A Food Guide for Pregnant Women

Dispel the rumors and clarify the myths about foods that are healthy during pregnancy and those to steer clear of.

Red-Light Foods

pregnant mom drinking water

During your pregnancy there are a few things that might stress you out, but eating shouldn't be one of them. Unfortunately, all of the advice you hear -- from friends, family, and yes, even total strangers -- about what is and isn't safe during pregnancy is enough to confuse anyone. "There are a lot of old wives' tales out there," says Elizabeth Ward, RD, of Reading, Massachusetts. So if you're wondering what's okay to eat (and whether you have to give your favorite foods the boot for nine months), check out our guide.

 

Foods to Avoid

Why are some foods off-limits when you're pregnant -- but fine if you're not? First, changes to your immune system now make you more vulnerable to food-borne illnesses. What would've meant stomach upset before could mean serious complications now -- from dehydration to miscarriage.

So to be safe, avoid the common culprits of food-borne illness:

Eggs: Because raw eggs may be tainted with salmonella, a bacterium that can cause fever, vomiting, and diarrhea, watch out for restaurant-made Caesar salad dressing, homemade eggnog, raw cookie dough, and soft scrambled or sunny-side up eggs -- any dish in which the eggs (both yolk and white) are not cooked completely. "If eggs are cooked, the risk is gone," adds Madeleine Sigman-Grant, PhD, maternal child health and nutrition extension specialist at the University of Nevada.

Sushi: With the exception of California rolls and other cooked items, sushi is not safe when you're expecting, either, because it may contain illness-inducing parasites.

Unpasteurized Juice: Stay away from juice (like cider) sold at farm stands; it may not have undergone pasteurization, a processing method that kills bacteria and toxins. Though the majority of milk and juices sold in stores today are pasteurized, there are still some brands on shelves that aren't, so read labels.

Other foods are unsafe due to possible contaminants that can harm the fetus:

Some Varieties of Fish: Fish, which boasts omega-3 fatty acids that help baby's brain development, is a great meal choice right now. But some varieties should be shunned due to high levels of methyl-mercury, a pollutant that can affect baby's nervous system. These include swordfish, shark, and tilefish -- all big species that live longer, accumulating more mercury in their flesh. (You may want to avoid these fish entirely during your childbearing years because your body stores mercury for up to four years, Ward advises.)

In fact, most types of fish contain traces of mercury, so you'll want to limit your weekly consumption of safer varieties too. According to the newest guidelines from the FDA, you can enjoy up to 12 ounces a week (roughly two meals) of lower-mercury fish such as salmon, catfish, pollack, shrimp, and canned light tuna. Of those 12 ounces, only 6 should come from canned "white" albacore tuna, which tends to contain more mercury than light tuna. If you're eating fish caught in local waters, check online with your state's department of health for advisories (if you can't find any information, limit yourself to 6 ounces).

Yellow-Light Foods

Some foods are fine in small amounts, but don't go overboard.

High Levels of Caffeine: When it comes to caffeine, "the studies can be very confusing," says Sigman-Grant. While one small study did link caffeine to increased health risks in the fetus, stronger studies have shown that caffeine is not harmful in moderate amounts. So currently the guidelines suggest no more than 300 milligrams per day, roughly the amount found in two or three 8-ounce cups of coffee. And that comes as a relief to many moms-to-be. Stephanie McClure, a mother of two, in Westerville, Ohio, had a terrible time going cold turkey. "After a few months I went to my doctor and asked if there was any way I could have just a little bit of coffee," remembers McClure, who says her doctor gave the okay for a couple of cups a day. "I immediately ran to Starbucks and ordered a mocha latte."

