Eating the right foods during pregnancy is important for the health of both mother and baby. However, there are some foods that pregnant women may need to avoid or limit due to safety concerns. One item that many pregnant women wonder about is cheese, and if there are certain cheeses they should avoid during pregnancy.
Soft cheeses
Soft cheeses are typically made with unpasteurized (raw) milk and have higher moisture content. The CDC advises pregnant women to avoid soft cheeses such as:
- Brie
- Camembert
- Blue-veined cheeses like Roquefort
- Feta
- Goat cheese
- Mexican-style cheeses like queso blanco fresco
The reason for avoiding these cheeses is that they have a higher risk of containing a type of bacteria called Listeria monocytogenes. Listeria can cause an illness called listeriosis, which can be harmful during pregnancy.
What is Listeria?
Listeria monocytogenes is a type of bacteria that can contaminate certain foods like unpasteurized dairy products, soft cheeses, deli meats, hot dogs, and refrigerated smoked seafood. Eating foods contaminated with Listeria can cause an illness called listeriosis.
For healthy adults, listeriosis often just causes temporary symptoms like fever, muscle aches, nausea, and diarrhea. However, for pregnant women, listeriosis poses unique risks.
When a pregnant woman gets infected with Listeria, it can spread to the fetus through the bloodstream. This can potentially lead to miscarriage, stillbirth, preterm labor, or life-threatening illness in the newborn baby.
How to avoid Listeria
Because of the risks listeriosis poses during pregnancy, it’s recommended that expectant mothers avoid the following higher-risk foods:
- Soft cheeses made with unpasteurized milk
- Hot dogs, luncheon meats, cold cuts unless heated before eating
- Smoked seafood like salmon, trout, whitefish, tuna, mackerel (unless it’s an ingredient in a cooked dish)
- Raw or undercooked meat, poultry, seafood
- Unpasteurized milk or foods made with it
Thoroughly cooking foods, avoiding cross-contamination, and practicing good food hygiene can also lower the risk of Listeria infection.
Pasteurized vs unpasteurized cheese
Cheeses made from pasteurized milk are considered safer because the heat from pasteurization kills harmful bacteria like Listeria, Salmonella, and E. coli. Pasteurization involves heating milk to at least 161°F for 15 seconds.
Cheeses made from unpasteurized (raw) milk may contain bacteria if proper precautions are not taken during cheesemaking. If raw milk comes from cows, goats, or sheep infected with bacteria, those germs can be present in the resulting cheese.
Is pasteurized cheese safe during pregnancy?
Cheeses made from pasteurized milk are generally considered safe to eat during pregnancy. These include popular cheeses like:
- Cheddar
- Mozzarella
- Colby
- Monterey Jack
- Swiss
- Gouda
- Muenster
- Provolone
- Hard cheeses like Parmesan
As long as these cheeses are made with pasteurized milk and are not mold-ripened varieties (like Brie), they pose minimal risks for pregnant women. Some pasteurized soft cheeses would also be considered safe, like pasteurized ricotta.
What about cheese made from raw milk?
The CDC recommends that pregnant women avoid cheeses made from unpasteurized (raw) milk, including soft cheeses like feta, Brie, Camembert, blue-veined cheeses, and Mexican-style cheeses such as queso fresco.
Eating raw milk products like these may expose pregnant women to bacteria like Listeria, Salmonella, E. coli, and Campylobacter. Again, these types of illnesses can lead to serious complications when contracted during pregnancy.
Cheeses made from raw milk that have been aged over 60 days are less risky. The FDA requires aging these raw milk cheeses for at least 60 days, which is thought to reduce bacterial levels. However, pregnant women are still advised to avoid them.
Tips for enjoying cheese safely during pregnancy
Here are some safe ways pregnant women can enjoy cheese without worrying about bacteria like Listeria:
- Opt for pasteurized cheeses and read food labels closely.
