Food allergy and food intolerance
If you have a medically diagnosed food allergy, or are excluding foods due to a food intolerance, you should ensure that you are getting the required nutrients you need while you are pregnant.
It’s important to note that food intolerances, and particularly food allergies in adults, are much less common than people think. People may self–report that they have a food allergy or intolerance, but figures for people with allergy or intolerance using scientifically recognised diagnostic tests are much lower than self-reported figures. The National Institute for Health and Care Excellence (NICE) guidelines recommend against the use of 'alternative' test kits, available online and in some shops. NICE says there is little evidence that these work and can lead to unnecessarily restrictive diets. So, you should speak to your health professional if you think you may have a food allergy or intolerance, before changing your diet.
What are the most common food allergies?
Common foods causing food allergies include milk, egg, peanuts, sesame seeds, fish, shellfish, tree nuts, wheat and soya. All these foods must be labelled if they are present or added to foods.
How likely is it that my baby will develop a food allergy?
Food allergy is relatively rare, affecting an estimated 1-2% of adults in the UK. Food allergy appears to be slightly more common in young children, with an estimated 6–8% of children under 3 years old having a proven food allergy. Many children outgrow their allergies to milk or eggs, but a peanut allergy is often life-long.
If I have a food allergy, is my child more likely to develop one?
Babies are more likely to develop an allergy if a parent or sibling has a medically diagnosed allergy (such as eczema, asthma, hayfever or food allergy). Your baby will also have a higher risk of developing a peanut allergy if they have another medically diagnosed allergy (such as eczema or another food allergy).
Breast milk provides the ideal nourishment for newborns. European, American and international academic and health groups strongly recommend exclusive breastfeeding for 6 months, with introduction of complementary foods no earlier than about 6 months, once your baby is developmentally ready for this. Peanut and hen's egg can be introduced from around 6 months of age. Evidence shows that delaying introducing peanut or hen's egg beyond 6 to 12 months of age may actually increase the risk of your child developing an allergy to these foods, and it is important that once introduced to these foods, they are still a normal part of your infant's diet. However, if you have a family history of early-onset eczema or suspected food allergy, then you should seek medical advice before introducing these foods.
If you're not breastfeeding, ask your doctor for advice on what kind of formula to give your baby.
Can I help reduce the risk of my baby developing an allergy in pregnancy?
The increase in the number of children with a food allergy in recent decades has led to the suggestion that a mother's diet during pregnancy may be a key factor in determining a child's risk of developing a food allergy. However, an expert review published in 2018 by COT (Committee on Toxicity of Chemicals in Food, Consumer Products and the Environment) concluded that there was no sign that avoiding allergenic foods (such as peanut, hen's egg) during pregnancy reduces the risk of your child developing an allergy. Therefore, it is not recommended that mothers avoid allergenic foods during pregnancy or while breastfeeding. There is also a lack of consistent evidence to suggest that other aspects of the diet, such as eating fruit and vegetables, fish, or particular fats or fatty acids, could reduce the risk of a child developing an allergy. So, it is important not to restrict your diet during pregnancy, as this may negatively affect your and/or your baby’s nutrition.
It has also been a suggested that consuming some supplements during pregnancy, such as probiotics, may reduce the risk of your child developing a food allergy. However, the evidence to support this is limited and guidelines make no specific recommendations about the use of probiotics or other supplements during pregnancy to reduce the chance of your baby developing an allergy.
I have heard some pregnant women avoid peanuts to prevent peanut allergies in their children. Is there any benefit or truth to this?
Current government advice does not recommend avoiding peanuts during pregnancy (unless you are allergic to peanuts yourself), as this has not been shown to reduce the chances of your baby developing a peanut allergy. The same is true for other allergenic foods, such as hen's egg and foods containing gluten, and you should not avoid eating any particular foods while pregnant, other than those that are recommended for reasons of food safety (such as soft blue cheeses). Find out more on our page on what not to eat when pregnant.
I have a food allergy. How can I make sure I’m getting the right nutrients for me and my baby?
If you are avoiding certain foods due to your own medically diagnosed food allergies and are concerned you may not be getting all the nutrients you need during pregnancy, then you should speak to your midwife or GP. Depending on your allergies, you may be referred to a dietitian to help support you in your choices of alternative foods, which will provide you with the nutrients you and your baby need.
Food safety in pregnancy
It is always important to be careful about how you prepare and store food in the home to avoid the nasty bugs that can cause food poisoning. When you are pregnant, planning a baby or have just had your baby, it is more important than ever. Just following some basic guidelines can really help to reduce your risk of getting food poisoning. Remembering the four ‘Cs’ can be useful:
Clean: Wash hands and surfaces often
Cross-contaminate: Separate, do not cross–contaminate
Cook: To safe temperature
Chill: Refrigerate properly
Clean
- Wash your hands with soap and warm water and dry them - before handling and preparing food and after touching raw foods (especially meat), going to the toilet or changing nappies, touching animals (including pets) and touching bins.
