Pregnancy: Foods to avoid, foods to enjoy

A study published in January, 2008 confirmed a strong link between a common item in many women’s diets and miscarriage. This inspired me to do some research outside of my usual field. I’m a pediatrician, not an obstetrician– but as they say, “An ounce of prevention is worth a pound of cure.” Since pregnant women are said to be eating for two, I figured we might just be able to get the equivalent of two pounds of cure out of a few simple dietary steps. Along the way, I also found some intriguing studies with new information about what pregnant women should eat more of—and the news is good. Eating more of your favorite foods might really be able to help your unborn baby.

First, let’s review the foods that ought to be avoided. The recent study I mentioned looked specifically at caffeine, and found that the consumption of more than 200 milligrams of caffeine doubled the risk of miscarriage. This is equal to about 2 cups of coffee or five 12 ounce cans of cola. The lesson here is to keep your caffeine consumption reasonable, and to cut back if you’re a big Starbucks fan.

Alcohol should always be avoided in pregnancy. There is no safe lower limit; adverse effects on a baby’s health can be seen with even very low amounts of alcohol consumption. If you’re pregnant, trying to become pregnant, or there’s any possibility of your becoming pregnant, avoid all alcoholic drinks.

Hot dogs and luncheon meats can harbor a cold-loving bacteria called “listeria.” These items are safe for pregnant women only if well cooked. Soft cheeses made from unpasteurized milk may also harbor this bacteria. These are usually imported cheeses, such as brie, camembert, feta, blue cheese, or imported Mexican-style cheeses. These kinds of cheese are only safe during pregnancy if made from pasteurized milk.

What about artificial sweeteners and other chemicals used in foods? There’s no convincing evidence that these can harm your unborn baby, but moderation is a reasonable precaution. I would not recommend more than a few Diet Cokes a day, both for the artificial sweeteners and for the caffeine content.

Some fish are especially high in mercury, which is potentially toxic to the developing brain. It’s best to avoid the fish that have the highest mercury content, including shark, swordfish, king mackerel, and tilefish (also called white or golden snapper.) Tuna has a moderate amount of mercury, so you should limit tuna consumption to about one serving a week. The canned, light tuna has the less mercury than fresh tuna or canned white (albacore) tuna.

These are important benefits to eating fish that should not be overlooked. They’re an excellent source of essential fatty acids (often called “omega-3s”) that are important for brain and eye development. A study of about 12,000 pregnant women published in 2007 found that women who consumed more fish had children who were more intelligent and did better in several developmental areas. So though mercury-laden fish should be avoided, consumption of at least 2 meals of seafood each week is a good idea. Choose seafood that is high in fat but low in mercury content, such as salmon, herring, or sardines. Shrimp, tilapia, pollock, and cod are also good choices.

A diet rich in the B-vitamin folate (sometimes called “folic acid”) can help prevent serious birth defects such as spina bifida and cleft lip. Prenatal vitamins always include folic acid, and foods such as enriched cereals, leafy greens, and beans are also excellent sources. Since 1998, all grain products in the United States have been fortified with folic acid, which should go a long way towards preventing many birth defects of the spine.

Because about half of pregnancies are unplanned, it is important for all women of child-bearing age to try to follow this diet. This is especially true for folic acid consumption, as prevention of birth defects requires good folic acid sources beginning very soon after conception.

Some women have been told in the past to avoid foods that seem to lead to serious allergy problems in children. But the evidence that mom can prevent allergies in her child by avoiding things like peanuts or eggs during her pregnancy just hasn’t held up. If mom is allergic, she must avoid these foods; but as long as she’s not, this is one group of foods that that moms don’t need to worry about.

Studies have confirmed that prenatal exposures to a variety of flavors can increase a baby’s acceptance and enjoyment of different foods. So other than the few “watch-out-for” foods we’ve discussed, it’s best if mom does try to enjoy a big range of different foods and flavors. You want pesto? Knock yourself out! I’m not sure I’d have the stomach for pickles and anchovies, but if that’s what you’re craving, by all means indulge. And have some ice cream, too. You need the calcium, and you deserve a treat.

© 2008 Roy Benaroch, MD from

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2 Comments on “Pregnancy: Foods to avoid, foods to enjoy”

  1. Linda Says:

    Folate is indeed very important! I took supplements all throughout my pregnancy to help ensure my child would not have any birth defects. She didn’t! I came across this site on folate and I think it would make a good companion to your post! Also, I’d recommend women should be getting folate in their diet regardless of if they’re pregnant — it also helps fight depression symptoms.


  2. Dr. Roy Says:

    Linda makes an excellent point. For folate to be effective at preventing birth defects, it must be taken from the very start of pregnancy. Since about half of pregnancies are unplanned, it really is best for all women of child-bearing years to take folate supplements, or eat foods rich in folate, every day.


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