What food should I avoid cooking for someone who is pregnant?

The foods NHS guidance advises against, the ones people wrongly avoid, and how to adapt a meal without making it dull.

Difficulty: beginner
Time: 10 min
Read: 3 min
Safety: warning

Short answer

Avoid raw or undercooked meat and fish, mould-ripened and unpasteurised soft cheeses, liver and pâté, and raw or lightly cooked eggs unless they carry the British Lion mark. Cook everything through, reheat thoroughly, and wash salad and vegetables well.

Pregnancy changes the immune response, so infections that would be mild otherwise can be serious. The list of foods to avoid is shorter than the internet suggests, and knowing what is genuinely on it makes cooking for someone far easier.

Safety

This is general guidance based on NHS advice and is not a substitute for a midwife or GP. Pregnancy raises the risk from listeria, toxoplasma and salmonella substantially, and listeriosis in particular can be serious for the baby even when the mother has mild symptoms. When in doubt, leave it out.

Step by step

Cook all meat thoroughly.No pink in pork, poultry, burgers, sausages or minced meat. Whole cuts of beef and lamb should also be cooked through rather than served rare, because of toxoplasma.
Avoid liver and liver products.Liver, liver pâté, liver sausage. The vitamin A content is high enough to be a risk to the developing baby. This includes all pâtés, meat and vegetable, because of listeria.
Skip mould-ripened and blue soft cheeses.Brie, camembert, chèvre with a white rind, roquefort, gorgonzola, danish blue. They are low-acid and moist, which suits listeria. Cooking them until steaming hot makes them safe.
Check cheeses that are fine.Hard cheeses including cheddar, parmesan and stilton are fine even if unpasteurised. Pasteurised soft cheeses — mozzarella, feta, cream cheese, cottage cheese, halloumi, ricotta, paneer — are fine too.
Use British Lion eggs and cook others through.Eggs with the red Lion stamp can be eaten runny or raw. Non-Lion and imported eggs should be cooked until white and yolk are solid.
Limit fish rather than avoiding it.No shark, swordfish or marlin. No more than two portions of oily fish a week, and no more than two fresh tuna steaks or four medium tins of tuna. Raw shellfish and sushi-grade raw fish should be avoided unless previously frozen.
Cook shellfish thoroughly.Cooked prawns, mussels and crab are fine. Raw or lightly cooked shellfish and cold-smoked fish carry a listeria and norovirus risk.
Wash salad, fruit and vegetables carefully.Soil carries toxoplasma. Rinse thoroughly, and be cautious with pre-packed salads that have been open for a while.
Reheat leftovers properly.Steaming hot all the way through, once only. Listeria grows slowly even at fridge temperatures, so leftovers should be eaten within a day or two.
Adapt rather than remove.Hot baked camembert instead of a cheeseboard, a hard cheese and chutney sandwich instead of pâté, cooked prawns instead of smoked salmon. The meal does not have to be dull.

Tips

Hard cheese is fine, even unpasteurised. The risk is in soft, moist, mould-ripened cheese.
British Lion eggs can be runny. That is a significant change from older advice.
Cooking a risky cheese until piping hot makes it safe — baked camembert is fine.

Common mistakes

Avoiding all cheese — Hard cheeses, pasteurised soft cheeses and cooked soft cheeses are all fine under NHS guidance. Cutting out cheese entirely removes calcium and protein for no benefit.
Assuming leftovers are fine for the usual three or four days — Listeria is unusual in that it grows slowly even at fridge temperatures, so the margin is smaller in pregnancy. Leftovers should be eaten within a day or two and reheated until piping hot.

If it doesn't work

Planned a cheeseboard

Cause: Soft mould-ripened cheeses — Fix: Bake the camembert until molten and piping hot, and add hard cheeses, which are all fine.

Recipe calls for a raw egg mousse or mayonnaise

Cause: Raw egg — Fix: Use British Lion eggs, or a shop-bought mayonnaise, which is made with pasteurised egg.

Wanted to serve a rare steak

Cause: Toxoplasma risk — Fix: Cook it through, or serve a slow-cooked cut instead, which is cooked well past any risk.

Smoked salmon starter

Cause: Cold-smoked fish and listeria — Fix: Use hot-smoked salmon or mackerel, which has been cooked, or cooked prawns.

Uncertain about a specific food

Cause: Advice changes — Fix: Check the current NHS page or ask a midwife rather than relying on older lists.

Questions people ask

Can someone pregnant eat runny eggs?

Yes, if the eggs carry the British Lion mark, which indicates vaccination against salmonella. NHS advice changed to allow this. Eggs without the mark, and eggs from abroad, should be cooked until solid.

Is all unpasteurised cheese off the list?

No. Unpasteurised hard cheeses such as some cheddars and parmesan are fine, because their low moisture and high acidity do not suit listeria. It is soft, mould-ripened and blue cheeses that should be avoided unless cooked until piping hot.