From Deli Meats to Unwashed Produce, Here’s the Food to Avoid When Pregnant

You know it's important to eat well when you’re pregnant, but sometimes it can be hard to know just what that means.

In addition to eating a well-balanced diet, getting extra calories and taking the best prenatal vitamins with folic acid to fill nutrient gaps, there's also a list of foods to stay away from during pregnancy. You'll find the "do-not-eat" further down, but first, let's talk about why you can't eat certain things when you're pregnant.

Why should you avoid certain foods during pregnancy?

Your immune system is busy keeping the growing baby in your belly healthy, so it's a little bit weaker in reacting to the outside world around you. This means that, when you're pregnant, you’re more susceptible to illnesses caused by bacteria, viruses and parasites—including those found in food like E. coli, salmonella and toxoplasmosis. Not only can these make you sick, but severe cases can cause preterm labor or miscarriage.

And since you're passing along almost everything to your growing baby, what you eat—from the mercury in fish to caffeine in coffee—affects them too.

What is listeria?

You may have heard of listeria after recent outbreaks—listeria is a bacteria found in some raw foods, and being pregnant puts you at greater risk of getting sick with listeriosis (the illness caused by ingesting listeria) and experiencing complications from it.

Listeriosis infections are rare, but there are still a few dozen cases of it every year.

So how do you avoid it? Be sure to take extra precautions and practice food safety, regardless of what you eat:

• Wash your produce.

• Wash your hands every time you touch raw food.

• Clean your fridge and kitchen regularly.

• Cook meat until well done.

As with most things related to pregnancy, if you're not sure about what’s safe to eat or drink and what’s not, be sure to talk with your healthcare provider.

What not to eat when pregnant

Raw fish and shellfish

• Sushi: Doctors agree that you should avoid sushi with raw fish while you’re pregnant. Raw fish can have parasites and bacteria that can make you sick. But you don't have to avoid all sushi—sushi that uses fully cooked, low-mercury fish is totally fine. In fact, fish is a great food to keep in your pregnancy diet since it provides nutrients that are essential for fetal development. Just make sure the fish you eat isn't high in mercury (more on that below). So go ahead and give in to your sushi craving (as long as it's fully cooked).

• Raw shellfish: You should avoid eating raw oysters while you're pregnant—those parasites and bacteria again.

Raw meat, eggs and flour

Raw or undercooked meats can carry harmful bacteria like toxoplasmosis and salmonella.

Raw and unpasteurized eggs can carry salmonella, so be sure to cook your eggs thoroughly. Raw flour can also carry salmonella and E. coli, so no raw batters or cookie dough while you're pregnant (sorry).

And be sure to wash your hands really well with soap and water after handling any raw meat or eggs to prevent cross-contamination.

Fish high in mercury

Some fish have high amounts of mercury, which is a dangerous heavy metal. Here’s a convenient wallet card listing which fish are safer to eat and which to avoid. It’s useful for early childhood, too, since mercury can affect your child’s developing brain and other organs.

Fish to avoid:

• Tuna: albacore, ahi, bigeye, yellowfin

• Mackerel: Spanish, gulf, king

• Sea bass

• Grouper

• Marlin

• Orange roughy

• Shark

• Swordfish

• Tilefish

• Bluefish

Fish that's okay to eat: The full list is much longer, but these are the most popular:

• Tuna: Canned chunk light, skipjack

• Salmon

• Catfish

• Halibut

• Herring

• Anchovies

• Sardines

• Tilapia

• Trout

• Sole

• Squid

• Clams

• Scallops

• Oysters

• Bass

• Mahi Mahi

• Lobster

Unpasteurized cheeses, milk and juice

Soft cheeses like brie, gorgonzola and camembert that are imported or made from unpasteurized milk can carry listeria. Same goes for unpasteurized milk and juices.

By law, all cheese sold across state lines in the US has to be pasteurized, so any of the non-imported stuff you'll find in the grocery is totally okay to eat. If you're not sure, read the label; if it says "unpasteurized," "imported" or "raw milk," avoid it. If you buy your cheese from a local shop or farmer's market, you should double check if it's made with unpasteurized milk. And in general, it's a good idea to avoid homemade or artisanal dairy products while you're pregnant, says Dr. Tamara Guichard, an ob-gyn from NYC.