- Clean work surfaces, including your chopping boards and utensils, thoroughly before and after preparing food, especially if you are preparing raw foods such as raw meat.
- Wash fruit and vegetables by rubbing them under water, for example in a bowl of fresh water, before eating.
Cross-contamination
- Have separate chopping boards for raw food (especially meat) and ready-to-eat foods or wash it thoroughly in between preparing different types of food, to avoid bacteria from raw food being transferred. Don't forget to also clean knives and other utensils thoroughly after using them to prepare food.
- Store raw food (especially meat) and ready to eat foods separately and do not allow them to come into contact or be placed on the same surface without washing it. Bacteria in raw food can be killed when you cook it, but not if they are transferred to foods like salads, fruit or bread.
- Make sure you cover raw meat, or keep it in a sealable container, and keep it on the bottom shelf of the fridge so that it cannot touch or drip on to any other foods.
- Do not wash raw chicken (or other poultry, like turkey) before cooking it, as washing may splash harmful bacteria onto kitchen surfaces.
Cook
- When you cook food, make sure that it is piping hot all the way through. Make sure that any meat, whether cooked in your kitchen or on the barbeque, is thoroughly cooked. During pregnancy, all rare (pink) meats should be avoided, including lamb and beef. Check that they are cooked all the way through with no pink meat on the inside. Insert a knife into the deepest part and make sure the juices run clear.
- When you reheat food, make sure it is piping hot all the way through. Foods should not be reheated more than once as cooling and reheating food more than once increases the risk of food poisoning.
Chill
- Use a fridge thermometer to check your fridge temperature and make sure it is between 0 and 5oC
- If you have leftovers or food that you are not going to eat straight away, cool it as quickly as you can (ideally within an hour and a half) and then store it in the fridge or freezer. Make sure you let the food cool down before you put it in the fridge, otherwise it may raise the fridge temperature. Eat foods that you have stored in the fridge within two days.
- Harmful bacteria can grow in foods with a 'use by' date (such as cooked meats, cheeses, prepared salads) so do not eat them after they have gone past the 'use by' date.
- Never put open cans in the fridge as the metal may transfer to the can’s contents – place the contents in a covered container instead.
- Do not refreeze raw foods or foods meant to be frozen (such as frozen desserts that have been thawed). Defrosted raw foods can be stored in the fridge for up to two days before being cooked. Defrosted cooked food must be reheated and eaten immediately.
This section is about common concerns that may be experienced in pregnancy, such as:
Nausea and vomiting ('Morning Sickness')
Nausea and vomiting occurs most commonly in the first trimester (12 weeks) of pregnancy. Symptoms should ease as the pregnancy progresses and typically will clear up by weeks 16-20. Around half of women experience vomiting, and nausea affects around 85% of pregnant women. The common term of 'morning sickness' is often misleading as it is normal for nausea and vomiting to occur at any time of the day. Though the exact cause is unknown, it’s suggested that the sickness is due to a hormone imbalance. Though it can be highly unpleasant, the good news is that nausea and vomiting is not usually harmful to the mother or the baby. However, about 1% of women can develop severe nausea and vomiting, this is known as hyperemesis gravidarum (HG), which may be dangerous for mum and baby and can require medical attention.
Hyperemesis gravidarum (HG)
HG describes nausea which can lead to vomiting up to 50 times a day, leading to dehydration, ketosis (a dangerous condition in pregnancy), weight loss and low blood pressure. In these severe cases, mums may not be getting the nutrients and fluids they need for themselves and their babies. It’s suggested that HG is linked to genetics and runs in families, so it could be helpful to know if there is a family history of HG.
The National Institute for Health and Care Excellence (NICE) recommends that pregnant women seek medical attention if they have:
- very dark urine, or have not passed urine for more than 8 hours
- abdominal pain or fever
- severe weakness
- vomiting blood
- repeated unstoppable vomiting
- inability to keep any fluids or food down for 24 hours.
Staying healthy when sickness strikes
It can be difficult to remain healthy when feeling nauseous, especially as smells can increase this feeling. When this is the case, mums-to-be could try to:
- Get plenty of rest.
- Avoid wearing tight clothes.
- Drink small amounts of fluids often throughout the day, rather than in large amounts in one go.
- Avoid drinking cold, tart or sweet beverages.
- Avoid skipping meals. Instead try eating small, frequent meals high in carbohydrate and low in fat.
