From caffeine to canned tuna, the list of foods moms-to-be should avoid can be overwhelming. Self-proclaimed cheese lover Elizabeth Hurley, mother of a 1-year-old in Boston, was frustrated by the conflicting information she found: “I read no soft cheeses at all, then no unpasteurized cheeses, and most specifically, no unpasteurized soft cheeses made outside of the United States. So could I eat a pasteurized soft cheese made in the U.S.?”
Confusing information is common thanks to old internet articles surfacing alongside the new research—and trying to make sense of all that’s out there can send even the most even-keeled expectant woman over the edge. And while it has long been advised to avoid soft cheeses, deli meats, caffeine and any amount of alcohol, but is it necessary to completely forgo these so-called forbidden foods? Not exactly, medical and food experts say. The key is not to take everything you read or hear at face value. Instead, let your doctor’s advice guide you, and study food labels to better inform your decision.
To spare your sanity, here’s a guide to help you—and your baby—stay healthy.
The official party line on drinking alcohol while pregnant is clear in the United States: Don’t do it. The Department of Health and Human Services says women should not consume alcohol if they may become pregnant, are pregnant or are breastfeeding.
Women often point to their childbearing, wine-sipping counterparts in Europe as proof that a little nip is acceptable in moderation, but even those tolerances appear to be changing. In 2007, the French Ministry of Health, Youth and Sports began recommending that pregnant women avoid drinking alcohol altogether. The United Kingdom and Switzerland also advise abstinence, but with the caveat that pregnant women who choose to drink should limit themselves to one or two servings once or twice a week. Myra Wick, MD, OB/GYN and medical geneticist at the Mayo Clinic in Rochester, Minnesota, notes that there is no research to indicate how much alcohol, if any, is safe for pregnant women. “Certainly if a patient has a celebratory event, a half glass of wine is probably fine, but we really don’t know just how much is OK,” she says.
Deli Meats and Spreads
The danger in eating a package of Oscar Mayer’s finest hot dogs lies in listeria—a toxic bacteria that can fester in cold turkey, bologna, etc and cause listeriosis. If it infects the placenta, the fetus is at higher risk for stillbirth or a miscarriage —and babies who do survive are at risk for premature birth. This doesn’t mean you have to forgo roast beef, but before you take a bite, either grill your sandwich or microwave the meat for 30 seconds until it’s steaming hot to kill listeria and make it safe for consumption.
According to the Centers for Disease Control and Prevention (CDC), listeria is also the reason pregnant women should avoid pâté, even vegetable pâté, from the refrigerated section of the store. Shelf stable meat spreads that do not require refrigeration prior to opening are a safer option.
As a general rule, cooked is in, raw is out—with the exception of both oysters and lobsters, which can have high levels of mercury and should generally be avoided throughout one’s pregnancy. The American Pregnancy Association advises women to steer clear of uncooked shellfish to prevent one of many food-borne illnesses and bacteria that can hurt both mom and baby. But hard-core pescetarians should take note: cooked shrimp, scallops, crabs, clams, and yes, even mussels are OK. Just be wary of red tide warnings in your area as algae-related infections aren’t killed through boiling.
Generally a good source of fiber and omega 3s, as well as protein, iron, calcium, folate, and zinc, soy at first appears a pregnant woman’s superfood. But some members of the medical field claim that phytic acid blocks the fetus’ absorption of the same iron and zinc it provides—both of which are important to your baby’s growth. According to Julie Redfern, RD, manager of nutrition consult services at Brigham and Women’s Hospital in Boston, however, it’s not that simple. “Soymilk and tofu, as well as all whole soy milk products in general, are fine, but concentrated soy in large amounts, such as soy protein powder, should be avoided. Women should instead use whey protein powder in their shakes and smoothies.”
Pregnant women are often fed the same mantra when it comes to cheese: hard is good, soft is bad. Conventional wisdom is that hard cheeses contain pasteurized milk, and soft cheeses are made with unpasteurized milk, which could still carry listeria that would be eliminated in the pasteurization process. But that statement isn’t necessarily true, says Richard Sutton, owner of the St. James Cheese Company, a specialty cheese shop in New Orleans. “As a general rule, a decent assumption is that virtually any soft cheese in the U.S. is going to be pasteurized,” he says.
The Food and Drug Administration mandates that if cheese is made with raw milk, it has to be aged 60 days. Doing so with soft cheeses, however, causes spoilage, so most cheese makers opt for pasteurization instead. Consumers are actually more likely to find hard cheeses that contain raw milk because they can better withstand the aging process. But to be safe, steer clear of soft cheeses including Camembert, brie, feta, blue cheeses, gorgonzola, Roquefort, and any Mexican cheeses that include queso fresco or queso blanco—unless they clearly state they were made with pasteurized milk or unless you’re planning to boil them (e.g., feta cheese on pizza).
Pasteurization in and of itself doesn’t completely exempt nonfirm fromage, Sutton says. Because soft cheeses tend to contain more moisture, they can be more susceptible to bacteria passed along during handling and storage. An easy rule of thumb: When in doubt, ask your healthcare provider.
Does the success of your day depend on a morning java jolt? If your answer is yes, don’t fret. The March of Dimes says one 12-ounce cup of coffee per day is fine; Redfern directs women to drink no more than one 10-ounce cup per day. “After that, all tea or coffee should be decaf—and remember,” she warns, “black tea still has one-third the caffeine of coffee.” Green tea also includes caffeine although the amount will vary by maker. The March of Dimes also recommends steering clear of energy drinks, which can contain much more caffeine than coffee, and lots of sugar too.
The risk here comes from mercury, which can affect a baby’s hearing and vision and cause brain damage. Though it’s a particularly tricky food with confusing limits, one serving of solid white per week is fine, according to the FDA. To further minimize risk, Redfern advises pregnant women to have one 6-ounce can of chunk light tuna, which has the least amount of mercury, per week. Although tuna takes a lot of the mercury rap, be mindful of other fish that are high in the metal—like swordfish, marlin, orange roughy, shark, king mackerel and tilefish—which the EPA recommends pregnant women not eat at all.
Oh, veggie omelets, what a nutritional punch you pack! Eggs are a good source of choline, which helps a baby’s brain develop and protects against neural tube defects. One egg contains about 113 milligrams, and pregnant women should aim for about 450 milligrams per day. Explains Redfern, “A lot of woman are turned off by meat early on in their pregnancy, making eggs a great alternative protein. Women with high cholesterol should limit themselves to three whole eggs a week and after that, egg whites.” Like with raw fish and raw meats, it’s safest to avoid dishes with undercooked or raw eggs, which can contain salmonella. Remember, raw eggs may be included in other items like homemade ice cream, dairy products, mayonnaise, hollandaise sauce, eggnog, raw cookie dough, and some Caesar dressings.