean, and radish sprouts.

Why: Sprout seeds can harbor Salmonella, Listeria, and E. coli in conditions that are virtually impossible to wash away. The FDA specifically advises pregnant women to avoid raw sprouts.

Safe practice: Cooked sprouts (such as in a stir-fry) are safe, as cooking kills the bacteria.

7. Caffeine

Limit to under 200 mg per day.

Why: Caffeine crosses the placenta, and the fetus cannot metabolize it efficiently. Excessive caffeine intake has been associated with increased risk of miscarriage and low birth weight in observational studies. ACOG recommends keeping caffeine under 200 mg per day during pregnancy. The WHO also advises limiting caffeine.

What 200 mg looks like:

• One 12-oz (355 ml) cup of brewed coffee
• Two 8-oz (240 ml) cups of black tea
• About five 12-oz (355 ml) cans of cola

Note: Chocolate also contains caffeine (a typical dark chocolate bar has about 20-60 mg), so factor that into your daily total.

8. Alcohol

Avoid entirely. No amount of alcohol has been established as safe during pregnancy.

Why: Alcohol crosses the placenta freely and can cause Fetal Alcohol Spectrum Disorders (FASDs), which include physical abnormalities, learning disabilities, and behavioral problems. Fetal Alcohol Syndrome (FAS) is the most severe form and is entirely preventable by avoiding alcohol.

Authority consensus: ACOG, WHO, CDC, NHS, and AAP all state that no amount of alcohol is known to be safe during pregnancy. This is unanimous across every major health organization worldwide.

9. Raw Fish and Shellfish

Avoid: Sushi with raw fish, sashimi, raw oysters, raw clams, and ceviche.

Why: Risk of Listeria, Vibrio, Salmonella, and parasites. Pregnancy reduces immune function, increasing susceptibility to these infections. Both the NHS and FDA advise against raw fish during pregnancy.

Safe practice: Cooked fish and shellfish are safe and recommended for their omega-3 fatty acid content, per the FDA guidelines mentioned above.

Quick Reference Summary

The Bottom Line

When uncertain about whether a food is safe during pregnancy, err on the side of caution and consult your healthcare provider. Proper food handling — washing produce thoroughly, avoiding cross-contamination, and cooking to safe temperatures — further reduces risk. A well-balanced diet with safe foods is one of the best things you can do for your baby.

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