Pregnancy comes with a lot of dos and don’ts when it comes to food. One of the biggest no-nos for pregnant women is eating deli meats like pepperoni. But why exactly is pepperoni off limits during pregnancy? Let’s take a closer look.
Quick Answers
What is pepperoni?
Pepperoni is a type of salami usually made from pork and beef mixed with spices like paprika, garlic, and pepper. It is then air-dried or smoked to preservation. The pepperoni you find on pizza or in the deli section of the grocery store has been cured and fully cooked.
Why do doctors advise against eating pepperoni while pregnant?
Doctors recommend pregnant women avoid pepperoni and other deli meats due to the risk of contamination with the bacteria Listeria monocytogenes. Listeria can lead to an illness called listeriosis, which can cause pregnancy complications like miscarriage, stillbirth, and illness or death in newborns.
What risks does Listeria pose during pregnancy?
If a pregnant woman contracts listeriosis, the results can be devastating. Listeria can cross through the placenta and infect the baby, potentially leading to miscarriage, stillbirth, premature delivery, or life-threatening illness in the newborn. Listeria can also cause flu-like symptoms in pregnant women like fever, muscle aches, and diarrhea.
Are all deli meats risky or just pepperoni?
It’s recommended that pregnant women avoid all deli meats, not just pepperoni. In addition to pepperoni, other deli meats like ham, roast beef, turkey, and salami also pose a Listeria risk and should be avoided. The process of slicing deli meats at the deli counter can introduce Listeria bacteria.
What other foods should be avoided during pregnancy?
In addition to deli meats, pregnant women should also avoid the following foods that have a risk of Listeria or other contaminations: raw/undercooked meat and seafood, raw eggs, soft cheeses, unpasteurized milk and juice, raw sprouts, and cut fruit/veggies that are not washed well.
What is Listeria?
Listeria monocytogenes is a type of harmful bacteria that can contaminate certain foods and cause an illness called listeriosis if ingested. Here’s an overview of how Listeria works:
- Caused by the bacterium Listeria monocytogenes which is found in soil, water, and some animals/animal products.
- Listeria bacteria are killed by pasteurization and cooking but can still contaminate certain foods after processing.
- Can grow even in refrigerated conditions unlike many other bacteria.
- Most healthy adults may just experience short-term, flu-like symptoms if infected.
- Pose the greatest risk to vulnerable populations like pregnant women, newborns, older adults, and those with weakened immune systems.
In pregnant women, Listeria poses a significant risk because even a mild illness in the mother can lead to severe health problems in the baby if the infection spreads to them.
Why Deli Meats Pose a Higher Listeria Risk
All deli meats, including pepperoni, ham, turkey, roast beef, and other cured/cooked meats can harbor Listeria bacteria and cause contamination. Here’s why deli meats are more prone to Listeria growth than other meats:
- The curing and cooking process does not always kill the bacteria.
- Slicing deli meats can introduce new bacteria from the equipment and environment.
- The nitrates/nitrites used to cure meats can allow Listeria to thrive.
- After cooking, deli meats are typically not reheated again before serving.
- Kept refrigerated for long periods allowing potential Listeria growth.
- Higher moisture content and lower salt content than other cured meats.
- May be contaminated through handling at the deli counter.
Even for healthy adults, consuming contaminated deli meats poses a listeriosis risk. But for pregnant women, their vulnerability makes contaminated deli meats especially dangerous.
Listeria Infection in Pregnancy
When a pregnant woman becomes infected with Listeria, the results can be tragic. The Listeria bacteria can be passed to the developing baby through the bloodstream or amniotic fluid. Here’s an overview of how listeriosis affects pregnancy:
Pregnancy Complications
- Miscarriage – Listeria infection can result in miscarriage in the early stages of pregnancy before 20 weeks.
- Stillbirth – Babies over 20 weeks can be stillborn if the mother contracts listeriosis.
- Preterm labor and delivery – Listeria raises the risk of preterm labor starting before 37 weeks.
Newborn Complications
- Neonatal sepsis – Newborns may develop a dangerous blood infection from Listeria bacteria.
- Pneumonia – Babies can develop pneumonia after inhaling Listeria-infected amniotic fluid.
- Meningitis – Listeria bacteria can infect the brain and spinal cord covering.
Because Listeria can pass through the placenta during pregnancy, the baby can become infected resulting in septicemia, pneumonia, and meningitis after birth. These neonatal infections have a mortality rate up to 30%.
