Can you eat smoked salmon when you're pregnant? And what about your daily coffee or that chunk of stilton on your cheeseboard? Dietitian Dr Frankie Phillips has the answers.
Mums-to-be are often bombarded with masses of information and food is one area where confusion abounds. Sometimes even the experts don’t agree on the rules. Some foods should be completely avoided as they might make you ill or could harm your baby, while others are safe under certain conditions. So here’s the lowdown on what you can eat safely, including a few simple swaps, and why some foods are best left off the shopping list for a few months.
Cheese and milk
Cheese can be a very confusing food during pregnancy. It's recommended that pregnant women don’t eat mould-ripened soft cheeses (including brie, camembert and chèvre) or blue veined soft cheeses (gorgonzola, danish blue, roquefort). The higher moisture content and lower acidity of these cheeses means there's a risk of them containing a type of bacteria called listeria. Listeria can cause a type of infection called listeriosis, which may lead to miscarriage, stillbirth and illness in newborn babies. However, if cooked thoroughly until they are piping hot all the way through, these cheeses are safe to eat.
Hard cheeses, including stilton, are safe to eat even if they are unpasteurised. Soft cheeses, such as feta, mozzarella and cottage cheese are safe to eat if they are pasteurised.
Pasteurised and UHT (or long-life) milks are all safe, and so is any yogurt (including ‘bio’ yogurt), ice cream and cream made from pasteurised milk. Unpasteurised milk, including goat's and sheep’s milk and products made from them (including yogurt, cream and ice cream), should be avoided as they may contain harmful bacteria.
Plant-derived milk substitutes are safe during pregnancy, but it’s best to choose those that are fortified with calcium, and ideally also with vitamin B12 and iodine too.
Safe to eat
- Unpasteurised hard cheese (including stilton)
- Pasteurised soft cheeses (including feta, mozzarella and cottage cheese)
- Pasteurised and UHT milk and products made from these
Best to avoid
- Mould-ripened soft cheeses (including brie, camembert and chèvre)
- Unpasteurised soft cheeses
- Blue-veined soft cheeses (gorgonzola, danish blue, roquefort)
- Unpasteurised milk
Having too much caffeine during pregnancy can increase your risk of miscarriage and can put your baby at risk of a low birth weight as caffeine passes through the placenta into the baby’s body. However, it's OK to have some caffeine and current advice suggests that 200mg caffeine per day is a safe amount – that’s about two mugs of instant coffee or three cups of tea. Cola has around 40mg of caffeine per can but check the labels of energy drinks as these can be very high.
There’s not much information about whether herbal teas are completely safe in pregnancy, so it’s best to have no more than four cups of herbal tea per day. If you’re not sure if certain herbal products are safe, ask your GP or midwife for advice.
The alternative: Decaffeinated tea, coffee and soft drinks are safe to have during pregnancy.
No amount of alcohol has been shown to be safe in pregnancy, so the safest way is to avoid alcohol if you’re planning a pregnancy as well as during pregnancy to reduce any risk to your baby. Like caffeine, alcohol passes through the placenta, but as a baby’s liver is still developing, it cannot process the alcohol in the same way an adult can. In extreme cases, drinking alcohol during pregnancy can lead to miscarriage, premature birth and low birth weight and can also cause learning and behaviour problems.
The alternative: Try alcohol-free beers, mocktails or sparkling water
Since 2017, some eggs which are produced according to a food safety standard called the British Lion Code of Practice are considered very low risk for salmonella. Eggs produced in this way have a Red Lion logo stamped on their shell, and these are safe for pregnant women to eat raw or partially cooked (with a runny yolk) and products made from them including mousses, soufflés and fresh mayonnaise. Any eggs that are not stamped with the Lion logo need to be cooked thoroughly until white and yolk are solid.
If you don't know whether the eggs used are Lion Code or not, such as when you are eating out, ask the staff.
Non-hen eggs such as duck, goose and quail eggs should always be cooked thoroughly.
Fish is a highly nutritious food, providing omega-3 fats, iodine and selenium. White fish can be eaten any time, but during pregnancy, it’s best to limit oily fish, like sardines, mackerel and salmon, to no more than twice a week. There’s no need to avoid smoked salmon in the UK – it’s safe to eat during pregnancy.
Tuna is no longer considered an oily fish, but it should be limited to two fresh steaks or four cans per week because it may contain small amounts of mercury.
While they are probably not part of your regular diet, shark, marlin and swordfish should be avoided completely, as these fish could have harmful levels of pollutants, such as mercury.
Shellfish is safe to eat only if it has been thoroughly cooked before eating as raw shellfish might cause food poisoning. King prawn curry is still on the menu, but give the oysters a miss, for now.
Sushi is safe to eat if it's been made with cooked fish or shellfish; or pre-frozen raw wild fish, so you might need to check on the pack or ask in the restaurant. If in doubt, avoid sushi made using raw fish.
Safe to eat
- Smoked salmon (in the UK and if it's frozen first)
- Sushi if it has been made with cooked fish or cooked shellfish or pre-frozen raw wild fish, or if it is vegetarian sushi
- Shellfish (if they have been thoroughly cooked through)
Best to avoid
- Raw fish and shellfish
- Tuna (no more than two steaks or four cans per week)
Fish oil and vitamin supplements
Pregnant women are advised to take folic acid supplements during the first trimester, and NHS Healthy Start vitamins provide the right amount of folic acid along with vitamin D and vitamin C. It’s important to avoid any high dose supplements and any that contain vitamin A, such as fish oils, during pregnancy as too much vitamin A can be harmful for the developing baby.
Raw and undercooked meat
All meat and poultry, including steaks, roast meat, sausages and burgers, should be cooked until there is no trace of pink or blood at all.
Cured/fermented meats like Parma ham and salami are uncooked and could contain parasites that may cause toxoplasmosis, leading to miscarriage, stillbirth or birth defects. If you want to eat these foods, check on the label to see if they need to be cooked. Cooking them lowers the risk (so it’s fine to have cooked peperoni on a pizza for instance). Freezing these meats at home for four days before eating them can also lower the risk of contamination. Cold cooked meats, such as roast ham, are safe to eat.
All types of pâté need to be avoided during pregnancy. Liver pâtés (and all liver products) have too much vitamin A, which can harm your baby’s development, and even fish and vegetable pâtés might contain listeria.
Safe to eat
- Cold cooked meats such as roast ham
- Well-cooked meat and poultry (including steaks, roast meat, sausages and burgers)
Best to avoid
- Cured/fermented meats such as Parma ham and salami unless they are cooked
- All types of pâté
A word on nuts
Midwives used to advise pregnant women to avoid nuts. However, when researchers took a closer look, they found it is fine to eat nuts, including peanuts, when you’re pregnant as it’s not going to increase the risk of allergy in your baby. Unsalted nuts can be a handy nutritious snack, too.
Don’t worry if you had these foods and drinks before you knew you were pregnant as the risk is low. Just follow the guidelines for the rest of your pregnancy and if you’re still concerned have a chat with your midwife.
More details about what foods are safe to eat, and information about eggs, liver and supplements can be found at NHS online.
Do you have any tips or advice for eating during pregnancy? We'd love to hear from you below...
This article was last reviewed on 7 October 2019 by Dr Frankie Phillips.
Dr Frankie Phillips is a registered dietitian and public health nutritionist specialising in infant and toddler nutrition with over 20 years' experience.
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