Deli meats

If you're a fan of cold deli sandwiches or charcuterie boards, you'll need to make some compromises during pregnancy since deli meats can develop listeria. "Deli meats are generally advised to be avoided during pregnancy," says Lyndsay Hall, a registered dietitian. "But if you're someone who really can’t go without them, then they can be heated until they're physically steaming in order to kill any potential harmful bacteria."

You'll need to thoroughly heat:

• Cold deli meats (AKA sandwich meat, lunch meat, cold cuts, sliced meat). This includes the meat you get freshly sliced at the deli counter as well as the pre-sliced meat from brands like Oscar Meyer, Hillshire Farm, Buddig, etc.

• Hot dogs

• Cold cured meats like salami and smoked fish/lox

"The easiest way to steam deli meat is likely in the microwave," Hall says. "The amount of time will vary between microwaves, but a good 30 to 60 seconds should do it, depending on how much deli meat you are heating at one time. The rule of thumb is that you need to see steam coming off it to know it’s safe." She also recommends wrapping deli meat in tin foil and heating it in the oven or toaster oven, though that method will take longer.

If you're buying a deli sandwich from, say, Subway, Jersey Mike's or your local deli, you should order your sandwich to be toasted. It's even a good idea to ask them to toast it twice, just to make extra sure it's hot enough to kill any potential bacteria.

Unwashed fruits and veggies

Take a little extra time and scrub those fruits and veggies, no matter if you got them from the grocery store, a farmer's market or your own backyard. "Washing produce helps get rid of harmful bacteria and parasites like Toxoplasma that risk getting you and your baby sick," Hall says.

Even if you're not planning to eat the outside of the produce, you should still wash it thoroughly. "Thicker-skinned produce like melons and citrus fruits should be scrubbed with a brush," Dr. Guichard says. "Make sure to wash all produce under running water, even if you plan to peel them, to reduce the risk of getting sick during pregnancy."

Dr. Guichard also advises that leafy greens should be carefully and thoroughly washed. They can hold dirt and germs in their folds, which may get missed if you're just doing a quick rinse.

Take extra care with produce that's been bruised, too. "Bacteria is more likely to cluster in bruised or damaged parts of fruits and vegetables, so be sure to cut these parts off!" Hall says. No need to toss the whole thing if there are only a couple of small bruises.

And while you want to eat of lots of vegetables and fruit while you’re pregnant, you should probably leave sprouts—like alfalfa and bean—out of your salads, as they've been repeatedly linked to salmonella, listeria and E. coli outbreaks over the last thirty years.

Caffeine and pregnancy

Should pregnant people have caffeine? The most conservative recommendations are 200 milligrams of caffeine a day. That’s about one 12-ounce cup of coffee or two and half shots of espresso, and there’s evidence that even more than that doesn’t increase the risk of miscarriage.

“Most data suggest that low to moderate caffeine intake in pregnancy isn't associated with any adverse outcomes to the baby or pregnancy,” says Dr. Nathan Fox, ob-gyn and creator of the Healthful Woman podcast. So don’t hold back on that latte—you’ll get some extra calcium, too.

The same rules apply to caffeinated sodas and teas. “As far as we know, the source of the caffeine shouldn't make a difference on the effect,” Dr. Fox says. As long as you're staying within the acceptable intake range, you can have caffeine every day.

As for herbal teas, some herbs may not be safe to consume during pregnancy, so be sure to check with your doctor first.

Alcohol and pregnancy

Excessive drinking during pregnancy causes fetal alcohol syndrome, and your ob-gyn or midwife will almost definitely tell you absolutely no alcohol. While there isn't a lot of information about minimal alcohol consumption during pregnancy, the recommendation is to avoid all alcohol during pregnancy.

What about drinks like kombucha and non-alcoholic beer and wine? Hall calls this a "gray area" because the alcohol content is so minimal that they're legally allowed to be labeled as non-alcoholic. "Although it seems insignificant, technically, guidelines outline that any amount of alcohol may cause potential harm to your growing baby," Hall says. "So for some, it's likely an easy choice to stay away from kombucha [and similar drinks]."