- Avoid soft cheeses (like Brie) unless they are clearly labeled as pasteurized.
- Heat hot dogs, deli meats, and cold cuts before eating them.
- Cook smoked seafood dishes thoroughly to an internal temperature of 145°F.
- Choose hard cheeses like cheddar and Swiss.
- Make cheese sauces and cheese-based dips with pasteurized cheese.
- Use pasteurized cheese on cooked pizzas.
- Avoid cross-contamination by keeping raw meats like poultry away from ready-to-eat foods.
Pregnant women should also take care to avoid mold-ripened soft cheeses like Brie and Camembert unless they are labeled as made with pasteurized milk. The same goes for blue cheeses – choose a pasteurized version when possible or avoid them if unsure.
Health risks of eating unpasteurized cheese while pregnant
Here is a summary of the potential health risks faced by pregnant women who eat cheese made from unpasteurized milk:
- Listeria monocytogenes: Can cause an illness called listeriosis, which may lead to miscarriage, stillbirth, preterm labor, infection in the newborn.
- Salmonella: Food poisoning caused by this bacteria can cause nausea, vomiting, abdominal cramps, diarrhea, fever, and dehydration in the pregnant woman. Severe cases may need to be hospitalized for treatment.
- E. coli: While most strains of E. coli are harmless, one particular strain called E. coli O157:H7 can cause a condition called hemolytic uremic syndrome if contracted during pregnancy. This syndrome damages red blood cells and kidneys, and may be life-threatening.
- Campylobacter: This bacteria causes food poisoning with symptoms like diarrhea, cramping, abdominal pain, nausea, and vomiting. Usually self-limiting, but may require IV fluids if severe. Campylobacter infection during pregnancy may increase risk of miscarriage or stillbirth.
In addition to potentially contracting these foodborne illnesses, pregnant women infected with these bacteria can pass the infection to their unborn babies through the bloodstream or amniotic fluid. This highlights why avoiding raw milk cheese is especially important during pregnancy.
Playing it safe
The best approach is to avoid cheeses made from unpasteurized milk entirely during pregnancy unless they have been aged more than 60 days. Though the risks are relatively low, pregnant women are more vulnerable to foodborne pathogens compared to the general population.
To maximize safety, opt for pasteurized dairy products as much as possible, especially for soft cheeses that will not be thoroughly cooked. Reading labels carefully and heating deli meats or smoked seafood before eating them can also help lower risks.
What happens if you eat soft cheese while pregnant?
If a pregnant woman eats soft cheese made from unpasteurized milk, such as Brie or feta, she runs the risk of contracting a foodborne illness like listeriosis or salmonellosis. However, not every exposure leads to infection.
Here’s a look at the range of possibilities if a pregnant woman consumes contaminated soft cheese:
- May not get sick at all – Her immune system may successfully fight off the bacteria before an infection develops. The level of contamination and dose of pathogens play a role here.
- Develops a mild illness – Symptoms like fever, diarrhea, abdominal cramps may occur for a day or two before clearing up on their own.
- Develops a serious illness requiring treatment – If a high level of pathogens was ingested, a severe case of listeriosis or salmonellosis could occur, requiring IV fluids and antibiotics. Hospitalization may be needed.
- Passes illness to fetus – The bacteria could spread to the developing baby and cause complications like miscarriage, stillbirth, or dangerous neonatal infection.
Again, the likelihood of these more serious outcomes is quite low with just one instance of eating higher-risk cheese. But it’s impossible to predict with certainty, which is why avoiding these cheeses is advised.
Steps to take if you ate unsafe cheese while pregnant
Here are some steps to take if you are pregnant and realize that you accidentally ate a soft cheese made with raw milk:
- Contact your obstetrician and explain the situation. They can advise you on any tests or monitoring needed.
- Watch for symptoms of food poisoning like stomach cramps, nausea, vomiting, diarrhea in the next 1-2 days.
