What Cheese is Safe for Pregnancy?

Originally published 10/12/2022. Updated for accuracy and relevancy on 09/22/2023.

By OBGYN Dr. Kenosha Gleaton

Raw Sushi, deli meat, alcohol, and others foods can be dangerous during pregnancy. Did you know that some cheeses should also be avoided? Let’s talk about the difference between pasteurized and unpasteurized cheese, and why it’s important to read the label before consuming dairy products. 

Can I Eat Cheese While Pregnant?

Cheese! It's widely known and widely loved, but not always safe for pregnancy. Some kinds of cheese could put you and your baby at risk for infection, which is why it’s important to know what’s safe to consume and what you should avoid. Fortunately, if you’re a big cheese lover, don’t worry too much, as there are still many options available for you to choose from. 

Pasteurized vs. Unpasteurized 

Dairy products, including cheese, can be pasteurized or unpasteurized. The pasteurization process is essentially a way to kill off bacteria in raw milk before it’s packaged and sold for consumption. In this process, the milk is heated to at least 150°F for a few seconds up to 30 minutes, and then cooled down. [1] 

In the United States, all cheese sold in stores is supposed to be pasteurized or aged for at least 60 days. [2] Still, there are some states where you may be able to purchase raw milk cheese or be served unpasteurized cheese in restaurants. [3] 

Unpasteurized Cheese

Some common unpasteurized cheeses include:

• Feta
• Brie
• Camembert
• Queso fresco
• Goat cheese
• Blue cheese

Luckily you should be able to find pasteurized versions of your favorite cheeses in stores, but be wary when eating out or shopping anywhere that doesn’t have clear labels on products. Learn more about pregnancy nutrition. 

Risks of Unpasteurized Cheese During Pregnancy

In general, pregnant women should avoid consuming unpasteurized milk and dairy products, as well as large quantities of soft cheeses. [4] This is even more important if the cheese is served cold, if you’re eating out, or if you’re unable to verify the cheese has been pasteurized. 

If you’re wondering why it’s so important to only eat pasteurized cheeses, the answer is pretty simple: bacteria. Listeria, Salmonella, and other bacteria may be present in raw milk cheese. [4] During the pasteurization process, these bacteria are killed off by heat, which decreases the likelihood of any contamination or bacteria. The same is true for cooking or baking with unpasteurized cheese, which is why you should take special precautions if being served cold cheese. 

Over the years, surveillance has shown a decrease in bacteria found in dairy products, however the incidence of infection or illness among pregnant women remains about 20 times higher than the general population. [5] Certain infections such as listeriosis can be detrimental to your health and your pregnancy. 

The safest option is to only consume dairy products that are clearly labeled as pasteurized. When in doubt, don’t eat it! 

What Is Listeria?

Listeria is a type of bacteria found in soil, water, and some animals such as cattle and poultry. [6] If it’s consumed, listeria may cause a foodborne illness known as listeriosis, which is a very extreme and dangerous type of food poisoning. Listeriosis most commonly occurs in the elderly, pregnant people, newborns, or others with weakened immune systems. [6] 

Symptoms of listeriosis include flu-like symptoms such as fever, muscle aches, upset stomach, headache, and stiffness. [7] It can take up to two months after exposure for symptoms to appear, and many pregnant women never experience any symptoms despite passing the infection to the fetus. [7] In extreme cases, listeriosis may cause miscarriage or stillbirth, or could lead to lifelong health problems including paralysis, seizures, organ damage, and more. 

Listeria can contaminate many foods including raw meat, deli meat, unpasteurized dairy products, raw vegetables, and others. [6] Listeriosis is relatively rare, but is often severe. 

How to Prevent Listeria

The four best ways to protect yourself from listeria are [8]:

1. Storing items properly: Make sure your refrigerator is set at 40°F or below, and your freezer at 0°F. 
2. Eating foods quickly: Don’t leave deli meat or other ready-to-eat meals sitting in your fridge any longer than the packaging recommends
3. Cleaning properly: Make sure you’re cleaning spills immediately and with the appropriate disinfectant. Be careful not to cross contaminate and ensure you’re cleaning out your fridge regularly. 
4. Avoiding unpasteurized dairy products: Stick to pasteurized milk and cheese, or be sure to cook cheese until it’s steaming hot to kill off bacteria and reduce the risk of listeriosis. 