- Avoid any foods or smells that trigger symptoms. Cold meals may be more easily tolerated if nausea is smell-related.
Acupressure has also been found to be useful in some cases, and support from friends and family can help.
Meal and snack ideas
Plain savoury snacks can be helpful, for example, toast, crackers and crispbread. Try adding simple savoury toppings to boost nutrient intake, for example yeast extract provides B vitamins, cheddar cheese gives some extra calcium and peanut butter provides vitamin E and zinc, as well as protein.
Lunch and dinner
Bean or vegetable soups can be a great choice at this stage as they are comforting, nutritious and can maintain hydration.
Drinks
As well as eating regularly, it is essential to remain hydrated, especially after vomiting, so try to drink fluids regularly throughout the day. As well as providing water and some vitamins and minerals, drinks such as smoothies can provide calories, which can be useful if nausea causes a loss of appetite. Some women find that other herbal teas such as peppermint or chamomile can help deal with nausea. As there is limited information on the safety of herbal teas in pregnancy, it has been recommended to limit the amount you drink to four cups a day. Try to be aware of drinks containing caffeine. The caffeine allowance during pregnancy is currently 200mg a day but as caffeine is dehydrating, it is important to maintain water consumption throughout the day.
Ginger
Ginger is safe and effective in reducing nausea and vomiting in pregnancy. It helps by emptying the stomach, keeping food down. Ginger products such as fresh ginger or ginger teas can be useful to reduce symptoms.
Vitamin B6
Vitamin B6 (pyridoxine) and its compounds are often used in morning sickness drugs. Though it may not reduce vomiting, it can help reduce nausea with minimal side effects. Around 10-25mg of pyridoxine is recommended every 8 hours with a maximum of 200mg a day.
Keeping active
Although it may seem an unpleasant idea when feeling ill, some mums-to-be find that keeping active actually helps them deal with nausea and vomiting symptoms at this stage of pregnancy. Gentle exercises, such as yoga and swimming, can be useful as the stretching can be helpful during labour too. It is important to maintain a healthy lifestyle, but NICE recommends avoiding vigorous exercise and contact sports, as this can put pressure on joints and increase the risk of falling over or sustaining an injury.
How common is indigestion?
Indigestion is very common during pregnancy and has been reported to affect up to 8 in 10 women in late pregnancy.
Indigestion can occur at any stage of pregnancy, but is most common:
- during later pregnancy (27 weeks onwards)
- in women who had indigestion before they became pregnant
- in women who have had a previous pregnancy
What are the symptoms of indigestion?
Symptoms normally occur after eating and can include:
- burping
- feeling uncomfortably full (bloated)
- regurgitation (food coming back up from the stomach)
- heartburn (burning sensation or ache in your chest)
- nausea (feeling sick)
- vomiting
The good news though is that these symptoms rarely cause complications and in most women symptoms will disappear shortly after delivery. However, symptoms may be frequent, severe and/or distressing.
What causes indigestion in pregnancy?
Indigestion in pregnancy is thought to be due to both mechanical and hormonal reasons. You are more likely to have indigestion when you are pregnant because of hormone changes. Rising pregnancy hormone levels (oestrogen and progesterone) are thought to be responsible for relaxing the lower oesophageal sphincter – a ring of muscles that act as a gateway between your oesophagus (food pipe from your mouth) and your stomach. This allows stomach acid to leak back up (acid reflux) and cause a burning or uncomfortable feeling in the chest, often known as heartburn.
In later pregnancy, it has also been suggested that indigestion can be due to the pressure on the stomach from the growing womb, and this can also increase the likelihood of acid reflux. The increased pressure may also delay stomach emptying and affect how fast your food can pass through the gut.
Management of heartburn in pregnancy
A range of strategies have been used to relieve symptoms, including advice on diet and medication. However, there is little good scientific research on dietary suggestions such as restricting fatty foods or reducing meal size.
Expert opinion is that diet and lifestyle changes may help and should remain the first line treatment for heartburn in pregnancy. Lifestyle and dietary changes are safe and inexpensive, and they also allow the person to be involved in their choice of management. However, if heartburn is severe and causes considerable discomfort, medication may be advised after consultation with a healthcare professional.
Tips to avoid indigestion
Unfortunately there is no way to guarantee you will avoid indigestion, but here are some diet and lifestyle tips suggested by health guidelines, which may help:
- Try having frequent smaller meals, rather than big meals.
- Avoid eating too much - you do not need to ‘eat for two’ during pregnancy.
- Try sitting up straight when you eat to help release some of the pressure on your stomach.
