Food and drink to avoid during pregnancy

The most important advice for avoiding food-borne pathogens is to ensure good hygiene when handling food and to eat food that has been thoroughly cooked or boiled and served piping hot. 

The best advice for avoiding excessive foreign substances or pollutants from food is to eat a varied and largely plant-based diet.

Fish, sushi and other seafood

Fish and seafood contain numerous important nutrients. The Norwegian Directorate of Health provides dietary advice on fish and other seafood. Nevertheless, fish and seafood can also contain microorganisms and foreign substances that can be harmful to the foetus. Special advice has therefore been issued for pregnant women. 

• Avoid partially fermented trout when you are pregnant due to the risk of harmful bacteria. 
• You can eat cured and smoked fish, but such fish should be eaten well before the expiry date. 
• You can eat sushi while pregnant, as long as it is made from fresh fish, but you should avoid the types of fish listed below. 

Fish and seafood to avoid due to the risk of foreign substances/pollutants: 

• seal meat 
• Greenland halibut over 3 kg 
• freshwater fish of the following types: all pike, perch over 25 cm, trout over 1 kg, arctic char over 1 kg 
• all self-caught freshwater fish 
• exotic fish such as shark, swordfish, skate and fresh tuna. Tinned tuna is safe to eat.
• fish liver and products containing fish liver, such as roe liver pâté 
• brown crab meat, the digestive gland of scallops and mussel kidneys 

Meat and cured meats

Everyone is advised to limit their consumption of red meat, especially processed meat products (such as sausages and minced meat products). The Norwegian Directorate of Health provides dietary advice on meat and meat products. 

Only eat meat that has been thoroughly boiled or cooked. The meat should not be pink and the juices should be clear. 

Avoid raw meat such as 

• cured meat/cured sausage 
• dry-cured meat 
• steak tartare 
• roast beef 

Sliced vacuum-packed cold meats should be eaten well before the expiry date.

Game

Game shot with lead ammunition may contain lead residues. If you are pregnant or trying to become pregnant, you should avoid game where there is a risk of lead residues from hunting ammunition.

Cheese and other dairy products

Cheese and dairy products can contain listeria bacteria. Listeria bacteria thrive and may grow in some cheeses, while the bacteria do not thrive in other types of cheeses. Listeria bacteria can cause serious illness and even death in people with underlying diseases and newborns. In pregnant women, the bacteria can lead to miscarriage. Although the likelihood of a listeria infection is very low, because of the severity of the consequences of the infection, pregnant women are advised to be careful with certain cheeses and other dairy products during pregnancy. 

You should avoid unpasteurised (raw) milk and products made from such milk. Pasteurisation means that the product has been heat-treated to kill any harmful bacteria. Cheese producers in Norway and the EU are required to label cheeses made from unpasteurised milk. 

All cheeses that have been heat-treated, for example on pizza, in hot sauces and so on, are safe, provided they have been heat-treated to above 70 degrees Celsius. Heat treatment kills listeria bacteria. 

Cheese and other dairy products to avoid: 

• soft cheeses and blue cheeses such as Brie, Camembert, Gorgonzola, Chèvre and Roquefort. This applies to cheeses made from both unpasteurised and pasteurised milk 
• semi-hard cheeses made from unpasteurised milk 
• washed-rind cheeses such as Vacherol, Taleggio, Munster, Saint Albray, Livarot, Pont-l'Evêque, Le Vieux Pané. This applies to cheeses made from both unpasteurised and pasteurised milk 
• fresh cheeses and other soft cheeses made from unpasteurised milk 
• unpasteurised (raw) milk and products made from such milk that have not been heat-treated. Unpasteurised milk and products made from such milk must be heat-treated 

Cheeses that are safe to eat: 

• hard cheese made from pasteurised or unpasteurised milk, such as Parmesan, Grana Padano, Gruyere and Emmental 
• semi-hard cheeses made from pasteurised milk, such as Gouda, and Swiss cheese, including for example Norvegia and Jarlsberg (all common yellow cheeses) 
• processed cheese, such as bacon cheese and ham cheese 
• freshly opened cream cheeses made from pasteurised milk 
• freshly opened preserved feta cheese and similar salad cheeses made from pasteurised milk, e.g. in jars in oil 
• brown cheese and soft whey cheese spread 

Alcohol, caffeinated drinks, herbal teas, liquorice and ginger

Alcohol

All substances ingested during pregnancy pass to the foetus via the placenta. If you consume alcohol during pregnancy, the foetus will have the same blood alcohol level as you. 

