What you eat and healthy nutrition are important during your pregnancy. And what you don’t eat is just as important.
This is due to two main reasons: Pregnancy hormones are changing your food cravings — i.e. think pickles and ice-cream. And your developing fetus’ ability to absorb what you eat. Hormonal changes in pregnancy can affect your taste preferences, hunger fullness cues and susceptibility to gastrointestinal distress — such as morning sickness. At the same time, fetal absorption heightens the importance of choosing safe, well-prepared foods that support your baby’s development.
“Pregnancy is like a food adventure,” says Lisa Jones, a registered dietitian based in Philadelphia. “Shifts (in hormones) can intensify hunger signals and lead to food aversions or cravings as your body adjusts to support fetal growth and development. Your hormones are basically DJing a whole new food playlist — so get ready for some unexpected remixes.”
If you’re newly pregnant, you may notice new food aversions or cravings that you didn’t have before. In response, it’s OK to adjust your diet to fit your current wants and needs, so long as you are vigilant about avoiding foods that are harmful to your baby too. Not sure what you should steer clear of? Read on to learn what foods to avoid during pregnancy and why.
[READ Pregnancy Checklist]
Adjusting Your Diet to Avoid Harmful Bacteria and Foodborne Illness
During pregnancy, you’re essentially feeding two people — or more, if you are pregnant with twins or triplets. When adjusting your diet for pregnancy, you are not only responding to your wants and needs, but those of your developing baby. Because of this, it is particularly important to avoid certain foods that your baby may not tolerate — as well as those that are dangerous to their health.
Many foods that are safe for adults can be toxic to fetuses, so it’s important to educate yourself on what foods to avoid.
“The reality is, as adults, we’re bigger bodies,” says Dr. G. Thomas Ruiz, a board-certified OB-GYN and lead OB-GYN at MemorialCare Orange Coast Medical Center in Fountain Valley, California. “Say you have a bad piece of steak, we can usually tolerate it better; whereas if you’re pregnant, there’s not that level of forgiveness.”
In addition, pregnant people and unborn babies have weaker immune systems, making them more susceptible to foodborne illnesses and more vulnerable to serious consequences if they develop them.
Remember, adds Ruiz, everything the mother eats passes on to the fetus.
[MORE: Best Nutrients and Foods to Eat When Pregnant]
Foods to Avoid During Pregnancy
Some examples of foods to avoid include:
— Alcohol
— Smoked fish
— High-mercury fish
— Raw or undercooked foods
— Unpasteurized milk and cheese
— Certain meats and pates
— Caffeine, to an extent
— Fish, to an extent
— Raw sprouts
Alcohol
No amount of alcohol is recommended in pregnancy due to alcohol’s risks to the developing fetus, including the development of fetal alcohol spectrum disorders. FASDs refer to various conditions that a baby can develop if exposed to alcohol in the womb — which can happen if alcohol content in the mother’s blood reaches the baby through the umbilical chord. These conditions can contribute to your baby developing behavioral issues, learning challenges and/or physical problems. Cases range in severity and some can be lifelong.
Smoked fish
Avoid smoked fish, such as smoked tuna or salmon, due to potential risks of listeria bacterium contamination.
Listeria bacteria exposure is dangerous because it puts babies at risk for a condition called listeriosis. Anyone who is exposed to listeria can be at risk for listeriosis, but developing babies can be especially vulnerable to severe outcomes. While healthy adults who develop listeriosis may come down with mild symptoms of nausea, vomiting and diarrhea, developing babies can be at risk for lifelong health ailments. After birth, babies with listeriosis may experience problems with the brain, kidneys or heart; blindness; paralysis; seizures or even death.
High-mercury fish
It is important to limit fish high in mercury due to risks of mercury, a heavy metal that can be deadly for the fetus. Examples of high-mercury fish to avoid include:
— Bigeye tuna
— King mackerel
— Marlin
— Orange roughy
— Shark
— Tilefish
— Swordfish
“Mercury is toxic to fetuses — it’s essentially a poison,” Ruiz explains. “It can lead to stillbirth and other problems with the fetal development. High levels of mercury are bad in adults, but a developing fetus is much more susceptible.”
Canned, chunk light tuna generally has a lower amount of mercury than other tuna, but still should only be eaten in moderation
[Read: Stomach Flu vs. Food Poisoning: How to Recognize the Difference]
Raw or undercooked foods
Avoid certain raw or undercooked foods, including:
— Raw fish, including sushi. This is important to avoid due to potential risks of parasites, bacteria and listeria contamination, which can lead to listeriosis, putting your pregnancy at risk for a miscarriage or stillbirth.
— Raw or undercooked eggs. Avoid this due to potential risks of salmonella poisoning. Babies who are exposed to the salmonella bacterium may be at risk for salmonellosis or meningitis after birth, which can be life-threatening conditions. They can also be at risk for blood infections like sepsis. Adults can also become sick from salmonella. However, because unborn babies are still developing, they can be at higher risk for severe disease and poor outcomes, should they be exposed to salmonella. Make sure egg yolks and whites are firm when cooking eggs.
— Raw or undercooked meats. This is due to potential risks of toxoplasmosis, a disease that can cause stillbirth.
Unpasteurized milk and cheeses
Avoid unpasteurized milk and unpasteurized soft cheeses — such as feta and goat cheeses — due to potential risks of listeria contamination. Soft cheeses have more moisture, which can make it easier for bacteria to grow.