- Keep a note of foods, drinks or activities that seem to trigger indigestion for you and if possible, try to avoid them at this stage. These may include:
- spicy foods
- fatty foods
- caffeine
- acidic citrus products/fruit juices (such as orange or tomato juice)
- fizzy drinks
- Try drinking a glass of milk when heartburn strikes.
- Avoid eating or drinking anything other than water for 3 hours before going to bed.
- Sleep in a propped-up position by using pillows or raising the head end of your bed to help keep the stomach acids down.
- Avoid smoking - this can harm your baby but can also cause indigestion.
- Avoid drinking alcohol, as this can contribute to indigestion. In 2016, the Department of Health updated the guidelines for alcohol consumption and has clarified that no level of alcohol is safe to drink during pregnancy. For more information on alcohol during pregnancy read our information.
- Check with your GP about any medications that may be causing or worsening symptoms, these can include non-steroidal anti-inflammatory drugs (NSAIDs), like ibuprofen and aspirin, medications widely used to treat a range of conditions.
If changes to your diet and lifestyle do not work and your indigestion is really bothering you, speak to your GP or midwife.
There are certain indigestion medications which are safe to use during pregnancy, and your GP or midwife can tell you which ones you can use.
Tiredness and difficulty sleeping is common throughout pregnancy.
In the first 12 weeks, you may feel particularly tired, and this is believed to be because of the hormonal changes you are going through at this time.
From around 16 weeks, and as you continue to get bigger, you may find it harder to get comfortable at night which can lead to sleeplessness and cause tiredness the following day. Also, after 16 weeks, when you lie flat on your back the growing baby presses on the main blood vessels. The effect is that less blood is pumped around your body, and this may lead to low blood pressure (hypotension), so you may want to sleep on your side instead. Later in pregnancy you may feel tired because of the extra weight you are carrying.
Tiredness in pregnancy could also be linked to a lack of iron in your body (known as iron-deficiency anaemia). Iron is needed during pregnancy for the blood supply to your growing baby, so it is important to eat plenty of foods high in iron to prevent deficiency, which can lead to your baby having a low birthweight.
Some groups of women may have a higher risk of iron deficiency if their intake of iron was low before becoming pregnant, such as young women and those on a vegetarian or vegan diet. You will be offered a range of blood tests during pregnancy, including one for anaemia, and you will be advised if you need to take supplements or boost the amount of iron needed from your diet.
Iron is found in red meat (such as lean beef), pulses (such as lentils and beans, like kidney beans), wholemeal bread, green leafy vegetables (such as spinach and watercress), dried fruit (such as apricots) and fortified foods like breakfast cereals. There are certain things in the diet that can affect how much iron is absorbed from your food. Vitamin C helps your body absorb iron from plant sources, so having a small glass of fruit juice (150ml) with a meal can help you get the most from your food. On the other hand, milk, tea and coffee can stop your body absorbing iron, so try not to drink them with meals (caffeine-containing drinks should also be limited during pregnancy).
It is important to eat a variety of foods to ensure that you obtain all the nutrients you and your baby need. Unfortunately, no single food or nutrient will guarantee you a good night’s sleep but making sure you have enough of certain vitamins and minerals is important (see table below).
| Nutrient | Role | Food Sources |
| Folate | Contributes to normal red blood cell formation |
|
| Riboflavin (vitamin B2) | Contributes to the reduction of tiredness and fatigue |
|
|
Niacin (vitamin B3) |
Contributes to the reduction of tiredness and fatigue |
|
| Vitamin B6 | Contributes to normal red blood cell formation |
|
| Vitamin B12 | Contributes to normal red blood cell formation |
|
| Vitamin C | Contributes to the reduction of tiredness and fatigue |
|
| Magnesium | Contributes to the reduction of tiredness and fatigue |
|
*Fish is an excellent source of various vitamins and minerals, and oily fish contains essential omega-3 fats, but some types of fish should be avoided or limited (see above).
During pregnancy, some women have cravings for particular foods, and food aversions. Despite these being quite common, there is not much research about their causes and so we do not fully understand why this happens.
Food cravings are strong urges for particular foods, which are more specific than normal feelings of hunger and can be very difficult to resist. The type of food which is craved is quite varied and may differ over the course of the pregnancy. A study in the US, looking at pregnancy websites, found commonly reported cravings were for chocolate, sweets, pizza, crisps and fruit. Other foods reported have included ice cream, pickles and curry.
Food cravings can occur during all stages of pregnancy but tend to disappear after the birth of the baby. It is not fully known why food cravings occur. One popular explanation is the changes in the body’s hormone levels during pregnancy, although the evidence to support this is lacking. Women often report an increase in taste and smell sensitivity, and there may be a link between changing sensory perceptions and food cravings, but the nature of this is unknown. Food cravings are not likely to be caused by a need for increased calories as they tend to occur in the early part of pregnancy, long before calorie requirements increase in the 3rd trimester (week 28 onwards).
