Foods to Avoid During Pregnancy: The Complete List (US, UK and European Guidance Compared)

The pregnancy avoid list looks long because it is written food by food. Behind it sit only four risks: a bacterium that grows in the fridge (listeria), a parasite in undercooked meat and soil (toxoplasma), a metal that builds up in big fish (mercury) and a vitamin that is toxic in excess (vitamin A). Add two limits, caffeine and alcohol, and you have the whole list.

Which foods fall under each risk is where the UK's NHS, the US Food and Drug Administration (FDA) and Centers for Disease Control and Prevention (CDC), France's food safety agency ANSES, the European Food Safety Authority (EFSA) and Germany's national pregnancy recommendations differ. This guide groups every food by its risk, gives each body's rule, and marks the differences, so you can follow the advice for where you live and understand why a friend abroad was told something else.

If you want the answer for one specific food, our pregnancy food library rates hundreds of foods as safe, caution or avoid, and the guides below cover the most-asked ones.

Where the US, UK and French rules draw the line between fine, conditional and avoid.

Which foods carry a listeria risk in pregnancy?

Listeria is the reason most of the list exists. The CDC says "about 1 in 25,000 pregnant women are infected with Listeria" each year in the US, that symptoms "are usually mild" and that "1 in 4 pregnant women who get this illness lose their pregnancy or their baby shortly after birth." It grows at fridge temperature, which is why the risky foods are chilled, ready-to-eat ones.

EFSA's 2018 opinion found that "more than 90% of invasive listeriosis is caused by ingestion of ready-to-eat food containing more than 2,000 colony forming units per gram," and that a third of cases are due to growth in the consumer's own fridge.

The pattern is that the US tests by label (pasteurised or not, reheated or not), the UK tests by cooking (steaming hot makes almost anything acceptable), and France tests by cheese type regardless of pasteurisation. All three agree on hard cheese, cooked food and anything heated through. For the per-food detail see our guides on feta, deli meat, prosciutto, pepperoni, hot dogs and smoked salmon, and the full cheese in pregnancy and listeria in pregnancy articles.

Which foods carry a toxoplasma or salmonella risk?

Toxoplasma lives in undercooked meat, unwashed produce and cat litter. The infection is mild for the mother and dangerous for the fetus, and it is the reason every body wants meat cooked through.

• Undercooked meat. The NHS: "raw or undercooked meat", with poultry and pork cooked until "there's no pink or blood", and "rolled joints of meat – must be thoroughly cooked all the way through." The CDC gives temperatures: whole cuts to at least 145°F (63°C) with a three-minute rest, ground meat to 160°F (71°C), poultry to 165°F (74°C), and notes that freezing meat "for several days at sub-zero (0°F) temperatures before cooking" greatly reduces the risk. Germany's recommendations name "raw sausage meat such as salami or raw ham" as "particularly problematical."
• Raw and lightly cooked eggs. This is a country difference. The NHS says hen eggs "that have the red British Lion stamp or are produced under the Laid in Britain scheme can be eaten raw" or runny; other hen eggs, and all duck, goose and quail eggs, "should only be eaten well-cooked." The FDA puts "raw or undercooked eggs or foods containing raw or undercooked eggs" on the avoid list for higher-risk groups and warns about restaurant Caesar dressing, custards and sauces. Outside the UK there is no Lion scheme, so the US rule is the safe default across Europe.
• Raw shellfish and raw fish. Avoid raw oysters, clams and mussels (CDC: "may be contaminated with Toxoplasma"; NHS: "raw fish and raw shellfish"; ANSES: "raw shellfish, raw fish (sushi, sashimi, taramasalata)"). Cooked shellfish is fine everywhere: the NHS lists "cooked shellfish, including prawns, crab, lobster" as safe. See can I eat sushi, shrimp and crab.
• Unwashed produce, soil and cat litter. Rinse fruit and vegetables under running water, wear gloves in the garden, and have someone else change the litter daily (CDC).

Which fish should I avoid or limit in pregnancy?

