Coffee. Cheese. Cold cuts. The list of foods to avoid during pregnancy seems to go on and on, and it can seem like all our favorites are suddenly off the table just when we’re feeling like we could really use some comfort food. But how many of the foods that one woman in your moms-to-be Facebook group swears you need to trash are legitimate no-nos, and how many foods do pregnant women end up avoiding due to wives’ tales and bad science? Do you really need to clean out your entire fridge and start over? You’ve got just nine months of pregnancy (give or take), so let’s dive in and get some answers!
What’s off the menu?
You’ve already said Bye bye cute little two-door car, hello mom van. And you’re sharing your body with a growing human. So what else do you have to change? Let’s start with the good news, shall we? “Truly, the list of foods that are big no-nos is pretty short,” says Anita Somani, MD, an OB-GYN with Comprehensive Women’s Care at OhioHealth Riverside Methodist Hospital in Columbus, Ohio. The following foods should be avoided—that is, completely cut out of your diet—when pregnant, according to Somani:
- Raw Meat, Raw Fish, Deli Meat, and Unpasteurized Cheese
- Fish That Are High in Mercury
Studies on how much alcohol will hurt a growing fetus send moms-to-be mixed signals, but the official stance of the American College of Obstetricians and Gynecologists (ACOG) leaves nothing up to interpretation. The official ACOG statement warns, “Even moderate alcohol use during pregnancy can cause lifelong problems with a child’s learning and behavior. Any amount is risky for women who are pregnant or trying to become pregnant. All types of alcohol are harmful, including beer and wine.” Drinking alcohol during pregnancy has been linked to fetal alcohol syndrome (FAS) in infants, a condition that leads to problems with brain development, lower-than-average height and weight, smaller-than-normal head size, and abnormal facial features. Conflicting headlines and studies aside, ACOG’s ruling notes, “Birth defects related to alcohol are 100 percent preventable by not drinking during pregnancy.”
Pregnant women are 13 times more likely to contract listeriosis, a food-borne illness caused by the listeria bacterium. According to ACOG, the disease can cause miscarriage, preterm labor, and stillbirth, as well as neonatal listeriosis and possible neonatal death. Your favorite cold cuts, raw meats, and unpasteurized cheeses all make the list of foods with a high risk of listeria contamination—hence the suggestion that you steer clear. It’s also recommended you keep track of Food and Drug Administration (FDA) food recalls, as some fresh produce has been linked to listeriosis outbreaks in recent years. You can visit the FDA’s site regularly or sign up for recall warnings to be sent right in your email inbox.
Mackerel, swordfish, marlin, ahi tuna, shark, tilefish, and orange roughy make the list of no-nos from the FDA, as mercury is considered a neurotoxin that can harm unborn babies.
According to the Environmental Protection Agency, exposure to mercury in the womb can “adversely affect unborn infants’ growing brains and nervous systems.” Because they’re still developing, a fetus’ systems are also more vulnerable to the effects of mercury than an adult’s would be.
Stay the course or buckle in for change?
So, if there aren’t that many foods you really need to avoid during pregnancy, you can just keep on eating the way you did when you were eating for one, right? Not so fast. Step away from the junk food aisle for a second and listen up. The biggest dietary changes you should commit to aren’t necessarily in types of foods at all, Somani says, but in how much (or how little) a woman should be consuming during the nine-plus months she’s carrying her baby. A woman’s pre-pregnancy weight can affect her own health, so it only stands to reason that it can affect her pregnancy, from increasing her chances of developing gestational diabetes to upping her risk of preeclampsia, a pregnancy-related blood pressure disorder. Your OB-GYN will likely ask you to hop on the scale early on, not only to record your weight for monitoring purposes, but to determine your nutrition plan for the entirety of your pregnancy. They may start talking goal weight gain…or even weight loss. “If someone is overweight, we encourage them to lose at least 10 percent of their body weight to improve fertility, decrease the risk of diabetes and hypertension and stillbirth,” Somani says. “If someone is underweight, we encourage them to gain weight or eat more calories during pregnancy to decrease growth restriction in the fetus.” If your pre-pregnancy weight was within healthy limits, you’re ahead of the game. “There is less risk of neural tube defects and growth issues,” Somani says. For women in this boat, the big diet changes will depend on pre-pregnancy proclivities. If you drank alcohol, lunched on sushi or beef tartare, dined on unpasteurized cheese, or spent a lot of time bellying up to the deli for sliced cold cuts, get ready to give things up. Otherwise, ACOG recommends moms-to-be eat a well-balanced diet that consists of protein, carbohydrates, and fats, says Yves-Richard Dole, MD, an OB-GYN at Mercy in Baltimore. In general, a mom with a body mass index (BMI) that’s considered “normal” should shoot for weight gain of about 25 to 35 pounds over the course of the pregnancy, he adds.