Nitrate-Rich Foods: It's also smart to go easy on hot dogs (which should always be eaten cooked) and cured meats such as bacon and sausage. These contain nitrates, additives that have been called into question for possible links to brain tumors and diabetes. Although studies aren't conclusive, it makes sense to limit your consumption -- these foods aren't great nutritional choices anyway. What about your beloved diet sodas? They're considered safe during pregnancy and, beyond not being a stellar nutritional choice, there's no scientific evidence that they cause harm. But on the downside, at least one artificial sweetener (saccharin) that's often found in diet sodas does cross the placenta, and artificially sweetened drinks are usually low in nutritional value. So again, we recommend moderation.

Green-Light Foods

Good news! A few foods you may have thought were forbidden actually aren't.

Soft Cheeses: Soft cheeses such as Brie, feta, and Gorgonzola were once considered potentially harmful because they can harbor listeria. Listeriosis, an illness caused by the bacteria listeria, can be passed to the fetus, leading to miscarriage, premature delivery, or stillbirth. However, the FDA now allows soft cheese during pregnancy, as long as it's made with pasteurized milk. Most cheese sold in the United States is, but "don't ever take that for granted," says Ward. It's still important to check labels, especially with imported brands. If you live in a border state, steer clear of soft Mexican cheeses like queso blanco in markets (they aren't typically pasteurized).

 
Cheese During Pregnancy: Safe or Not?
Cheese During Pregnancy: Safe or Not?

Cooked Deli Meats: When Jennifer Vito, a mom in San Antonio, heard that deli meat was also off-limits because of listeriosis concerns, she found it difficult to eliminate it when she was expecting. "If I can't have deli meat, what am I supposed to eat for lunch?" she says. "I ate a lot of peanut butter and jelly sandwiches and snacked on veggies." But deli meat is fine during pregnancy as long as you heat it first to kill bacteria (pop your sandwich in the microwave or order a hot or toasted sandwich at the deli -- just make sure the meat is steaming before you eat it). "It's a pain to heat it, but it would be worse to get listeriosis," says Ward. If you would prefer to pass on deli meat, try other high-protein lunches like a veggie burger, a bean burrito, or chicken salad made with some leftover grilled chicken breast and low-fat mayo.

Fresh Produce: Finally, fruits and veggies should be a staple in your diet, especially during pregnancy, because they're high in vitamins and fiber. But take a few commonsense precautions: Rewash bagged lettuce (even if the label says it's triple-washed) to wash away any possible traces of salmonella or E. coli. In fact, you should wash the outside of all fruits and vegetables -- even if you're not going to eat the skin. "Otherwise you drag the germs into the flesh when you cut it," says Sigman-Grant.

But what's the bottom-line best advice on what to eat these nine months? Mix it up. "Don't rely on the same foods every day," Sigman-Grant says. "You dramatically diminish your risk of being exposed to something harmful if you eat a variety." What's more, by varying your diet, you'll also deliver a healthy mix of nutrients to your growing baby.

The News on Alcohol

Alcohol has long been considered a no-no during pregnancy. But many doctors still advise their patients that an occasional drink is okay. "My doctor told me I could have up to 4 ounces of red wine once or twice a week and that it would actually be good for me," remembers Amy Quinn, a mom in Mullica Hill, New Jersey. So have the rules on drinking changed?

Absolutely not, warn many experts. Heavy drinking can lead to Fetal Alcohol Syndrome (FAS), which causes mental retardation and a host of abnormalities. But according to the March of Dimes, even moderate drinking may lead to more subtle physical and mental damage. And because no one knows exactly what amount of alcohol causes FAS, it's smart to steer clear.

How to Eat Healthy During Pregnancy: What "Eating for Two" Really Means
How to Eat Healthy During Pregnancy: What "Eating for Two" Really Means

Sally Kuzemchak is a registered dietitian and writer in Columbus, Ohio.

Originally published in American Baby magazine, December 2005.

The information on this Web site is designed for educational purposes only. It is not intended to be a substitute for informed medical advice or care. You should not use this information to diagnose or treat any health problems or illnesses without consulting your pediatrician or family doctor. Please consult a doctor with any questions or concerns you might have regarding your or your child's condition.

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