There are as many types of product called ‘sausage’ as there are questions about it in pregnancy. I decided to create a complete guide to eating sausage in pregnancy, because the current information isn’t very clear, particularly on what is classed as a ‘sausage’.
Can Pregnant Women Eat Sausage and Summer Sausage? Because sausages are usually served cooked and hot, sausage is usually safe to eat when pregnant. Cold sausage like summer sausage is much safer when it’s heated up, to lower the risk of listeria contamination.
Sausages are eaten in so many different ways, you might be wondering if your particular favorite type of sausage or recipe is pregnancy-safe. To help out, this guide covers almost every sausage you’re likely to come across.
When is Sausage Unsafe For Pregnant Women To Eat?
Sausages come in many varieties, but the common factor is that they’re usually made of ground meat and spices that is processed in some way, from smoking to curing, to baking and boiling.
Because sausages are made of ground ingredients, they should always be cooked or heated up thoroughly before being eaten.
Whole cuts of raw meat can have bacteria on the outside, but this is usually the site exposed to heat, so the bacteria get killed in the cooking process.
Bacteria on the surface of ground meat (or meat substitute), however, effectively gets ‘mixed in’ to the center of the sausage (yum). On top of that, the meat can come from more than one part of an animal, or different parts of it (source: Consumer Reports). The chances of bacterial contamination are increased.
The good news? Cooking sausage all the way through kills harmful bacteria. If a sausage has been cooked and then cooled, this is still an opportunity for bacteria to grow on the surface, particularly if it’s ready-sliced, as this increases the surface area.
For these reasons, all kinds of sausage are safer when cooked or heated until ‘steaming hot’. If you want an accurate way to measure this, you’ll definitely need a food thermometer (the best ones I’ve tested are here).
Summer Sausage: Is It Safe in Pregnancy?
Summer sausage gets queried a lot as it doesn’t need refrigeration until it’s opened, and it’s usually eaten cold. Popular brands include Hickory Farms, Old Wisconsin and Hillshire Farm.
Summer sausage typically contains less water and more salt and nitrates than other types of sausage. This makes it harder for bacteria to grow, as found by tests conducted by the University of Georgia, reported in the New York Times. This doesn’t mean that bacteria won’t grow at all, just that its growth may be stalled in such types of sausage.
It’s worth remembering that Summer sausage is a deli meat, and deli meats are not considered safe for pregnant women unless heated until steaming hot. For more on this, there’s a complete guide to deli meat here, including how to make it safer in pregnancy.
The conclusion? You can eat summer sausage in pregnancy if it’s been heated up, like you would with any other deli meat. If you’ve eaten it cold, don’t panic, as the chances are still very slim that you’ll contract any illness, but it’s much safer to take the ‘heated’ option overall.
Types of Sausage and Their Pregnancy Safety
Pregnant women often ask for specific information on their particular favorite type of sausage, so to put your minds at rest, here are the most common sausage types and whether they are safe in pregnancy or not:
- Battered sausages – common in the UK, this is a sausage deep-fried in batter. The only thing to check is that it’s been cooked all the way through, with no pink in the middle. Cut it in half and check beforehand, and try to keep such fatty, fried foods to a moderate level in pregnancy.
- Turkey and Chicken sausages are no different to beef, ham or pork sausages when it comes to safety during pregnancy. The same goes for vegetarian (e.g. tofu) sausages too. Because of the way they are made, from ground ingredients, no matter what’s in the sausage, it needs to be fully cooked or steaming hot before you eat it.
- Liver sausage (also called liverwurst) may need to be avoided in pregnancy, due to its high levels of vitamin A. In the UK, women are advised to avoid liver products altogether, whereas in the USA and Australia, they aren’t. You can read more about an excess of Vitamin A in pregnancy here.
- Breakfast Sausage (sometimes called links) or sausage patties are safe if fully cooked and served hot. They often come frozen before they’re prepared, so check they’re done all the way through.
- Hot, spicy sausages are fine if these guidelines on sausages, in general, are followed – the fact a sausage is spicy has no bearing on pregnancy-safety, though you might want to see how spicy food affects you in pregnancy.
- Pickled sausages should not be eaten cold, and should be heated instead to be safest. A 2016 study found that pickling does inhibit bacterial growth, but it cannot be ruled out entirely (source: PubMed).
- Vienna Sausages or canned/tinned sausages, including those in jars like bratwurst and frankfurters, should be treated like hot dogs, in that they should be heated up until steaming hot before eating them. For more on hot dogs and that type of sausage, there’s a guide here.
- Sausages named after their origin, like Polish sausage (kielbasa), Italian sausage , Andouille sausage and so on, should be treated like all other sausages and the ‘heat until hot’ rule applies. Some dry sausages like Polish kabanos are essentially the same as salami, and should be classed as deli meats.
