Foods to Actually Avoid During Pregnancy (and Myths That Aren't True)

The foods to genuinely avoid during pregnancy share one thing in common: they carry a higher risk of bacteria or parasites that can cross the placenta and harm the developing baby, even when the mother's symptoms are mild.

The evidence-based avoid list includes raw or undercooked meat, poultry, and eggs (risk of Salmonella and Toxoplasma), raw or undercooked fish and shellfish including raw sushi and raw oysters (risk of parasites and bacteria), high-mercury fish — shark, swordfish, king mackerel, tilefish, bigeye tuna, and marlin (mercury damages the developing nervous system), unpasteurized dairy products including raw milk and cheeses made from raw milk (risk of Listeria), deli meats and hot dogs unless heated to steaming/165°F (Listeria risk), unpasteurized juice and cider, raw sprouts (alfalfa, bean, clover — bacteria can get inside the seed), and unwashed fruits and vegetables.

The reason these matter more during pregnancy is that your immune system is naturally suppressed to protect the baby, making you 10 times more likely to get listeriosis than a non-pregnant person. An infection that might give you a bad day can cause miscarriage, stillbirth, or serious newborn illness.

This is one of the most common pregnancy food questions — and the answer is more nuanced than a blanket "no." Raw fish sushi should be avoided because of the risk of parasites and bacteria. However, cooked sushi is perfectly safe and can actually be nutritious during pregnancy.

Safe sushi options include cooked shrimp (ebi), cooked crab, cooked eel (unagi), California rolls (imitation crab is cooked), tempura rolls, and vegetable rolls. These give you the sushi experience without the raw fish risk.

If you eat cooked fish sushi, choose low-mercury options like salmon, shrimp, pollock, tilapia, and catfish. Avoid high-mercury fish regardless of whether they're cooked. The FDA recommends pregnant women eat 2-3 servings (8-12 ounces) of low-mercury fish per week because the omega-3 fatty acids and DHA are actually beneficial for fetal brain development.

One practical note: if you're eating at a restaurant, make sure cooked rolls are prepared on clean surfaces and not cross-contaminated with raw fish. Reputable sushi restaurants maintain strict separation, but it's worth mentioning your pregnancy to your server.

The current medical consensus is that moderate caffeine intake — up to 200mg per day — is considered safe during pregnancy. That's roughly equivalent to one 12-ounce cup of brewed coffee, or two cups of black tea.

Caffeine crosses the placenta, and the fetus metabolizes it much more slowly than you do. High caffeine intake (over 300-400mg daily) has been associated with increased risk of miscarriage and low birth weight in some studies, though the evidence is debated. A 2020 review in BMJ Evidence-Based Medicine suggested that no level of caffeine is proven safe, but major medical organizations (ACOG, WHO, NHS) continue to endorse the 200mg guideline based on the overall body of evidence.

Practical caffeine math: a Starbucks Grande (16 oz) brewed coffee has about 310mg — already over the limit. A tall (12 oz) is about 235mg, still a bit high. Better options include a single espresso shot (~63mg), a cup of green tea (~30-50mg), or half-caf coffee. Don't forget hidden caffeine sources: chocolate, energy drinks, some sodas, certain teas, and some medications.

If you're struggling with fatigue (which is normal in pregnancy), prioritize sleep, hydration, and protein-rich snacks before reaching for extra caffeine.

The soft cheese rule is widely misunderstood. The issue isn't softness — it's pasteurization. Soft cheeses made from pasteurized milk are perfectly safe during pregnancy. The risk comes from unpasteurized (raw milk) cheeses, which can harbor Listeria monocytogenes.

Safe to eat (when made with pasteurized milk): brie, camembert, mozzarella, cream cheese, ricotta, cottage cheese, feta, goat cheese, mascarpone, and processed cheese. In the United States, commercially produced cheese is almost always pasteurized — check the label.

Cheeses to avoid: any soft cheese specifically made from unpasteurized or raw milk (common at farmers' markets and specialty shops), queso fresco and queso blanco from brands that don't pasteurize, and imported soft cheeses where pasteurization status is unclear.

Hard cheeses like cheddar, Swiss, and Parmesan are safe regardless of pasteurization because their low moisture content makes them inhospitable to Listeria. The practical takeaway: don't deprive yourself of cheese — just check the label for "pasteurized" and you're good to go.

Deli meats (including turkey, ham, roast beef, salami, and bologna) carry a small but real risk of Listeria contamination. The bacteria can grow even at refrigerator temperatures, which is why deli meat is singled out as a pregnancy concern.

The actual risk is low — the CDC estimates about 1,600 cases of listeriosis per year in the U.S., of which about 200 are pregnancy-related. But the consequences can be severe: listeriosis during pregnancy can cause miscarriage, stillbirth, premature delivery, or life-threatening infection in the newborn.

The safe workaround is simple: heat deli meats until they're steaming hot (165°F / 74°C). Microwaving a deli sandwich until the meat is steaming, or heating slices in a skillet, kills Listeria. Many pregnant women heat their deli meat and continue to enjoy sandwiches throughout pregnancy with no issue.

The same heating rule applies to hot dogs, pâté, meat spreads, and smoked seafood (like lox). Once heated to steaming, the Listeria risk is eliminated. If you can't heat it — like at a cold buffet or picnic — choose other protein options instead.

Alcohol is the one true zero during pregnancy. Unlike caffeine, where moderate amounts are considered safe, no amount of alcohol has been proven safe during pregnancy. This is the position of ACOG, the CDC, the AAP, the WHO, and virtually every major medical organization worldwide.

Alcohol crosses the placenta freely and reaches the same concentration in the fetus as in the mother. But the fetus metabolizes alcohol much more slowly, meaning exposure lasts longer. Alcohol can cause fetal alcohol spectrum disorders (FASDs), which include physical abnormalities, learning disabilities, behavioral problems, and intellectual disability. FASD is the leading preventable cause of birth defects and developmental disabilities.

There is no known safe type of alcohol (wine isn't safer than liquor), no safe amount, and no safe trimester. The risk is highest during the first trimester when organs are forming, but the brain develops throughout pregnancy and remains vulnerable.

If you drank before you knew you were pregnant — as many women do — don't panic. The risk from a few drinks in very early pregnancy is likely low. But from the point of a positive test onward, abstaining is the only evidence-based recommendation. If you're finding it difficult to stop, your provider can connect you with confidential support resources.

Pregnancy food rules have a way of multiplying beyond the evidence. Here are common myths you can safely ignore.

Myth: You can't eat any fish. Reality: You should eat 2-3 servings of low-mercury fish per week — omega-3s and DHA are important for fetal brain and eye development. Just avoid high-mercury species and raw preparations.

Myth: Spicy food is harmful. Reality: Spicy food is perfectly safe. It may worsen heartburn (already a pregnancy staple), but it won't harm the baby, induce labor, or cause birth defects.

Myth: You need to eat for two. Reality: You only need about 340 extra calories per day in the second trimester and 450 in the third — that's a yogurt parfait, not a second dinner. Excessive weight gain carries real risks including gestational diabetes and preeclampsia.

Myth: Honey is dangerous during pregnancy. Reality: Honey is unsafe for babies under 1 year (botulism risk), but an adult's digestive system handles Clostridium botulinum spores without issue. Honey in pregnancy is fine.

Myth: Peanuts cause allergies. Reality: Current research shows no link between eating peanuts during pregnancy and childhood peanut allergy. Avoiding peanuts is unnecessary unless you're personally allergic.