Pregnancy
Foods to Avoid While Pregnant (and What to Eat Instead)
The main foods to avoid while pregnant are alcohol, high-mercury fish, raw or undercooked meat, fish and eggs, unpasteurized milk, cheese and juice, and cold deli meats or hot dogs unless they're heated until steaming. These can carry bacteria, parasites or mercury that are more dangerous in pregnancy. Keep caffeine under 200 milligrams a day, too.
The good news: most of the fixes are simple. Choose pasteurized, cook things through, and you can still eat well, including out.
"I already ate it." Now what?
This is the most common panicked question, so let's answer it first. If you had a turkey sandwich or a spoonful of raw cookie dough before you knew the rules, the odds that anything happens are low. The risk from these foods is real but small for any single exposure.
What to do: note the date, and watch for fever, chills, muscle aches, diarrhea or vomiting over the next few weeks. Listeria symptoms can show up days to weeks later and may feel like a mild flu. If they appear, call your provider and mention what you ate. If there's a recall on something you ate, call even without symptoms.
Why some foods are riskier during pregnancy
Pregnancy shifts your immune system, so some foodborne infections become more likely and more serious. The big four:
- Listeria: bacteria that can grow even in the fridge. Pregnant people are much more likely than others to get listeriosis, which can cause miscarriage, stillbirth, preterm labor or serious newborn infection, sometimes when the parent has only mild flu-like symptoms.
- Toxoplasma: a parasite in undercooked meat, unwashed produce and cat feces that can harm the baby's brain and eyes. (Yes, someone else should scoop the litter box if possible.)
- Salmonella and E. coli: from raw eggs, undercooked poultry, raw flour and unwashed produce.
- Mercury: a metal in some large fish that can affect the baby's developing brain and nervous system.
The full list, with swaps
| Avoid | Why | Safer choice |
|---|---|---|
| Alcohol of any kind | No known safe amount | Sparkling water, mocktails |
| Shark, swordfish, king mackerel, tilefish from the Gulf of Mexico, bigeye tuna, marlin, orange roughy | High mercury | Salmon, shrimp, cod, tilapia, sardines, canned light tuna |
| Raw fish and shellfish (sushi, sashimi, raw oysters, ceviche) | Bacteria, parasites | Cooked fish and shellfish; cooked or vegetable sushi |
| Refrigerated smoked seafood (lox, nova) | Listeria | Smoked fish cooked into a hot dish, or shelf-stable canned versions |
| Cold deli meats, hot dogs, refrigerated pâté | Listeria | Heat until steaming (165°F); shelf-stable pâté |
| Rare or undercooked meat and poultry | Toxoplasma, bacteria | Cook to safe internal temperatures (below) |
| Raw or runny eggs (soft-cooked eggs, homemade Caesar dressing, raw cookie dough) | Salmonella | Eggs cooked until yolks are firm; pasteurized eggs |
| Raw flour and raw dough or batter | E. coli | Baked goods; edible "heat-treated" dough |
| Unpasteurized (raw) milk and cheese | Listeria, other bacteria | Pasteurized milk and cheese |
| Soft cheeses like queso fresco, brie and feta unless labeled pasteurized | Listeria | Pasteurized versions or hard cheeses |
| Unpasteurized juice or cider | Bacteria | Pasteurized juice |
| Raw sprouts (alfalfa, clover, mung bean, radish) | Bacteria | Thoroughly cooked sprouts |
Even pasteurized soft cheeses like queso fresco have been linked to Listeria outbreaks when contaminated after pasteurization, so buy from reputable sources and keep an eye on recalls.
Eating out in New York while pregnant
City life means a lot of takeout and deli counters. Some practical translations of the table above:
- Bagel order: a bagel with cream cheese is fine (it's pasteurized). Lox is the problem. Swap in a hot egg cooked hard, or butter and tomato. Skip store-made deli salads (egg, tuna, chicken), which the FDA lists as a Listeria risk; make your own at home instead.
- Deli sandwich: ask for the turkey or ham heated on the grill or in the panini press until it's steaming. Many delis will do it if you ask.
- Sushi night: order cooked rolls (shrimp tempura, eel, crab stick, cooked salmon) or vegetable rolls. Skip anything raw.
- Steakhouse or burger spot: order steak at least medium (145°F plus rest) and burgers well done (160°F).
- Brunch: eggs over hard or scrambled firm. Hollandaise and soft-poached eggs are the ones to pass on unless the restaurant uses pasteurized eggs.
- Coffee runs: a large drip coffee from a chain can be well over 200 mg on its own. A small, a half-caf, or tea is an easy fix.
Safe cooking temperatures
Use a food thermometer:
- Whole cuts of beef, pork, lamb and veal: 145°F, then rest 3 minutes
- Ground meats: 160°F
- Poultry (whole or ground): 165°F
- Leftovers and casseroles: 165°F
- Fish: 145°F, or until it flakes and is opaque
How much fish should I eat while pregnant?
