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Foods to Avoid
Foods To Avoid During Pregnancy
Food Safety
Listeriosis:
Listeria monocytogenes in a pathogenic bacterium which causes a group of diseases
collectively known as Listeriosis. Listeriosis in pregnancy is characterised by diarrhoea,
headache, fever, muscle pain, meningitis, septicaemia, as well as spontaneous abortion.
Listeria monocytogene can grow at refrigeration termperatures but os killed by cooking and
pasteurisation. Therefore, unpasteurised milk and unpasteurised dairy products are not
recommended during pregnancy.
Some refrigerated foods with a long shelf life (greater than 5 days) which are consumed without
further cooking also have a high risk of contamination since L. monocytogenes can grow at
refrigeration temperatures. Such foods include soft cheese (even those made with pasteurised
milk), paté, smoked salmon, deli meats (e.g. luncheon meats), and pre-prepared salads (e.g.
coleslaw).
Toxoplasmosis:
Toxoplasmosis is caused by the bacterium Toxoplasma gondii and infection is caused by
ingestion of Toxoplasma oocytes excreted in cat faeces, or by eating raw or undercooked meat
with visible cysts from infected food animals. Infection with this bacterium during pregnancy can
result in the transfer of the bacterium to the foetus and result in spontanoeus abortion or serious
handicap in the newborn.
Raw or undercooked meats, poorly fermented or cured meats, and unwashed fruit and
vegetables are potential sources of this bacterium and should be avoided during pregnancy.
Meat should be well cooked (no pink meat) and served piping hot to prevent Toxoplasma gondii
infection. Hand washing (especially after handling raw meat and unwashed vegetables) and
other hygiene practices are of utmost importance as well as wearing gloves when gardening or
changing cat litter.
Salmonella
While Salmonella infection is unlikely to cause any problems with a pregnancy or with fetal
development, it’s very unpleasant to suffer the effects during pregnancy. Pregnant women are
advised to take steps to minimise the risk of infection: cooking eggs till the yolk and white are
solid and avoiding products that may contain raw egg, such as homemade mayonnaise (shop
bought mayonnaise is acceptable due to it not containing raw egg).
Campylobacter
Campylobacter and Salmonella are both relatively common contaminants of meat. Like
Salmonella, Campylobacter causes the usual symptoms of food poisoning (diarrhoea, vomiting,
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stomach pains and cramps and fever) that can be particularly hard to cope with during
pregnancy. There is no particular risk to the infant or to the pregnancy from Campylobacter
infection.
Foods to avoid
With so many conflicting stories in the media about risks during pregnancy, often from dubious,
unscientific sources, many pregnant women feel vulnerable and confused about what advice to
trust for the welfare of their unborn child. Healthcare professionals can provide valuable and
reliable information and advice to such women, who should be urged to take care during their
pregnancy but not to the point of inappropriate anxiety.
The following article looks at risks to the health of both the mother and her unborn infant that
some foods may pose during pregnancy and offers sensible guidelines to minimise potential
problems.
Foods, drinks and supplements that should be avoided in pregnancy
Vitamins and other supplements, including fish liver oil supplements, which contain
vitamin A (or retinol)
Liver and liver products
Milk that has not been pasteurised or ultra-heat treated
Dairy products made with unpasteurised milk including all soft cheese and
mould-ripened cheese (even those made with pasteurised milk), e.g. Brie, Camembert,
Goat's cheese, and blue cheese, e.g. Danish Blue, Stilton, Roquefort.
Pâté of any sort
Uncooked and undercooked ready-prepared meals
Raw and partially cooked eggs and food that may contain them
Raw meat products and partially cooked meat
Uncooked cured or smoked meats
Smoked salmon and gravid lax fish
Unwashed fruit and vegetables, including ready-prepared salads
Raw shellfish
Shark, swordfish and marlin
Limit tuna to one fresh tuna steak (150g) per week or two 240g tins of tuna per week.
Avoid alcohol completely during pregnancy.
Food Preparation and Hygiene:
Always wash hands before handling food
Wash fruit and vegetables thoroughly before eating
Keep raw and cooked meats separate when cooking and in the fridge and wash hands
and chopping boards thoroughly after contact with uncooked meats.
Use different kitchen utensils and chopping boards when cooking raw and cooked meats
to avoid cross contamination
Clean kitchen surfaces with disinfectant after preparing uncooked meat
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Cook all foods thoroughly especially meat and fish and serve hot
Ensure the temperature of the fridge is <5°C
Avoid eating foods past their 'use by' date
Water from a contaminated supply should not be consumed. Check with your local
authority that your tap water is safe for consumption.
Drink bottled water only when abroad.
