One of the biggest questions I get asked by patients is if they really need to make dietary changes during pregnancy, and the answer is yes!

There is a risk in eating certain foods in pregnancy as well as a risk created by how food is prepared and stored.

What we worry about most is food poisoning from bacteria such as Listeria and Salmonella. In some cases, food poisoning can cause early labour or miscarriage or a baby to be born with the symptoms of bacterial meningitis, which is a severe and fatal infection.

Let’s start with one of the most common food related queries, eggs.

Runny eggs. It is common to think it is the yolk that is the problem, but we want you to make sure the white of the egg is fully cooked. This is sometimes hard to guarantee in dishes like pavlova and quiches.

Eggs that are classified as “intact” such as poached eggs, boiled eggs and fried eggs need the egg white to be fully “set” to be safely eaten, the yolk can still be a little runny.

Eggs that are classified as “mixed” such as scrambled eggs, an omelette or a quiche need to be cooked the whole way through until they are steaming hot with no liquid left.

Any condiments that may contain raw egg such as mayonnaise or aioli should contain an acidic ingredient such as vinegar or lemon juice which makes them safe to eat.

Next on the list is raw meat and fish.

Any minced meats from any animal such as a sausage, rissole or a hamburger, or whole meat like steak or roast meat needs to be cooked right through so that the meat is no longer bleeding.

We are often told to avoid seafood particularly big fish like tuna due to the suspected level of heavy metals. If you are eating fish caught and sold in Australia it is normally safe as fish is highly regulated, this means that you can eat fish during pregnancy so long as it is cooked all the way through.

But what about sushi? Firstly, no raw fish or shellfish. However, other sushi rolls with vegetables, cooked fish or chicken may be ok if you make it yourself or see it being made with refrigerated ingredients and you eat it immediately.

I also want to talk about Christmas and the festive season

If your festive season is anything like mine, family and friend gatherings include shared tables filled with charcuterie boards, prawns, maybe oysters, cheeses, hams… And they often stay out all day, sometimes in the sun. Not ideal for anyone but pregnant women need some special precautions.

• Any cured meats or charcuterie foods should not be eaten during pregnancy and these often form the backbone of a good festive platter.
• Cheeses in Australia are pasteurised, and technically, they would be ok to eat but I caution you as it is often not the milk that is the problem but the process of making the cheese that allows bacteria to grow after the cheese has been produced. Soft cheese is more of a risk as bacteria can grow in soft cheeses easier than hard cheese. Best to avoid the cheese platter.
• Christmas ham needs to be cooked all the way through, and this is my favourite way anyway, smothered in a sweet sticky glaze. Yum. Please eat within 2 hours.
• Avoid all types of shellfish in pregnancy as these can contain E. coli and tends to be eaten raw, meaning the bacteria is never killed.
• Fermented foods are generally safe to eat during pregnancy if it hasn’t been out of the fridge too long. See next point!
• Choose to eat when the food is first presented and avoid foods that usually need to be refrigerated but have been out of the fridge for more than 2 hours.

And it wouldn’t be Christmas without a pavlova, so can you eat it if you are pregnant? If the pavlova has risen, set and formed a shell then you can eat the pavlova however if the pavlova has not properly risen and is damp in the centre then please avoid.

The takeaway for Christmas is, eat food that has just been prepared, eat cooked meat and fish, make sure the egg white is cooked, enjoy dessert that has just come out of the fridge and sit back and let someone else do the dishes!

We often leave out the most important issue with food safety – handling and storage!

Often the culprit in food poisoning is how we handle it.

Firstly, we need to wash or sanitise our hands before handling food. If there is one thing that Covid-19 has taught us is that washing or sanitising our hands is number one defence against infection and cross-contamination.

Secondly, food needs to be stored in clean containers, cooled before refrigerating and kept in a refrigerator that is less than 5 degrees. Make sure you store meat or other liquid-based food well, so it doesn’t drip onto food below.

Thirdly, we need to wash our food. Pre-packed salads from supermarkets marked as pre-washed are generally safe to eat as these have been regulated and thoroughly washed. All other fruit and vegetables, including frozen berries can be washed with vinegar, boiling water or even just a good hand wash and scrub with a cloth, this removes 99% of bacteria.

If you want to know more about safe foods in pregnancy, about this time last year Brigid sat down with food safety expert Greg Kennedy on all things about eating safely in pregnancy on our podcast The Kick Pregnancy Podcast.

You can listen to this episode of The Kick here

Written by Obstetrician and Gynaecologist Dr Patrick Moloney