It is important to distinguish food cravings from a condition called 'pica', which is the eating of non-food items (for example soil, clay, soap, toothpaste and ice), and is also reported to be more common in pregnancy. If you are craving eating something which is not a food, it is important to speak to your midwife or doctor, as consuming it may be harmful to you and/or your baby.
We know that it is important for both mum and baby to avoid gaining too much weight during pregnancy. Cravings for high-sugar or high-fat foods in pregnancy may mean your daily calorie intake goes beyond what your body needs. Cravings for foods such as sweets, desserts and chocolate have been shown to increase calorie intake in pregnant women.
Formal guidelines for coping with cravings in pregnancy are not available but eating a small amount of the food you crave and/or trying to substitute it for a low-calorie variety or healthier alternative may be an option. For example, if you are craving sweet food, try eating a sweet tasting piece of fruit such as a piece of pineapple or a small handful of berries. A couple of squares of dark chocolate may also be able to satisfy a chocolate craving, saving you from eating a whole milk chocolate bar. Below are a few ideas to make common food cravings a bit healthier:
| Craved food | You could try… |
| Sweets (chocolate and other confectionery) | A sweet tasting piece of fruit, dried fruit or fruit canned in its natural juice |
| Savoury high-calorie food (such as chips, pizza, takeaways) | Oven baked low-fat chips, a small slice of pizza with vegetable topping and lots of salad, or homemade curries, stir fries and noodle dishes |
| Meat | Lean cuts of meat with the fat trimmed off |
| Dairy (savoury such as cheese) | Reduced fat cheese |
| Dairy (sweet such as milkshake) | Low-fat fruit yogurt, or make your own milkshake with fruit (like bananas or berries) |
| Carbohydrate foods (such as crisps, cereals) | Wholegrain baked crisps, no-added-sugar breakfast cereal |
| Cold food (such as ice cream) | Fruit sorbet or frozen yogurt |
Constipation is a common symptom experienced in pregnancy, and it is associated with poorer quality of life.
What causes constipation during pregnancy?
Production of the hormone progesterone is increased during pregnancy which is important for the healthy development of the baby. Progesterone causes relaxation of some of the bowel muscles which makes it harder for food and bodily waste to move through the gut, thus slowing down the intestinal movements, sometimes causing constipation.
Other causes of constipation can also include reduced physical activity and changes in dietary habits.
Taking iron supplements during pregnancy can also cause constipation, so it is a good idea to make sure that you are eating plenty of iron-rich foods to avoid the need to take supplements.
What are the signs of constipation?
- A reduction of the frequency at which you would normally pass stools
- Hard stools which are difficult to pass
- Lower abdominal pain
- The feeling that not all faeces have been excreted
- Feeling bloated or sick
How to treat and manage constipation
Initial treatment of constipation in pregnancy should be non-pharmacological, that is without the use of medication, and can involve:
- increasing dietary fibre
- physical activity
- increasing fluid intake
These recommendations are largely based on expert opinion. Managing constipation in this way generally has few side effects, although increasing fibre intake quickly can cause bloating and flatulence. If you typically eat a low-fibre diet, it is advisable to increase intake of fibre gradually to minimise these effects.
Fibre
Fibre is vital in helping to prevent constipation, as it helps food pass through the digestive system more easily. On average, most people in the UK have lower fibre intakes than the recommended 30g/day, so fibre intake should be increased. Naturally occurring fibre comes from plants, and foods containing fibre include fruit, vegetables, beans and other pulses and wholegrain cereals.
Foods which are good sources of fibre (contain at least 3g of fibre per 100g of the food) include:
- peas, sweetcorn, green beans, broccoli and onions
- high-fibre breakfast cereals, such as wholegrain cereals and porridge
- wholegrain starchy carbohydrates, such as wholemeal bread and wholemeal pasta
- potatoes with skins on
- beans and pulses like baked beans and humous
- nuts and seeds, for example hazelnuts, pistachio nuts, cashew nuts and peanut butter
Sorbitol
Sorbitol is a compound found within fruit which can act as a natural laxative. Fruits (and their juices) that have a high sorbitol content include:
- apples
- apricots
- grapes (and raisins)
- peaches
- pears
- plums (and prunes)
The concentration of sorbitol is higher in dried fruit.
In general, a balanced diet containing wholegrains, pules, fruit and vegetables is advised. This is not only part of the treatment for constipation but recommended for general health. Eating at least five portions of a variety of fruits and vegetables per day is recommended by the government to reduce the risk of some cancers, heart disease and many other chronic conditions, including constipation.