Fish is encouraged in pregnancy by every body, for omega-3 and iodine, with two limits: mercury in large predatory fish, and pollutants in oily fish.

The NHS tuna limit is the question we are asked most; our how much tuna and canned tuna guides have the can-by-can arithmetic.

Which foods are high in vitamin A, or carry other risks?

• Liver and liver products. The NHS says to avoid "liver and liver products" because they are "high in vitamin A, which can harm the baby." That includes liver pâté and liver sausage. Fish liver oil supplements are out for the same reason; a pregnancy multivitamin without retinol is the alternative.
• Game meat. The NHS adds "game meats such as goose, partridge, pheasant and venison" because they "may contain lead" shot.
• Liquorice root. "Liquorice root may be harmful to your baby's development, so it's safest to avoid it" (NHS); ordinary liquorice sweets are fine.
• Herbal teas. The NHS says to "avoid drinking more than 4 cups of herbal tea a day" because research is limited.
• Peanuts. Not on any list. The NHS: "peanuts and other nuts are safe to eat unless you've been told not to have them." Avoiding them does not prevent allergy in the baby.
• Honey. Safe in pregnancy. The honey rule applies to babies under 1, not to you; see can I eat honey pregnant.

How much caffeine and alcohol is allowed in pregnancy?

Caffeine: 200 mg a day, everywhere. The NHS: "you should not have more than 200mg of caffeine a day", noting that high intakes "have been linked to miscarriage and stillbirth." EFSA's 2015 assessment sets 200 mg a day, consumed throughout the day, as safe for the fetus, and Germany's national recommendations adopt it. ACOG's committee opinion says moderate consumption "less than 200 mg per day does not appear to be a major contributing factor in miscarriage or preterm birth." The figure covers coffee, tea, cola, energy drinks and chocolate together; our caffeine and matcha guides have the per-cup numbers.

Alcohol: none is the only agreed safe amount. The CDC: "There is no known safe amount of alcohol use during pregnancy", "no safe time" and "all types of alcohol can be harmful." The NHS: "it's safest to avoid alcohol." Germany's recommendation is the firmest: women who are planning a pregnancy and pregnant women "must avoid alcohol", because "it is not possible to define a safe and risk-free amount of alcohol for the fetus."

Where US, UK and European guidance differs

The differences are real but narrow: cheese, eggs and sushi. On everything else, the lists line up, and the safest reading is the strictest one that applies to you.

How do I eat out and shop safely while pregnant?

The food is only half of listeria; the other half is time and temperature. The FDA's eating-out advice is to "always request that your food be cooked thoroughly, especially meat, poultry, fish, and eggs", to send lukewarm food back, to ask for raw sprouts to be left off, and not to take leftovers home "if you won't be arriving home within 2 hours of being served."

Germany's recommendations say that in restaurants and cafeterias pregnant women "should where possible consume food that has been heated immediately prior to consumption." ANSES's fridge rules apply at home: 4°C, respect use-by dates, store leftovers no more than three days, reheat above 70°C.

Checking a plate or a menu against all of this is what Avo Pregnancy is for: scan the dish or the menu and it shows which items are safe, which need to be cooked through, and which to skip, with the guidance behind each answer. Our eating out while pregnant guide walks through a restaurant menu course by course.

What should I do if I ate something on this list?

First, do not panic: the risk from a single exposure is small, and most listeria and toxoplasma exposures never become infections. Then:

1. Note what and when. Listeria symptoms "usually start within 2 weeks" for invasive illness (CDC) and can be as mild as "a fever and feel more tired and achy than normal."
2. Watch for symptoms, including fever, aches, chills, nausea or diarrhoea, and, the NHS adds, stomach ache or "reduced baby movement."
3. Call if symptoms appear. The NHS says to ask for an urgent GP appointment or call 111 if you are pregnant and think you may have listeriosis; in the US call your obstetrician. Antibiotics treat it.
4. Do not wait for symptoms if the food was recalled. Tell your doctor; some will test or treat on the basis of exposure alone.

Our I ate something I shouldn't have guide covers the scenarios one by one.