Flu-Like Symptoms in Mothers
Pregnant women with listeriosis may experience mildly flu-like symptoms including:
- Fever
- Chills
- Muscle aches
- Nausea or vomiting
- Diarrhea
However, many pregnant women may not experience any symptoms at all or simply have a mild, brief illness that resolves. But even without symptoms, they can still pass the infection to the developing baby with devastating effects.
Listeria Risk Factors
While all pregnant women should avoid high-risk foods like deli meats, pepperoni, and soft cheeses, some women are at an even greater risk for listeriosis. Factors that can increase the chance of Listeria infection include:
- Weakened immune system – Chronic health conditions, medications, stress
- Pregnancy – The developing baby is highly vulnerable
- Age – Older adults have a higher risk of infection
- Food consumption habits – Eating higher-risk foods like deli meats, unpasteurized dairy
Women who have any of these risk factors should be extra cautious and avoid any foods that may be contaminated with Listeria bacteria during pregnancy. Speak with your doctor about any health conditions or medications you are taking that could potentially weaken your immune system as well.
Listeria Prevention During Pregnancy
The good news is that listeriosis is easily preventable in pregnancy by avoiding contaminated foods. Here are some tips for pregnant women to prevent Listeria infection:
- Avoid all deli meats including ham, turkey, salami, roast beef and pepperoni.
- Only consume pasteurized dairy products – milk, cheese, yogurt.
- Do not eat soft cheeses like feta, Brie, Camembert unless they are clearly labeled as pasteurized.
- Cook meat to safe internal temperatures to kill any bacteria present.
- Wash fruits and vegetables thoroughly before eating.
- Avoid cross-contamination in the kitchen by using separate cutting boards for meats and produce.
In addition to being diligent about food hygiene and preparation, pregnant women should also avoid eating at salad bars, buffets, or delis where cross-contamination is more likely. With some simple precautions, expectant mothers can avoid Listeria infection and have a healthy pregnancy.
Safe Food Alternatives to Pepperoni
Although pepperoni needs to stay off the menu during pregnancy, you do not have to miss out on pizza or sandwiches entirely. There are plenty of delicious Listeria-free foods you can safely enjoy. Here are some healthy alternatives:
Vegetarian Pepperoni
- Soy-based or seitan pepperoni
- Mushroom pepperoni
- Eggplant or zucchini pepperoni
Vegetarian pepperoni is made from plants, not meat, so it poses no risk of contamination. Look for soy and seitan pepperoni slices to put on your next pizza.
Other Pizza Toppings
- Vegetables – mushrooms, bell peppers, onions, spinach
- Fruits like pineapple, olives, tomatoes
- Fresh mozzarella cheese
- Cooked chicken breast, sausage crumbles or meatballs
Load up your homemade pizza with tons of fresh veggies, cheese, fruit, and cooked proteins like chicken sausage.
Sandwich and Wrap Fillings
- Turkey breast
- Hard salami
- Hummus
- Grilled veggies, eggplant, zucchini
- Avocado
- Cheeses like cheddar, Swiss, provolone
Turkey breast, hummus, cheese, and grilled or roasted veggies are all excellent sandwich fillings to replace pepperoni. A little creativity goes a long way to making tasty lunches.
Snack Alternatives
For a pepperoni-style snack without the risk, try these options:
- Air-popped popcorn seasoned with parmesan cheese or spices
- Roasted chickpeas
- Nuts like almonds, walnuts, pistachios
- Seeds such as pumpkin or sunflower
- Hummus with whole wheat pita or veggie sticks
- Fresh fruits like apple slices with peanut butter
You definitely don’t need to miss out on flavor or crunch just because you are skipping the pepperoni for a while.
When Can You Eat Pepperoni Again?
Once you’ve reached the end of your pregnancy, passed all the major milestones, and delivered your baby, the Listeria risks are diminished. Here’s when it’s generally safe to add pepperoni back to your diet:
- Full term delivery – After 37 weeks gestation
- Healthy baby and mother post-delivery
- Baby older than 3 months
- No longer breastfeeding
The first few months are still a vulnerable time for your newborn’s health, so waiting until baby is 3 months or older reduces any foodborne illness risks. If you are breastfeeding, continue to avoid pepperoni since any Listeria in your diet could pass to your baby through milk. But after baby is weaned, you can finally bite into that delicious pepperoni pizza again!
