Eating safely in pregnancy in Spain, cured ham, cheese and fish

Key rules

• Toxoplasma: If you are not immune to toxoplasma, cured meat must be frozen or cooked before you eat it.
• Cheese: Choose pasteurised or hard, long-matured cheese, and skip raw-milk and soft mould-ripened cheese.
• Fish: Avoid swordfish, shark, bluefin tuna and pike, and choose cooked fish over raw.
• Eggs: Avoid raw or runny egg in dishes such as homemade mayonnaise, alioli and soft tortilla.

The short version

In Spain, the foods to watch in pregnancy are cured ham and cured meats, raw-milk and soft cheeses, a few high-mercury fish, raw or almost raw fish, and runny eggs. You can still eat socially. Most of these have a safe version: frozen, cooked, pasteurised or simply a different fish.

The warning box below lists the foods to avoid. This page explains how to handle them in practice.

Cured ham, chorizo and salchichón

The risk is toxoplasma, a parasite, and also Listeria. A blood test early in pregnancy shows whether you are immune to toxoplasma. Ask your midwife or doctor for the result and what it means for you.

• If you are not immune, avoid raw or cured meat such as jamón, chorizo and salchichón unless it has been frozen or cooked first.
• Freezing at -20°C for at least 48 hours, or cooking to at least 70°C inside, kills the parasite.
• Cured meats can also carry Listeria, so cooked or heated products are safer. Think of hot ham in a toasted sandwich or chorizo cooked through in a stew.
• If you are immune, the toxoplasma risk is lower. Your doctor will give you advice for your own case.

At a bar, a ham plate is the usual trap. Ask for something cooked, or skip it and take the other tapas.

Cheese

The risk is listeriosis. Avoid:

• Cheese made with raw (unpasteurised) milk.
• Soft or mould-ripened cheeses such as brie, camembert and blue cheeses (Roquefort, Cabrales, gorgonzola).
• Fresh soft cheeses like queso fresco, unless the label says they are made from pasteurised milk.

Safer choices are hard, long-matured cheeses, processed cheese, pasteurised fresh cheese, and any cheese cooked until steaming hot. Cut the rind off soft cheeses. In a restaurant, ask whether the cheese is pasteurised.

Fish

High-mercury fish. Avoid swordfish (emperador), shark (cazón, tintorera and similar), bluefin tuna (atún rojo) and pike (lucio). This also applies while breastfeeding and when planning a pregnancy. Other fish, including small blue fish and white fish, are fine in a varied diet. Limit canned light tuna.

Raw or almost raw fish. Sushi, ceviche, marinated anchovies and lightly smoked or salted fish can carry anisakis parasites. Restaurants must freeze such fish at -20°C or below for at least 24 hours before serving. Fully cooked fish needs no freezing, and some farmed fish, such as farmed salmon, are exempt. At home or in a restaurant, the simplest choice in pregnancy is fish cooked all the way through.

Eggs

Raw or undercooked eggs can carry Salmonella. Avoid tortilla poco cuajada (runny tortilla), and homemade mayonnaise, alioli, mousse and tiramisu made with raw egg. Choose egg dishes cooked until yolk and white are firm. Sauces and desserts made with pasteurised egg are fine. At home, keep eggs refrigerated, throw away cracked ones and eat homemade raw-egg sauces quickly, or skip them.

Eating out and at family meals

• Ask how a dish is made. "¿Está cocinado del todo?" (Is it fully cooked?) and "¿Es de leche pasteurizada?" (Is it pasteurised milk?) are enough.
• Choose hot, cooked dishes when you cannot find out.
• Tell hosts early that you are pregnant. In Spain, ham and cheese are often put out as a welcome.

After the birth

Honey should not be given to babies under 12 months because of infant botulism. The FAQ below covers this and other common questions.

What to watch out for

• Cured ham and cured meats: Jamón, chorizo and salchichón can carry the toxoplasma parasite and Listeria if you are not immune to toxoplasma. Both can harm a pregnancy. Eat them only after freezing at -20°C for at least 48 hours, or cooked to at least 70°C inside. Cooked or heated products are safer. Ask for a blood test early in pregnancy to learn whether you are immune.

• Raw-milk and soft cheeses: Cheese made with raw (unpasteurised) milk, and soft or mould-ripened cheeses such as brie, camembert, Roquefort, Cabrales, gorgonzola and queso fresco, can cause listeriosis, a serious infection in pregnancy. Check the label for pasteurised milk before you eat any soft cheese, and ask when you are at a bar or restaurant.

• High-mercury fish: Swordfish (emperador), shark (cazón, tintorera and similar), bluefin tuna (atún rojo) and pike (lucio) contain high levels of mercury. This applies in pregnancy, while breastfeeding, when planning a pregnancy, and for children under 10. Choose small blue fish or white fish instead, and skip these four on menus and at family meals.

• Runny eggs and raw-egg sauces: Tortilla poco cuajada, homemade mayonnaise, alioli, mousse and tiramisu made with raw egg can carry Salmonella. Ask for the tortilla fully set, with yolk and white firm.

• Raw or almost raw fish: Sushi, marinated anchovies, salted or lightly smoked fish can carry anisakis parasites if the fish was not frozen first. Ask the restaurant whether the fish was frozen first, or choose fully cooked fish. The freezing rule is set out in Food safety risks in Spain, raw fish (anisakis), eggs and seafood.

Frequently asked questions

Can I eat jamón if I am immune to toxoplasma?

Possibly, because women who are immune to toxoplasma face a lower risk from cured ham. A blood test early in pregnancy shows whether you are immune. Ask your doctor or midwife for advice based on your result.

Which cheeses are safe to eat in pregnancy?

Hard, long-matured cheeses, processed cheese and pasteurised fresh cheese are safer choices in pregnancy. Any cheese cooked until steaming hot is also fine. For soft cheeses with a rind, remove the rind.

Can I eat canned tuna while pregnant?

You can eat canned light tuna in pregnancy, but only in limited amounts. Small blue fish and white fish are better choices for a varied diet. Bluefin tuna (atún rojo) is the one to avoid completely.

When can my baby eat honey after birth?

Your baby should not have honey until they are 12 months old, because of the risk of infant botulism. Babies also need pasteurised or sterilised milk, or formula, and no raw or undercooked meat, fish or eggs.