Food safety in pregnancy

Most foods remain suitable in pregnancy, but some need care with preparation and storage. UK and US advice differs, even for foods with the same name.

Why some foods need extra care

Listeria bacteria can contaminate some ready-to-eat foods. Unlike many other foodborne bacteria, they can grow in a refrigerator. The resulting infection, listeriosis, can cause serious pregnancy complications and illness in a newborn. Refrigeration still matters, but it does not replace the cooking advice for particular foods.

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

Check the type of cheese

In the UK, pasteurised soft cheeses such as cottage cheese, cream cheese, mozzarella and feta are on the NHS safe-to-eat list. Brie, camembert and soft blue-veined cheeses need thorough cooking, even when made with pasteurised milk. The NHS says cheese cooked until steaming hot is suitable.

US CDC guidance lists pasteurised cottage cheese, cream cheese, feta and mozzarella as safer choices. It gives separate advice for queso fresco-type cheeses made with either pasteurised or unpasteurised milk, and unheated deli-sliced cheese. Check the type and preparation as well as whether the milk is pasteurised.

Meat, liver and eggs: check the local rule

The NHS allows cold pre-cooked meats such as ham or chicken if kept chilled 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.

Avoid liver and liver products under NHS guidance because their high vitamin A content can harm the baby. For other pâtés, advice differs too: the NHS gives chilling and use-by advice for meat and vegetable pâté, while US guidance treats refrigerated pâté as a riskier choice and favours shelf-stable products.

UK hen eggs carrying 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 thorough cooking. US guidance calls for firm yolks and whites, or pasteurised eggs in foods that will remain uncooked.

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 concern pollutants, including mercury. Raw seafood carries separate 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 translating the UK tuna limit into a US serving rule. For locally caught fish, check local fish advisories.

The NHS advises against raw fish and raw shellfish, including sushi made with raw fish even if previously frozen. It says cold-smoked or cured fish and cold ready-to-eat prawns need cooking until steaming hot. Wash fruit and vegetables thoroughly, and keep packaged salads chilled until use.

If you have already eaten something

The NHS says a small amount of a food or drink advised against is unlikely to affect the baby if you did not become ill. If you are worried, speak to your midwife or doctor. Still get help for symptoms, even if you are unsure 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 food that pregnancy guidance says to avoid. Tell them you are pregnant and describe 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 lasting more than 48 hours, even if you cannot identify a food that caused it. Tell them you are pregnant.