- Drink plenty of fluids and rest to help your immune system stay strong.
- Monitor your temperature for fever, which could indicate infection.
- Seek medical care promptly if you develop concerning symptoms.
- Avoid higher risk foods for the remainder of your pregnancy.
In most cases, no major intervention is needed unless symptoms arise. But it’s wise to let your doctor know so they can ensure your pregnancy continues to progress normally.
Pasteurized cheese alternatives
Giving up soft cheeses completely during pregnancy may be disappointing for some cheese lovers. Here are some pasteurized alternatives to consider that can satisfy your cravings safely:
Cream cheese
Most cream cheese is made with pasteurized milk and is perfectly safe to enjoy during pregnancy. Just double check the label to be sure.
Ricotta cheese
Pasteurized whole milk or part-skim ricotta can be a good replacement for soft cheeses on pizza, in lasagna, in dips, and more. Opt for pasteurized.
Cottage cheese
The curds of cottage cheese have a similar texture to soft fresh cheeses. Choose low-sodium varieties to limit your sodium intake.
Mozzarella
Fresh mozzarella made from pasteurized milk is a mild, creamy cheese that can be used in cooking, on sandwiches, in salads and more. Part-skim versions are great options.
Mascarpone
This thick, sweet cream cheese from Italy works beautifully in desserts. Look for pasteurized mascarpone to enjoy it safely.
Neufchâtel
Similar to cream cheese in texture and tanginess, neufchâtel is lower in fat. It melts well and can be used in a variety of recipes.
Monterey Jack
With its creamy, smooth texture, Monterey Jack is a good substitute for soft cheeses in quesadillas, grilled cheese sandwiches, tacos, and Mexican dishes.
Pasteurized feta
Some brands make feta cheese using pasteurized milk. This allows pregnant women to enjoy the distinctive salty, tangy flavor safely.
With so many pasteurized alternatives, avoiding unpasteurized soft cheese during pregnancy is certainly doable. Be sure to also limit sodium, empty calories, and fat by choosing low-sodium and reduced-fat options when possible.
Cheeses to limit or avoid when pregnant
Here is a quick summary of some cheeses pregnant women may need to be cautious about:
Avoid completely
- Soft cheeses made with raw/unpasteurized milk like feta, Brie, Camembert
- Blue cheese made with raw milk
- Queso fresco and other Mexican-style soft cheeses made from raw milk
Limit intake
- Soft cheeses made with pasteurized milk (ricotta, cottage cheese, mascarpone, etc) due to higher sodium content
- Hard cheeses if you have pregnancy-induced hypertension, as they tend to be higher in sodium
Low-risk options
- Cheddar
- Mozzarella
- Monterey Jack
- Swiss
- Parmesan
- Colby
- Gouda
- Muenster
- Cream cheese
- Hard cheeses
- Processed cheeses (limit due to saturated fat)
Reading labels carefully, watching for raw milk or unpasteurized ingredients, and reheating deli meats can go a long way in minimizing risks from Listeria and other bacteria. When in doubt, choose a pasteurized cheese option for peace of mind.
Conclusion
Pregnant women need to be cautious about consuming soft cheeses, especially varieties made from raw unpasteurized milk. The risk is that these cheeses could contain harmful bacteria like Listeria, Salmonella, E. coli, and Campylobacter.
Eating contaminated soft cheeses raises a pregnant woman’s risk of food poisoning and complications like miscarriage, stillbirth, premature delivery, and illness in the newborn baby. While the chances of these serious outcomes are still low, avoiding unpasteurized soft cheeses is recommended as a precaution.
To enjoy cheese safely throughout pregnancy, choose pasteurized options whenever possible. Popular hard cheeses, processed cheeses, and soft cheeses labeled as pasteurized are all low-risk choices. With so many delicious pasteurized cheeses to pick from, it’s totally possible to satisfy cravings and avoid the cheeses of most concern during pregnancy.
