Food safety in pregnancy

Most foods are still fine to eat in pregnancy, but some need care with how you prepare and store them. UK and US advice differs, even for foods with the same name.

Why some foods need extra care

Listeria bacteria can get into some ready-to-eat foods. Unlike many other bacteria in food, they can grow in the fridge. The infection they cause, listeriosis, can lead to serious problems in pregnancy and illness in a newborn baby. Keeping food in the fridge still matters, but it doesn’t replace the cooking advice for certain foods.

Raw, undercooked or cured meat can carry a risk of toxoplasmosis, an infection that can cause miscarriage. Eggs without the UK approved-scheme markings need cooking thoroughly because of the risk of salmonella. The NHS says salmonella is unlikely to harm the unborn baby, but food poisoning can make you seriously ill.

Check the type of cheese

In the UK, pasteurised soft cheeses such as cottage cheese, cream cheese, mozzarella and feta are on the NHS list of cheeses that are safe to eat. Brie, camembert and soft blue cheeses need cooking thoroughly, even if they’re made with pasteurised milk. The NHS says cheese cooked until it’s steaming hot is fine.

US CDC guidance lists pasteurised cottage cheese, cream cheese, feta and mozzarella as safer choices. It gives separate advice for cheeses like queso fresco made with pasteurised or unpasteurised milk, and for deli-sliced cheese that hasn’t been heated. Check the type of cheese and how it’s prepared, as well as whether the milk is pasteurised.

Meat, liver and eggs: check the local rule

The NHS says you can eat cold pre-cooked meats such as ham or chicken if they’re kept in the fridge and eaten before the use-by date. It advises cooking cold cured meats such as salami and prosciutto until steaming hot. US CDC guidance goes further for deli meat and cold cuts: heat them until steaming hot before eating.

Under NHS guidance, avoid liver and liver products, because they contain a lot of vitamin A, which can harm the baby. Advice on other pâtés differs too. The NHS gives advice on keeping meat and vegetable pâté chilled and eating it by the use-by date. US guidance sees pâté kept in the fridge as a riskier choice, and prefers pâté that can be stored in the cupboard.

UK hen eggs with the British Lion stamp, or produced under the Laid in Britain scheme, can be eaten runny within their use-by date. Other hen eggs, and duck, goose or quail eggs, need cooking thoroughly. US guidance says yolks and whites should be firm, or to use pasteurised eggs in foods that won’t be cooked.

Choose fish by type and preparation

UK limits are no more than 4 cans or 2 tuna steaks a week, and no more than 2 portions of oily fish a week. The NHS advises avoiding shark, swordfish and marlin. These limits are about pollution in fish, including mercury. Raw seafood has its own infection risks.

US FDA/EPA advice is to eat 2 to 3 servings a week from its “Best Choices” list, with a serving of 4 ounces. Use that list rather than turning the UK tuna limit into a US serving rule. For fish caught locally, check local fish warnings.

The NHS advises against raw fish and raw shellfish, including sushi made with raw fish, even if it was frozen first. It says cold-smoked or cured fish, and cold ready-to-eat prawns, need cooking until steaming hot. Wash fruit and vegetables well, and keep bagged salads in the fridge until you use them.

If you have already eaten something

The NHS says a small amount of a food or drink you were advised to avoid is unlikely to affect the baby if you didn’t become ill. If you’re worried, talk to your midwife or doctor. Still get help for symptoms, even if you’re not sure what caused them.

Contact NHS 111 today in the UK, or your doctor or urgent care service in the US and elsewhere, if you feel unwell after eating a food that pregnancy advice says to avoid. Tell them you’re pregnant, and say what you ate and how you feel.

Contact your GP or NHS 111 today (UK), or your doctor or urgent care service (US and elsewhere), if you have a high temperature with aches or chills, or vomiting and diarrhoea for more than 48 hours, even if you don’t know which food caused it. Tell them you’re pregnant.