Fish is good for you in pregnancy. It brings protein, iron, iodine and omega-3 fats that help your baby's brain develop. The FDA and EPA recommend 8 to 12 ounces a week (2 to 3 servings) of low-mercury "best choice" fish, such as salmon, shrimp, cod, tilapia, pollock, catfish, sardines and canned light tuna. White (albacore) tuna is higher in mercury, so limit it to about one serving a week.
If you or family members fish locally, including New York rivers and lakes, check New York State Department of Health fish advisories before eating the catch.
How much caffeine is safe during pregnancy?
ACOG recommends less than 200 milligrams of caffeine a day. Rough guide:
- A 12-ounce brewed coffee is often close to 200 mg by itself
- Large coffee-shop drinks can contain much more
- Black and green tea, cola and energy drinks all count
- Chocolate has small amounts
Check labels, or ask the barista.
What about herbal teas and supplements?
Herbal products aren't regulated like medicines, and many haven't been studied in pregnancy. Ask your provider before using herbal teas in large amounts or any herbal supplement. Ginger is a common choice for nausea; see our morning sickness guide.
Liver and liver products are very high in vitamin A, and too much preformed vitamin A can harm the baby. Eat them only occasionally, and skip extra vitamin A supplements unless your provider recommends them.
What should I eat while pregnant?
A balanced plate of fruits, vegetables, whole grains, lean protein and dairy or calcium-rich alternatives covers most needs. Key nutrients:
- Folic acid: helps prevent neural tube defects. The CDC recommends at least 400 micrograms a day before and during early pregnancy; prenatal vitamins usually include more.
- Iron: supports your growing blood volume. Your prenatal vitamin plus lean meat, beans and fortified cereals help.
- Calcium and vitamin D: for bones and teeth.
- Iodine and choline: important for brain development. Not every prenatal vitamin has enough, so read the label.
- DHA (omega-3): from fish or a supplement your provider approves.
Take a daily prenatal vitamin, but don't double up. Ask your provider which one to use.
Do I need to "eat for two"?
No. You don't need extra calories in the first trimester. ACOG estimates about 340 extra calories a day in the second trimester and about 450 extra in the third for one baby. That's roughly a yogurt and a handful of nuts, not a second dinner. Healthy weight gain depends on your starting weight:
| Pre-pregnancy BMI | Recommended total gain (one baby) |
|---|---|
| Underweight (under 18.5) | 28–40 lb |
| Healthy weight (18.5–24.9) | 25–35 lb |
| Overweight (25–29.9) | 15–25 lb |
| Obesity (30 or higher) | 11–20 lb |
Food help in New York
If affording healthy food is hard, you may qualify for WIC, which provides nutritious foods and nutrition counseling during pregnancy, and for SNAP. Your prenatal office can often help you apply. Pregnant people on Medicaid can also ask their provider about a nutrition referral. To find a provider, search the directory or browse midwives in Brooklyn.
When to call your provider
Call your provider if:
- You ate something on the avoid list and develop fever, chills, muscle aches, diarrhea or vomiting, which can be signs of listeriosis or another foodborne illness, even weeks later
- You hear about a food recall affecting something you ate
- You can't keep food down or you're losing weight
- You crave non-food items like ice, clay or starch, which can be a sign of low iron
- You follow a vegan, vegetarian or restricted diet and want help covering your nutrients
Frequently asked questions
Can I eat deli meat while pregnant?
Cold deli meats and hot dogs can carry Listeria. They're considered safe if heated until steaming hot (165°F) just before eating.
How much caffeine can I have while pregnant?
ACOG advises keeping caffeine under 200 milligrams a day, roughly one 12-ounce cup of coffee. Tea, soda, energy drinks and chocolate count toward that total too.
Can I eat sushi while pregnant?
Skip raw fish, because it can carry bacteria and parasites. Sushi made with cooked fish or vegetables is fine, as long as the fish is a low-mercury kind.
Is any amount of alcohol safe during pregnancy?
No. The CDC and ACOG say there is no known safe amount or safe time to drink alcohol during pregnancy.
Sources
- ACOG — Nutrition During Pregnancy FAQ
- ACOG — Moderate Caffeine Consumption During Pregnancy (Committee Opinion 462)
- FDA and EPA — Advice About Eating Fish
- CDC — Listeria and Pregnancy
- CDC — Alcohol Use During Pregnancy
- USDA — Safe Minimum Internal Temperatures
- FDA — Food Safety for Pregnant Women and Their Unborn Babies
This article is for general education and is not medical advice. It does not replace an evaluation by a licensed clinician who knows your history. If you think you have a medical emergency, call 911.