Although some foods are strictly off the menu, there are others that pregnant women are told to avoid when possible but don’t have to eliminate entirely. Seafood, for example, may be on the must-avoid list when it’s served raw or if it’s high in mercury, but ACOG has recently loosened up its rulings on grabbing your dinner from the sea. These days, the group allows for moms-to-be to eat two to three servings (8 to 12 ounces) a week of a long list of fish, including fresh-water trout, catfish, cod, and even clams and shrimp. Other fish, such as albacore tuna or monkfish, get the thumbs up if they’re limited to 6 ounces per week. You may even want to work fish into your diet if you aren’t otherwise eating it, Somani says—at least the “good” kinds. “Fish that are high in omega-3 fatty acids … should be eaten in pregnancy,” she notes, because those omega-3s are good for babies’ development. You may even notice they’re one of the nutrients in a variety of prenatal vitamins. Likewise, avoiding unpasteurized cheeses doesn’t mean all cheeses make the “foods to avoid during pregnancy” list. Soft cheeses, such as feta, brie, and queso fresco, are sometimes pasteurized—you just need to check the packaging. Hard cheeses, such as cheddar, gouda, and parmesan, are almost always pasteurized, and semi-soft cheeses, like mozzarella, are typically in the clear as well. And while your BFF may have been told no coffee or other caffeinated beverages during her pregnancy, many doctors allow for a little morning pick-me-up once you’re in your second trimester. “Most experts state that consuming fewer than 200 mg of caffeine (one 12-ounce cup of coffee) a day during pregnancy is safe,” Somani says. Also allowed in limited doses? Giving in to your cravings. While “eating for two” is a dangerous myth that can result in too much weight gain, Dole says there’s no reason you can’t have a family member or partner supply you with a steady stock of the foods your body is crying out for. “Ice cream, chocolate, and french fries are common cravings that can be indulged in moderation,” he says. On the other hand, if you’re craving dirt, chalk, sand, toothpaste, or other non-edibles, you may be struggling with a pregnancy-related condition called pica. Skip the sampling and call your healthcare provider, Dole warns. Moms-to-be have long been warned against consuming peanuts during pregnancy, but you may find your OB-GYN giving you the all-clear to pop a can of Planters and chow down. While nut allergies have tripled in recent years, a study published in JAMA Pediatrics suggests the risk of your child developing a peanut allergy dips if you eat nuts while they’re in utero. Even better: The more peanuts and tree nuts a (non-allergic) mom ate, the lower her child’s risk, according to the study’s findings. “Peanuts have been discouraged in the past, but now we are encouraging them to reduce the risk of nut allergies in the fetus,” Somani explains.
So you know what not to eat during pregnancy. You know what to eat only sometimes during pregnancy. What about all the foods you should be eating throughout your nine months? Aside from eating a balanced diet, are there any specific foods you should be piling onto your plate? Absolutely, experts say. If you aren’t already doing so, pregnancy is the time to hike your folic acid intake to help your fetus develop and grow. Studies have found that folate deficiency is not only very common in women of childbearing age, but it has been associated with abnormalities like anemia and peripheral neuropathy in moms-to-be and congenital abnormalities in fetuses. The good news: Foods such as spinach, strawberries, and citrus fruits are rich in folates, Somani says, and they are “critical to preventing neural tube defects.” It’s suggested that women increase their folic acid intake to somewhere between 400 and 800 micrograms per day during pregnancy, although your OB-GYN will be able to nail down just how much you should be ingesting via food sources as opposed to vitamins and supplements. Calcium is another nutrient that can’t be ignored during pregnancy, whether it’s consumed via the “safe” cheeses, slugging down glasses of milk to fight that pregnancy heartburn, or eating (moderate amounts of) ice cream. Doctors still recommend taking a prenatal vitamin starting as early as possible. If you’re not pregnant yet but think it’s time to start trying to conceive, your doctor may even suggest you start with prenatal vitamins now. “The critical period of neural tube development is in the first trimester—often before a woman recognizes she is pregnant, and that’s where preconception folic acid is so important,” Somani points out.
Keep it going.
Once baby arrives, the diet pressure is off…sort of. Of course, nourishing, well-balanced meals are a part of being a healthy mom who can juggle motherhood and everything else life throws at you. If you’re formula feeding, you can re-introduce all of the forbidden foods, provided you’re not sharing them with baby! If you’ve opted to breastfeed, on the other hand, you will still need to abide by some of your pregnancy dietary restrictions, Dole says. “Eating well-balanced meals ensures an adequate milk supply, and it prevents mom from becoming chronically fatigued from nutritional deficiencies,” he notes. “Continuing prenatal vitamins is recommended to ensure an adequate supply of vitamins and minerals.” Caffeine can pass through breast milk, so Dole suggests keeping your coffee intake to a minimum, and mercury is still a risk, so seafood rules remain the same during breastfeeding as they were in pregnancy. Your child’s pediatrician may also have other recommendations for your diet based on any health issues baby is exhibiting (such as allergic reactions). But even breastfeeding moms get a break from the pregnancy-centric eating plan. The good news for breastfeeding moms? “Cravings for sushi, deli meats and sandwiches, and that favorite glass of wine can now be satisfied,” Dole says. And breastfeeding can help the body burn anywhere from 300 to 500 calories a day, so it may help you shed some baby weight if that’s one of your postpartum goals. Moms who are breastfeeding do still need to be wary of how much alcohol they consume and when, Dole warns. The American Academy of Pediatrics (AAP) recommends against mixing breastfeeding and alcohol, but its guidelines note that if a woman does choose to imbibe, she should do so “after she has nursed or expressed milk rather than before, and allow at least 2 hours per drink before the next breastfeeding or pumping session.” The AAP also warns against excessive drinking, as “there are concerns about long-term, repeated exposures of infants to alcohol via mother’s milk,” and “chronic consumption of alcohol may also reduce milk production.”