- Smoked sausages can be cold or hot smoked, and should be heated up before serving to make them safe. Some need to be cooked through rather than merely heated up as they’re still smoked but raw – check the packaging first.
- Chorizo sausage, Pepperoni Sausage and Salami sausage are all deli meats and should be heated up to make them safe for pregnant women to eat. If you eat these types of sausage, check out this guide to eating deli meat in pregnancy.
- Nduja is a spicy, soft spreadable salami. Due to its soft texture, it’s almost like a pate and is only safe if heated up – for example, when it’s added to a pasta sauce, which is a common way of eating it. Eating cold, spread nduja is best avoided in pregnancy.
- Blood Sausage (also called Black Pudding) is safe in pregnancy if heated up until hot like other sausages. It’s a very good source of iron, too, depending on the manufacturer (source: BBC).
Eating Dishes or Recipes Containing Sausage in Pregnancy
Sausages aren’t always eaten on their own, of course. In no particular order, here are some common dishes you’ll find sausage in, and whether or not they’re safe for pregnant women to eat:
- Wrapped in pastry (i.e. a sausage roll). These are fine for pregnant women to eat if they’re freshly cooked and ideally served hot. Sausage rolls, though very tasty, are high in saturated fat and calories and are best eaten in moderation, in pregnancy.
- Sausage on a pizza is safe in pregnancy as these are cooked through when the topping itself is heated in the pizza oven. You might want to read this guide to pizza toppings in pregnancy, which shows you what to look for.
- Sausage pasta is quite common, and is fine to eat if the sausage is hot and fully cooked. It usually is, but it doesn’t hurt to check first.
- Mcdonald’s sausages (for example, the ones you get in patty form in a McMuffin) are OK when pregnant if they’re freshly made to order – you can find out more about this in my pregnant woman’s guide to the McDonalds Menu.
- Grilled or BBQ sausage – this is best checked with a food thermometer (the best one I’ve found is here) because sausages often get cooked on the outside, but not in the middle. There should be no pink when eating a BBQ’d or grilled sausage, and it should be hot all the way through to the center for it to be safe.
Are Sausage Casings OK to eat When Pregnant?
I’ve concentrated so far on the sausage fillings, but I’ve also been asked about whether it’s OK to eat all kinds of sausage casing in pregnancy.
Most types of sausage casing are safe to eat in pregnancy. This includes natural casing such as pig/hog or sheep intestines or ones manufactured from collagen. Since eating sausages hot and fully cooked is safest, this also applies to the casing.
Occasionally you might find a cured salami type sausage that is wrapped in a plastic skin, rather than a natural edible one. They are stronger and tougher than natural casings. These should be removed – not for a specific reason in pregnancy, but because they’re chewy and inedible!
Are Nitrates in Sausage Bad For Pregnant Women?
Nitrates like potassium nitrate and sodium nitrite are frequently added to sausages to prevent them from going bad, and to keep a uniform color. Some manufacturers use natural nitrates, usually extracted from celery.
The FDA’s guidelines mean that food should have 500ppm (parts per million) or less of nitrates (source: FDA). It’s worth remembering that nitrates occur naturally in many foods – it’s the added ones that people are often concerned about.
At present, there are no guidelines that explicitly state that pregnant women need to avoid nitrates. The Food and Drug Administration (FDA) in the USA and the European Food Safety Authority both say that nitrates are safe if consumed at or below the specified levels.
Deli meats, like dried, cured and summer sausage, are higher in nitrates than other foods. To learn more about nitrates in deli meat, click here.
Can I Eat Expired / Out of Date Sausages In Pregnancy?
What ‘expired’ or ‘past best before’ or beyond ‘use by’ all mean are different, depending on your country’s food labeling regulations.
When you’re pregnant, it’s important to avoid foodborne illness, and avoiding expired or “out of date” food is one way of easily reducing your risk of getting sick. (source: NHS).
Fresh sausages (the type made of ground meat) should never be eaten past their expiration date as bacteria are far more likely to be present in raw, uncooked food (source: Scielo).
Cured, salted, smoked or otherwise preserved sausage such as salami, summer sausage or similar types will occasionally have very long shelf lives, often due to the amount of salt and preservatives in them.
In pregnancy, it’s safer to eat these types of sausages within the “use by” or expiration date and cook/heat them as you would normally.
If you have accidentally eaten sausage that was past its expiration date, then don’t panic, but monitor yourself for symptoms of food poisoning such as nausea or diarrhea that fall outside what is ‘normal’ for your pregnancy. If in any doubt at all, consult your healthcare provider.