In addition, avoid both pasteurized and unpasteurized mold-ripened cheeses, such as blue-veined cheeses (gorgonzola and Roquefort), brie and camembert.
Certain meats and pates
Avoid liver, meat or vegetarian pate, and game meats, such as goose or pheasant, due to potential risks of toxoplasmosis. Toxoplasmosis is a parasitic disease that can be particularly harmful to people who are pregnant or who have lowered immune systems. It is the leading cause of death from foodborne illnesses in the United States, according to the Centers for Disease Control and Prevention.
You can lower your risk for toxoplasmosis by ensuring that your meat is thoroughly cooked and letting it rest for at least three minutes before eating, but thanks to toxoplasmosis’s various transmission routes and human error, you may not eliminate risks altogether. Among other lingering risk factors, eating cooked meat that has touched cutting boards or utensils that have come in contact with contaminated meat can make you more vulnerable to toxoplasmosis. Additionally for cat owners, the parasite can linger in places like your cat’s litter box — it can spread through cat feces — putting you at risk for the disease if you don’t wash your hands before food prep.
Caffeine, to an extent
Limiting caffeine intake can be important due to caffeine’s impact on the blood vessels and blood flow. Research has demonstrated an association between maternal caffeine consumption and increased risk for miscarriage, stillbirth, low birth weight and offspring who develop overweight or obese. The American Pregnancy Association recommends avoiding caffeine during the first trimester to reduce the likelihood of a miscarriage.
General medical advice is to limit caffeine to under 200 milligrams, or no more than two cups of coffee, a day.
Fish, to an extent
Limiting total fish intake when pregnant can be smart due to additional risks of pollutants, bacteria, viruses or toxins that may exist in the food, but you don’t need to cut fish out of your diet completely.
Some fish contain healthy fats like omega-3s to support you and your baby, so the Food and Drug Administration recommends that pregnant people eat a modest amount of fish, consuming between eight to 12 ounces of fish a week, and choose options that are low in mercury. For further advice, the FDA also provides a pamphlet with serving size ideas and examples of good fish to choose from.
Overall, Ruiz says, “you have to know your food source, and (if it) is properly prepared to minimize those infections or problems.”
Raw sprouts
To get rid of harmful bacteria, wash all fruits and vegetables well before eating. When it comes to sprouts, however, washing may not be enough. Experts recommend you don’t eat any raw sprouts, such as alfalfa, clover, radish and mung bean because bacteria can get in the seeds before they sprout. Be sure to fully cook sprouts if you do eat them.
[READ Food Safety 101: How to Protect Yourself Against Foodborne Illness]
Foods to Avoid for Morning Sickness
In addition to avoiding foods that pose risks to your baby, you’ll want to stay away from foods that make you feel sick or queasy. That can mean staying away from foods that are hard to digest, cause GI distress like nausea, vomiting or acid reflux, or that you simply notice aren’t sitting well in your stomach. What you can and can’t tolerate in your own pregnancy may be different from what other people can tolerate, and from what you could tolerate before you were pregnant.
Some examples of foods that can make you feel unwell during pregnancy — and which you might want to avoid — include:
— Heavy meals
— Fatty foods
— Spicy foods
— Greasy foods
Healthy Swaps for Foods to Avoid During Pregnancy
You may feel overwhelmed by the long list of foods to avoid during pregnancy. The good news is that pregnancy doesn’t last forever — and you may be able to swap out your favorite food for a second-best option.
For instance, Jones recommends that sushi lovers opt for cooked seafood options or veggie rolls, or trade in a brie or soft goat cheese for a safe, pasteurized cheese option, like cheddar. Swapping out your coffee or tea for a decaf version can also be a way to get the taste you crave without the negatives to your baby.
“If cravings are strong, finding similar textures or flavors in safe foods can satisfy your appetite without compromising safety,” Jones says. “You can still party with your favorite foods,” she adds. “Just invite their safer cousins to the plate.”
If you find yourself experience frequent morning sickness or struggle to hold down meals, Ruiz recommends sticking to bland, easy-to-digest foods that don’t bother your senses of taste and smell or your GI tract.
Some examples of bland foods to reach for include:
— Dry toast
— Rice
— Unseasoned or lightly seasoned lean proteins
Calorie Intake During Pregnancy
While you may inevitably need to cut foods from your diet during pregnancy, it’s important not to let these omissions take away from your overall caloric intake. Your baby needs extra calories to grow, so it’s important to add back missing elements to your diet — and perhaps a few more onto that, as well.
According to the American College of Obstetricians and Gynecologists, pregnant people should consume an additional 340 calories per day starting in the second trimester, if they are carrying a single fetus. People should consume about 600 extra calories per day if carrying twins, and about 900 extra if carrying triplets.
“Make sure your diet includes a variety of fruits, vegetables, whole grains, lean proteins and healthy fats to meet the increased nutritional demands of pregnancy,” Jones says.
Adding in prenatal vitamins and working with a registered dietitian can also help you fill in nutritional gaps in your diet.
Last, try not to get discouraged. If you’re feeling overwhelmed or discouraged, Jones recommends to “focus on the risks, and remind yourself that these dietary changes are temporary but crucial for the baby’s health.”
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