A small glass (150ml) of fruit juice counts as one of your recommended five daily portions of fruit and vegetables. However, juice can only ever count as one portion a day, no matter how much you drink. This is because it does not contain the fibre found in whole fruits and vegetables. Fruit juice also contains free sugars that can damage teeth, so it's best to drink it with a meal because this can help protect teeth.
Fluids
To help prevent constipation, your fluid intake is important, particularly with a high-fibre diet. The recommended intake for fluids is about 8-10 glasses a day. Water is a great choice but tea, coffee, unsweetened fruit juice and smoothies can all count towards your fluid intake. Alcohol does not count towards your fluid intake. Remember that pregnant women should not have more than 200mg of caffeine a day. For more information see our page on hydration and pregnancy.
Keeping active
Simply getting up and moving about can help constipation. If you were not active before you got pregnant, do not suddenly take up strenuous exercise. If you start an aerobic exercise programme (such as running, swimming, cycling, walking or aerobics classes), tell the instructor that you're pregnant and begin with no more than 15 minutes of continuous exercise, three times a week. Increase this gradually to at least four 30-minute sessions a week. For more information see our page on physical activity in pregnancy.
Doing some gentle exercise may not only help alleviate your constipation but also improve your fitness too!
If there is a poor response to these changes, do seek further advice from your GP, pharmacist or health professional.
Which foods and drinks do I need to avoid when I'm pregnant, and why?
It is important to eat a healthy, balanced diet when you are pregnant, not only to help your baby grow healthily and give them the best start in life, but also to help you feel your best too. Find out more about a healthy, balanced diet by reading our pages on healthy and sustainable diets.
However, when you are pregnant there are certain foods and drinks that you are recommended to avoid or take care with, as there’s a small risk they may make you ill or harm your baby.
If you are concerned about anything you have eaten or drunk you should talk to your GP or midwife, but it is important to recognise that the risk of getting food-related illnesses during pregnancy is low.
Cheese
Avoid
- soft cheeses with white rinds such as brie, camembert and others with a similar rind, including goats' cheese with a rind (sometimes known as chèvre)
- soft, blue-veined cheeses such as Danish blue, gorgonzola and Roquefort
These cheeses can contain listeria bacteria that cause listeriosis. Listeriosis is an infection that can cause flu-like symptoms. Although listeriosis is extremely serious in pregnancy, it is very rare.
For example, between 2006 and 2015 in England and Wales, on average there were about 180 cases reported per year, and only about 1 in 8 of those was pregnancy related.
Enjoy
If the cheeses listed above have been cooked thoroughly (steaming hot all the way through), they are safe to eat in pregnancy, as this will kill any harmful bacteria.
There are, however, lots of soft or semi-soft cheeses that are safe for you to eat in pregnancy. These include:
- cottage cheese
- mozzarella
- feta
- cream cheese
- paneer
- ricotta
- halloumi
- some types of goats' cheese
- processed cheeses, such as cheese spreads and singles (slices)
All hard cheeses are safe to eat, even if they are unpasteurised (see 'Unpasteurised milk and cream' below), or blue veined (such as stilton), because they contain less water and so bacteria are less likely to grow.
These include:
- cheddar
- red Leicester
- double Gloucester
- Wensleydale
- edam
- emmental
- gouda
- gruyère
- jarlsberg
- parmesan
- stilton
Cheese is a good provider of nutrients such as calcium but remember that many cheeses are high in saturated fat and salt, and you should eat these in moderation.
Check the food label to choose reduced fat versions and those lower in salt.
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A spotlight on goats' cheese Do I have to avoid all types of goats’ cheese? Soft goats' cheese should be avoided, such as chèvre or others with a similar rind. These may be served in restaurants in dishes such as goats' cheese salad. But not all goats’ cheese is unsafe to eat.
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Unpasteurised milk and cream
Avoid
- unpasteurised milk and cream
Pasteurisation is a heat treatment process to kill bacteria and prevent food poisoning.
Unpasteurised or ‘raw’ milk (from cows’, goats’ or sheep) and ‘raw’ cream may contain harmful bacteria that cause food poisoning so you should avoid these during pregnancy. These can be sold at farmers' markets and farm shops.
In England, unpasteurised milk and cream must carry a warning saying that it has not been heat-treated and may contain harmful bacteria.
In Wales, there must be an additional warning for vulnerable groups (which includes pregnant women).
Raw drinking milk and cream is banned in Scotland.
Enjoy
Milks and yogurts sold in shops, supermarkets and restaurants in the UK are pasteurised and fine to eat but do take care about the cheeses that you buy, particularly soft, blue veined or cheeses with rinds if you are not using them in cooking.
