Sushi. Soft cheese. Sprouts — Experts recommend pregnant women avoid certain foods during pregnancy, yet many women don’t know why. Here is a primer on prenatal nutrition, as well as a list of foods moms-to-be should avoid.

Why do pregnant women have to be careful what they eat?

During pregnancy, what you eat and drink is your baby’s primary source of nourishment, which means everything you put into your body affects the health and development of your baby.

How much more do you need to eat?

Most women only need about 300-450 extra calories a day, and only during the second and third trimesters when your baby grows quickly. Normal weight gain during pregnancy is 25-35 pounds, even though the baby typically makes up only 6-10 pounds of that. That’s because your body is also creating all kinds of other things you’ll need to help your baby grow.

Here’s a sample breakdown of healthy weight gain from KidsHealth:

• 8 pounds: baby
• 7 pounds: extra stored protein, fat, and other nutrients
• 4 pounds: extra blood
• 4 pounds: other extra body fluids
• 2 pounds: breast enlargement
• 2 pounds: uterus enlargement
• 2 pounds: amniotic fluid
• 1 pound: placenta

Here are 6 things pregnant women should avoid:

 1. Unpasteurized milk, cheese and juice

Fresh juice, milk and unpasteurized cheese (aka soft or “fresh” cheese) may contain harmful bacteria (Listeria, Salmonella, E. coli) that haven’t been processed with heat. While these bacteria can make anyone sick, they are particularly dangerous for pregnant women.

Foods to avoid include:

• Certain cheeses:
  • Blue cheese
  • Brie
  • Camembert
  • Feta
  • Goat
  • Queso fresco
• Unpasteurized:
  • Milk
  • Juice
  • Apple cider

What to eat or drink instead:

Calcium is crucial during pregnancy, and dairy is the best source, so stick to hard or semisoft cheeses or add other sources of calcium.

Try:

• Hard cheeses (Parmesan, Gouda, cheddar)
• Semisoft cheeses (Havarti, Munster, mozzarella)
• Cream cheese, cottage cheese, and pasteurized cheese slices
• Yogurt (especially Greek, which contains more calcium)
• Soy milk
• Almonds
• Broccoli
• Greens
• Tofu

2. Fish that are high in mercury

Mercury is a metal found naturally in the environment, but human processes such as farming and burning coal have increased its levels in our waters and fish to sometimes-unhealthy degrees. While our bodies process mercury out over time, high levels can be harmful to an unborn baby’s developing brain and nervous system.

Foods to avoid include fish that often contain higher levels of mercury:

• Bigeye or Ahi tuna
• King mackerel
• Marlin
• Orange roughy
• Shark
• Refrigerated, smoked seafood
• Swordfish
• Tilefish

Smoked seafood (aka lox, nova or kippered salmon) should also be avoided because it could be contaminated.

What to eat or drink instead:

Fish contain high-quality protein and omega-3s, and it’s perfectly safe to eat up to 2 meals (12 oz.) a week of low-mercury fish or shellfish such as:

• Canned light tuna
• Catfish
• Clams
• Pollock
• Salmon
• Shrimp
• Tilapia

Albacore tuna (aka “white tuna”) has more mercury than canned light tuna, but you can eat up to 6 oz. of it per week as one of your fish meals.

3. Raw eggs

Most people don’t make a habit of eating raw eggs, but you might be eating them in some foods without knowing it.

Foods and drinks to avoid include:

• Eggnog
• Meringue
• Mousse
• Raw batter (cookie, cake, brownie)
• Tiramisu
• Homemade:
  • Caesar salad dressing
  • Mayonnaise
  • Ice cream
  • Custard
  • Hollandaise

Commercial mayonnaise, dressing and sauces contain pasteurized eggs that are safe to eat.

What to eat or drink instead:

Most egg-related questions can be solved simply by:

1. Purchasing pasteurized eggs, or
2. Cooking eggs until they are firm.

If you’re particularly worried about the issue, use egg products such as Eggbeaters (egg whites that have been pasteurized).

4. Raw meat, poultry, or seafood and unwashed fruits or vegetables

In general, pregnant women can become much sicker from food poisoning than non-pregnant people, and the consequences can be more severe. Raw meats and unwashed produce can carry bacteria that may result in premature delivery, serious infection or stillbirth.

Foods and drinks to avoid include:

• Raw meat in preparations such as tartare
• Raw or undercooked oysters, clams or mussels
• Jerky, which may not have been heated at a high enough temperature to kill bacteria
• Hot dogs, luncheon meats or deli meats
  • Exception: If these have been heated until steaming
• Refrigerated pâté or meat spreads
  • Exception: Canned meat spreads
• Local, recreationally-caught shellfish
  • Exception: Shellfish in stores and restaurants, which is regulated for safety
• Deli salads (ham, chicken, egg, tuna) as these may have been left sitting out at some point, which can breed bacteria.
  • Exception: Make them at home

5. Anything non-edible

Some pregnant women crave non-food items, such as clay and cornstarch. This condition is known as pica, and it can be very dangerous for the 20-68% of women who may experience it. If you experience these urges, contact your doctor immediately. 

6. Alcohol and caffeine

Alcohol can cause all kinds of problems for your baby, including affecting his or her size and organ development, or causing stillbirth or miscarriage, so the CDC recommends no alcohol consumption during pregnancy. Caffeine, however, is safe in small amounts. Experts recommend limiting your intake to about 1 cup of coffee or tea each day.

If you feel overwhelmed by all these rules, you’re not alone! It’s a lot to remember, but the good news is that you can adhere to most of these guidelines by simply:

1. Taking care with perishable foods (eggs, meat, poultry, fish, dairy) and
2. Cooking everything thoroughly.

BCBST members can get pregnancy support and resources through the Healthy Maternity program. This program offers benefits for an expecting mother through every stage of her pregnancy, including personalized, one-on-one support from a maternity nurse and additional tools to support her every step of the way.

Get more information about specific health terms, topics and conditions to better manage your health on bcbst.com. BlueCross BlueShield of Tennessee members can access wellness-related discounts on fitness products, gym memberships, healthy eating and more through Blue365®. BCBST members can also find tools and resources to help improve health and well-being by logging into BlueAccess and going to the Managing Your Health tab.