The unborn child’s organs are immature and still developing, and alcohol can inhibit and damage the formation of cells and organs. The brain is particularly vulnerable, as it develops throughout the entire pregnancy. 

There is no known lower limit for the amount of alcohol that can be harmful to the foetus. In other words, there is no safe limit and you are therefore advised to avoid alcohol completely throughout pregnancy.

Caffeinated drinks

Caffeine can affect the foetus during pregnancy. Caffeine can increase the risk of both miscarriage and foetal growth retardation. You are therefore advised to be careful with coffee, tea and other beverages that contain caffeine, such as cola and energy drinks. 

Drink a maximum of one to two cups of coffee or three to four cups of black tea per day. The maximum amount recommended during pregnancy is 200 mg daily. The World Health Organization states that intakes of more than 300 mg per day are associated with an increased risk of miscarriage and low birth weight. 

Caffeine content in different types of caffeinated drinks (per 100 ml): 

• steeping and filter coffee: 50-60 mg 
• instant coffee: 40 mg 
• espresso: 120 mg 
• tea: 26 mg 
• Coca-Cola: 13 mg 
• energy drinks: 12-32 mg (depending on the product) 

Check the caffeine content of your drink by reading the label on the bottle/packaging if you are unsure. The caffeine content may vary between different types of drink. 

Herbal tea

Herbal teas, rooibos tea, chamomile tea, peppermint tea, green tea and nursing teas may contain plant toxins (pyrrolizidine alkaloids) that can have harmful effects on health. The foetus in the womb and breastfed babies are particularly vulnerable, and pregnant and breastfeeding women should therefore be especially careful. 

To reduce possible health risks, the advice is to limit the consumption of this type of tea and alternate between different products. There is no lower limit as to when possible health risks may occur. The safest thing to do is therefore to avoid these types of tea as much as possible and choose rosehip teas or teas made from pure fruit extracts.

Liquorice and ginger

Pregnant women should limit their consumption of liquorice due to the risk of harmful effects of glycyrrhizic acid on the foetus during pregnancy. Glycyrrhizic acid is an endocrine disruptor found in the liquorice plant. There is considerable uncertainty regarding how much liquorice can be consumed before it becomes harmful to the foetus. It is therefore not possible to determine a level of liquorice that a pregnant woman can safely consume. 

Pregnant women and women trying to become pregnant should avoid ginger shots and ginger supplements. This is because animal studies show that large amounts of ginger can result in an increased risk of miscarriage.

Collecting bird eggs, seafood and reindeer meat from contaminated areas

Seagull eggs contain high levels of pollutants and should be avoided by pregnant women. Eggs from other wild bird species have not been studied, but eggs from other types of fish-eating birds are also likely to have high levels of pollutants (e.g. eider eggs). 

The Norwegian Food Safety Authority advises limiting or avoiding the consumption of fish and other seafood from certain contaminated areas (Mattilsynet.no, in Norwegian).

Due to contamination following the Chernobyl disaster in 1986, reindeer meat from some areas in Norway may still contain some radioactivity. Pregnant women should avoid consuming high levels of such meat. 

Toxoplasma and listeria

The parasite toxoplasma and the bacterium listeria can cause infections (toxoplasmosis and listeriosis respectively) that can, in the worst case, lead to miscarriage or birth defects. 

Toxoplasma (T. gondii) is a parasite that can be transmitted via cats and cat faeces. You can become infected by stroking cats or through food and drink that has come into contact with cat faeces, such as unwashed fruit and vegetables. You can also become infected by eating raw meat from animals infected with toxoplasma. 

Listeria (L. monocytogenes) is a bacterium that occurs naturally in water, soil and raw materials, and can be transmitted through foods that are eaten without being heated and foods stored in the refrigerator for a long time, such as 

• sliced meat and fish sandwich fillers nearing (or past) their expiry dates 
• smoked salmon 
• unpasteurised milk (see the section Cheese and other dairy products) 
• soft and semi-hard cheeses made from unpasteurised milk or raw milk (see the section Cheese and other dairy products) 
• blue cheeses 
• cured meats 

Dietary advice when travelling abroad

Many countries have a higher prevalence of harmful bacteria and parasites than we do in Norway. It is therefore a good idea for pregnant women to take extra precautions relating to food when abroad. You should also be particularly thorough with hygiene when abroad compared to in Norway. 

• Avoid raw meat and raw fish in particular. 
• Wash or peel raw vegetables, fruit and berries. 
• Also keep this advice in mind when eating at restaurants. 
• It can be a good idea to talk to a healthcare professional before travelling.