Eggs
Avoid
- raw or undercooked hen eggs NOT produced under the British Lion code*
- raw or undercooked duck eggs, quail eggs and goose eggs
- eggs from outside of the UK
*Eggs produced under the British Lion scheme are produced under strict hygiene and welfare standards and should carry a lion stamp on them.
Remember that the raw eggs listed above can be used to make foods such as homemade or restaurant made mayonnaises, soufflés, mousses and some ice creams, so if you are unsure do check that they have been made using UK Lion eggs.
Enjoy
The good news is that you can safely eat raw or lightly cooked hen eggs, or foods containing them, that are produced under the British Lion Code of Practice. More than 90% of UK eggs are produced this way and carry the British Lion mark. This is because the British Lion Code of Practice ensures high standards of food safety, and this scheme has drastically reduced the presence of salmonella in UK eggs.
Non-British Lion eggs and non-hens' eggs are typically safe to eat if they have been cooked until the whites and yolks are solid. Thoroughly cooking eggs will kill any salmonella bacteria.
Most shop-bought mayonnaises and dressings from large retailers contain pasteurised eggs so are safe to eat. If there is any doubt, check the food label to make sure.
Meat
Avoid
- raw or undercooked meat
- raw cured meats, for example Parma ham (prosciutto), chorizo, pepperoni and salami
A parasite that causes toxoplasmosis is found in raw and undercooked meat, unpasteurised goats' milk, soil, cat litter or faeces (poo), and untreated water. Toxoplasmosis is an infection that can affect the growing baby in pregnancy.
Enjoy
You can still enjoy meat as part of a healthy, balanced diet but it should be cooked thoroughly with no pink meat or blood left (so well cooked and not rare meat). Be especially careful with poultry (such as chicken, turkey), pork, sausages and minced meat, including burgers and meatballs.
Cold cooked meats like turkey, beef and chicken, and pre-packed meats such as ham and corned beef, are safe to eat in pregnancy. But remember that many processed meats are high in salt, so check the food label to choose those lower in salt.
Thoroughly cooking cured/fermented meats, like salami, prosciutto, chorizo and pepperoni will reduce the risk, for example pepperoni on a pizza or chorizo in a pasta dish. The NHS website also advises that freezing such cured or fermented meats for four days at home will reduce the risk from parasites, as freezing kills most parasites and makes the meat safer to eat.
If you are eating out in a restaurant that sells cold cured or fermented meats, you may want to ask if it’s been frozen, or avoid eating it to be on the safe side.
Liver and pâtés
Avoid
You should avoid all types of pâtés.
- liver and liver products such as liver pâté and sausage
- all types of pâtés, even fish, crab and vegetarian pâtés
Liver and liver products can have high levels of vitamin A, which can be harmful to your baby.
All types of pâtés may contain listeria bacteria which can cause listeriosis.
Fish and shellfish
Seafood is a great provider of nutrients in pregnancy but remember to:
Avoid
- shark, marlin and swordfish
- raw shellfish
- ready-to-eat cold-smoked and cured fish (such as smoked salmon, smoked trout and gravlax)
- raw or lightly cooked wild fish
Shark, marlin and swordfish can contain high levels of mercury that can harm your baby’s developing nervous system.
Raw shellfish carries a risk of food poisoning.
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A word on raw, ready-to-eat cold-smoked and cured fish. The Foods Standards Agency and Foods Standards Scotland (July 2023) advised that you should avoid ready-to-eat cold-smoked fish such as smoked salmon and smoked trout or cured fish such as gravlax because it has a higher risk of carrying Listeria, a type of bacteria that can cause serious illness in mothers and their babies. Cooking cold-smoked or cured fish until steaming hot all the way through (not just warm) will kill any bacteria that may be present. You can enjoy sushi, as long as the fish has been cooked thoroughly but do avoid sushi that contains cold-smoked or cured fish. Wild fish, such as wild Atlantic salmon or sea trout caught at sea or in UK rivers, can sometimes contain parasitic worms and harmful bacteria. Cooking thoroughly will kill any worms and/or bacteria. |
Limit
Oily fish can contain pollutants such as dioxins and polychlorinated biphenyls (PCBs). Therefore, you should not eat more than two portions of oily fish (such as salmon, trout, sardines, mackerel) and certain non-oily fish (such as dogfish, sea bass, sea bream, turbot, halibut, crab) each week.
You should also limit tuna to no more than two fresh tuna steaks (about 140g cooked or 170g raw each) or four medium-sized cans a week (about 140g per can when drained), as it contains more mercury than other types of fish.
Enjoy
Eating fish is good for you and for your baby’s development, because it is a good source of several vitamins and minerals, and oily fish also contains essential long-chain omega-3 fats that are important for your baby's eye and brain development.