Of course, always check with your own doctor for individualized advice about reintroducing any restricted foods like deli meats after your pregnancy. Some women may need to wait longer based on their health status or complications. But in general, once baby is here happy and healthy, low-risk foods can likely be enjoyed again in moderation.
Can You Heat up or Cook Pepperoni to Make it Safe?
You may wonder whether you could make pepperoni less risky by heating it up, cooking it more, or microwaving it before eating. Unfortunately, additional cooking is not guaranteed to destroy any Listeria bacteria that may be present. Here’s why:
- Listeria can survive and multiply even in refrigerated foods.
- It can grow at temperatures between 0-45°F unlike most foodborne pathogens.
- Heating deli meats does not necessarily reach a high enough temperature throughout to kill bacteria.
- The original curing and cooking process may have already allowed contamination.
For these reasons, the USDA and other health agencies advise that reheating deli meats is not considered an effective way to make them safe for pregnant women or higher risk groups. The best approach is just avoiding deli meats completely.
Proper Reheating Guidelines
If you do choose to reheat deli meats, follow these proper guidelines to reduce the risk as much as possible:
- Reheat to steaming hot, at least 165°F internal temperature.
- Use it immediately after reheating.
- Do not allow the food to cool and Listeria to regrow.
- Discard any leftovers – do not refrigerate and reheat again.
However, because of the potential for Listeria to survive initial heating, avoiding deli meats altogether is still the safest choice if you are pregnant or in an at-risk group. Discuss any questions or concerns with your healthcare provider as well.
Healthy Pregnancy Diet without Pepperoni
Although you need to cut out pepperoni for the time being, eating healthy, delicious foods is still totally possible in pregnancy. Follow these diet tips:
- Lean proteins – Cooked chicken, fish, beans, eggs
- Dairy – Choose pasteurized milk, yogurt, hard cheeses
- Fruits and vegetables – Eat plenty of produce and go for color variety
- Whole grains – Oats, quinoa, brown rice, whole wheat pasta
- Healthy fats – Nuts, seeds, avocado, olive oil
- Hydrate – Drink water as your main beverage
Following a balanced diet focused on the major food groups ensures you get sufficient nutrition for you and baby without needing any risky foods. Take a daily prenatal vitamin as well. With some thoughtful meal planning, you can eat right and avoid potentially harmful foods like pepperoni during pregnancy.
Listeria Prevention for Partners and Family
Partners and family members should also take care to prevent Listeria exposure during a woman’s pregnancy to avoid indirectly passing it to the mother or baby. Here are some tips for others in the household:
- Follow all the same dietary restrictions for higher risk foods.
- Cook meat, poultry, and seafood thoroughly to safe temperatures.
- Wash hands and kitchen surfaces often.
- Clean refrigerators and other appliances regularly.
- Avoid cross-contamination from raw meats to other foods.
- Ensure pregnant family members do not eat any questionable leftovers or foods.
Having family on board with Listeria prevention makes it much easier for pregnant women to avoid exposure. It also helps ensure no one else contracts listeriosis which could still pass to and endanger the baby indirectly. Exercise caution together.
When to Call the Doctor
If you are pregnant and experience any symptoms of listeriosis like fever, muscle aches, nausea, or diarrhea, contact your doctor right away even if symptoms seem mild. Timely treatment is critical to protect your health and your baby’s.
You should also let your doctor know if you have potentially been exposed to Listeria through:
- Eating recalled foods that tested positive for Listeria
- Eating higher risk foods like deli meats, soft cheeses, etc.
- Close contact with someone diagnosed with listeriosis
Your doctor can advise if you need testing, treatment, or additional monitoring. Speak up about any Listeria concerns during prenatal visits so steps can be taken to ensure your baby’s safety.
Bottom Line
Avoiding pepperoni and other deli meats is an important food restriction during pregnancy due to the risk of Listeria contamination. Listeria can lead to pregnancy complications like miscarriage, stillbirth, and illness or death of the newborn if the infection is passed from mother to baby.
While skipping beloved foods like pepperoni pizza may be disappointing, protecting your developing baby is the top priority. Focus on eating a balanced diet with safe, fresh foods you can enjoy over the nine months. With caution around higher risk foods, you can have a happy, healthy pregnancy and baby. Once baby safely arrives, you can gradually introduce previously restricted foods like pepperoni back into your diet.