Always wash hands:
before preparing and eating foods
before and after handling raw meat
after contact with animals
after going to the toilet or changing a baby's nappy
after gardening
Liver, liver products and supplements containing vitamin A
Liver and liver products contain high levels of vitamin A (retinol). Vitamin A is a fat soluble
vitamin and plays an important role in many biological processes. It is required for vision,
embryonic development, and for cell proliferation and differentiation. If vitamin A intakes are
high, however, it can build up in the body, and high levels have been shown to have harmful
effects on the developing fetus2. Consequently, pregnant women are advised to avoid liver and
liver products1.
The Irish recommended daily allowance (RDA) for vitamin A during pregnancy is 700?g/day
retinol activity equivalent (RAE)3, with a tolerable upper level of 3,000?g/day RAE (Institute of
Medicine, 2006).
As some vitamin supplements contain high levels of vitamin A, pregnant women need to be
careful about which type of supplement they take. A woman who wants to take a multi-nutrient
supplement should be directed towards those specially formulated for pregnancy. Fish liver oils
also contain high levels of vitamin A and should be avoided during pregnancy1 .
FSAI 2012 Guidance on Vitamin A Intake During pregnancy1
Alcohol
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There is no known safe alcohol intake in pregnancy therefore the Department of Health and
Children (2008) and the Food Safety Authority of Ireland (2012)1 recommend that pregnant
women avoid alcohol completely.
Alcohol is a teratogen (a substance which is harmful to the developing fetus), and can easily
pass through the placenta to the developing foetus. Alcohol consumption during pregnancy can
lead to the development of Foetal Alcohol Syndrome which is characterised by behavioural
problems, mental retardation, aggressiveness, nervousness, short attention span, growth
retardation, and birth defects4. The negative effects of maternal alcohol consumption on a
developing baby seem to occur at widely varying alcohol intakes. This makes it hard to justify a
‘safe’ alcohol intake during pregnancy1.
FSAI 2012 Guidance on Alcohol During Pregnancy1
Raw shellfish
Raw shellfish are another common source of viruses and bacteria that can cause food
poisoning, so the advice is to steer clear of these during pregnancy.1
Shark, swordfish and marlin
Concerns about high levels of mercury have led to a recommendation to avoid eating shark,
swordfish and marlin during pregnancy. Mercury at high levels can damage the developing
nervous system1.
Tuna
Due the mercury content of tuna, pregnant women should limit their intake of tuna to one fresh
tuna steak (150g) per week or two 240g tins of tuna per week1.
Allergenic Foods
In the past, it was recommended that mothers of infants at high risk of developing atopic
disease (infants with at least 1 first degree relative with an allergy) should avoid potentially high
allergenic foods during pregnancy including eggs, cow's milk, fish, peanuts, and tree nuts.
However, the most recent guidelines by the Food Safety Authority of Ireland (2012) state that
unless the mother is allergic to the food herself, there is no evidence to recommend the
elimination of these foods from her diet1.
FSAI 2012 Guidance On Potential Allergenic Foods During Pregnancy1
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Caffeine
Excess caffeine intake has been associated with adverse health outcome in pregnancy such as:
Miscarriage5
Sudden infant death syndrome (SIDS)6
Low birth weight7-8
Caffeine is absorbed freely across the placenta but cannot be broken down by either the
placenta or the foetus. In some cases, women go off coffee during pregnancy, and this natural
aversion may have some protective basis. As well as coffee, other foods such as tea, chocolate
and energy drinks also contain caffeine. The Food Safety Authority of Ireland (2012)
recommend that pregnant women should not have more than 200mg/day of coffee1
(approximately 2 cups of brewed coffee per day).
FSAI 2012 Guidance on Caffeine Consumption During Pregnancy1
References: 1. Food Safety Authority of Ireland (2012). Scientific Recommendations for a National Infant Feeding Policy, 2nd Edition. 2. Miller
RK et al. (1998). Periconceptional vitamin a use: How much is teratogenic? Reproductive Toxicology. 12(1): 75–88. 3. Food Safety Authority of
Ireland (1999). Recommended dietary allowances for Ireland. 4. March of Dimes Birth Defect Foundation. (1997). Public health education
information sheet: Drinking alcohol during pregnancy. 5. Fenster et al. (1991). Caffeine consumption during pregnancy and fetal growth. Am J
Public Health. 81(4): 458–461. 6. Ford RPK et al. (1998). Heavy caffeine intake in pregnancy and sudden infant death syndrome. Arch Dis
Child. 78: 9-13. 7. Bracken MB et al. ( 2003). Association of Maternal Caffeine Consumption with Decrements in Fetal Growth. Am J
Epidemiol.157:456–466. 8. Care. (2008). Maternal caffeine intake during pregnancy and risk of foetal growth restriction: a large prospective
observational study. BMJ. 337: a2332
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