Listeria During Pregnancy

Around 20% of all listeria infections occur in pregnant people, and pregnant people are 18 times more likely to get listeriosis than other healthy adults. [6] Listeriosis is a serious infection that can cause flu-like symptoms, dehydration, preterm labor, lifelong complications to the fetus, and even miscarriage or stillbirth. [7] Not everyone with listeriosis will have symptoms, so it’s important to protect yourself and avoid eating potentially contaminated products, especially while pregnant. 

Read more about pregnancy on the Natalist blog → 

What Cheese Can I Eat While Pregnant?

To help prevent listeriosis or other infections from raw milk cheese, you should stick to pasteurized, pregnancy safe cheeses such as [9]:

• Hard cheeses such as cheddar, gruyere, and parmesan
• Pasteurized semi-hard cheeses like edam and stilton
• Pasteurized soft cheeses including cheese spreads, cottage cheese, cream cheese, ricotta, mozzarella, goat cheese, and feta
• Any cheese that has been cooked until steaming hot should be safe for consumption

The most important thing to remember is that pasteurization or cooking until steaming hot are the only ways to kill listeria. If you can’t confirm whether or not a dairy product has been pasteurized, cooked, or has not been cross contaminated with listeria, you shouldn’t consume it.

When to Seek Help

If you believe you may have been exposed to listeria or are experiencing flu-like symptoms or stiffness of the neck, you should contact your doctor immediately. Symptoms could take up to two months to appear or may not appear at all. If you have concerns about specific foods, products, or symptoms, you should ask your doctor for more guidance. 

Key Takeaways

• Some cheeses are not safe for pregnancy because they may contain bacteria
• Pasteurized dairy products mean that the product has been heated to a temperature high enough to kill off bacteria, then cooled and packaged for sale or consumption. 
• Unpasteurized dairy products may contain bacteria such as listeria or salmonella which can cause life threatening symptoms
• Listeriosis is an extreme form of food poisoning caused by the bacteria listeria
• Listeroisis symptoms include flu-like symptoms and can lead to miscarriage, stillbirth, organ damage, paralysis, and more
• Not everyone with listeriosis will experience symptoms, and symptoms may take up to two months to appear
• Hard or aged cheeses should be safe for pregnancy, but soft cheeses should be avoided unless confirmed to be pasteurized or cooked until steaming hot

Support a healthy pregnancy with Natalist products- from comprehensive prenatal vitamins to pregnancy self-care items. 

References:

1. Pasteurization. International Dairy Foods Association. Accessed September 2023. https://www.idfa.org/pasteurization 
2. Title 21- Food and Drugs. [Code of Federal Regulations] [Title 21, Volume 2] [CITE: 21CFR133.146] June 2023. https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfcfr/CFRSearch.cfm?fr=133.146
3. National Conference of State Legislatures, “State Milk Laws,” ncsl.org, Aug. 29, 2016
4. Prevent Listeria. Centers for Disease Control and Prevention, National Center for Emerging and Zoonotic Infectious Diseases (NCEZID), Division of Foodborne, Waterborne, and Environmental Diseases (DFWED). April 2023. https://www.cdc.gov/listeria/prevention.html
5. Tam C, Erebara A, Einarson A. Food-borne illnesses during pregnancy: prevention and treatment. Can Fam Physician. 2010;56(4):341-343.
6. Get the Facts about Listeria. Food and Drug Administration. August 2020. https://www.fda.gov/animal-veterinary/animal-health-literacy/get-facts-about-listeria
7. Listeria and Pregnancy. FAQ 501. ACOG. August 2022. https://www.acog.org/womens-health/faqs/listeria-and-pregnancy
8. What You Need to Know About Preventing Listeria Infections. FDA. March 2018. https://www.fda.gov/food/buy-store-serve-safe-food/what-you-need-know-about-preventing-listeria-infections 
9. Foods to avoid in pregnancy. National Health Service. May 2023. https://www.nhs.uk/pregnancy/keeping-well/foods-to-avoid/