You should try to eat one portion (140g) of oily fish a week. As long as you do not eat more than two portions a week, the health benefits of eating oily fish are greater than the risks from pollutants.
There's no need for you to limit the amount of white fish and well-cooked shellfish you eat.
Peanuts
If you do not have a peanut allergy, peanuts are safe to eat in pregnancy.
In the past, if there was a history of allergies in the immediate family the UK government recommended against eating peanuts during pregnancy, because it was thought that they may increase the chance of the baby developing a peanut allergy.
However, more recent research does not suggest an increased risk and health advice has changed, so if you wish you can now choose to eat peanuts or foods containing peanuts (such as peanut butter) as part of a healthy, balanced diet, unless you are allergic to them. If you have concerns about the risk of peanut allergy, then discuss these with a GP or midwife.
Fortified foods and supplements with vitamin A
Avoid
- vitamin supplements and fish oil supplements with vitamin A
- foods fortified* with vitamin A
*Fortified foods are foods to which extra nutrients have been added (check the label)
High levels of the retinol form of vitamin A can be harmful to your unborn baby.
It's not safe to take multivitamins containing the retinol form of vitamin A, or fish liver oils, when you are pregnant, such as cod liver oil containing more than 700µg (micrograms) per day. Also, you should avoid foods that have vitamin A added (they may say 'fortified with vitamin A' on the label).
You should always ensure any supplements you take are appropriate for pregnancy.
Other foods
Liquorice
Avoid
- liquorice root
Liquorice root has a particularly high concentration of a compound called glycyrrhizin, which may be harmful to your unborn baby.
Enjoy
You can consume liquorice sweets – there's no specific recommendation to avoid them, but they typically are high in sugars so if eaten should be limited.
Liquorice teas are also safe to drink in pregnancy, as long they are within the limits of no more than four cups a day of herbal and green teas (see 'Herbal and green teas' below).
Caffeine
Limit
Caffeine can be found in:
- coffee
- tea (including green tea)
- chocolate
- some sports/energy/soft drinks
- some cold and flu remedies
Very high levels of caffeine during pregnancy have been linked to the baby having a low birthweight, which can increase the risk of health problems later in life. There is also a very slight risk that too much caffeine can cause miscarriage.
You should limit your intake of caffeine to around 200mg per day, which is roughly two mugs of instant coffee (see table below for caffeine content of more foods and drinks).
If you do occasionally have a bit more than 200mg, don't worry as the risks are very small.
|
Foods containing caffeine |
Approx. amount of caffeine (mg*) |
|
1 mug of instant coffee |
100 |
|
1 mug of filter coffee |
140 |
|
1 mug of tea |
75 |
|
1 mug of green tea |
55 |
|
1 can of energy drink (250ml) |
80 |
|
1 can of energy drink (500ml) |
up to 160 |
|
1 can of cola |
40 |
|
50g bar plain chocolate |
25 |
|
50g bar milk chocolate |
10 |
*mg=milligrams
Coffee from a coffee shop or restaurant may contain higher levels of caffeine compared to coffee made at home. If you are unsure about the level of caffeine, opt for decaffeinated versions.
It is important that you remember to drink plenty of fluids during pregnancy, and water and reduced fat milks are good choices. To cut down on caffeine intakes, you could try decaffeinated versions of tea, coffee and cola. For more information read our page on hydration and pregnancy.
Talk to your midwife, GP or pharmacist before taking any cold and flu remedies in case they are not suitable to take whilst you are pregnant.
Herbal and green teas
Limit
- herbal teas
- green teas
Little is known about the safety of herbal and green teas in pregnancy, so it is advised that you drink them in moderation and stick to those made with ingredients that tend to be a normal part of the diet, for example mint or blackcurrant tea.
The Food Standards Agency recommends that pregnant women should not drink more than four cups a day.
The NHS website recommends that you seek advice from your GP or midwife if you are unsure about which herbal products are safe to consume. Also, remember that green tea contains caffeine.
For more information on herbal medicines in pregnancy read this page from the NHS.
Alcohol
The safest approach may be to avoid all alcoholic drinks during pregnancy.
In 2016, the Department of Health updated the guidelines for alcohol consumption and the Chief Medical Officer now recommends the following to pregnant women:
Drinking heavily during pregnancy is linked to:
- early miscarriage
- premature birth
- restricted growth in the womb
- stillbirth
- illness in infancy and childhood
- learning difficulties and behavioural problems in infancy and childhood
- fetal alcohol syndrome (problems found in children whose mothers drank heavily during pregnancy such as facial abnormalities, heart defects, poor growth and severe mental and developmental problems).
If you are concerned or unsure about alcohol use during pregnancy, you should talk to your GP or midwife.