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There's no reason to avoid honey in a normal pregnancy

I’m Pregnant. Can I Eat Raw Honey?

Yes, you can! Pregnancy itself does not affect one’s ability to eat honey, raw or otherwise. A caveat is expectant moms with, or at increased risk of, gestational diabetes. More on this below.

I’m not sure where this idea that raw honey should not be eaten by pregnant women comes from, but it although it is common, it doesn’t seem to be based in facts or evidence. Here is an example of a website that gets it completely wrong.

Perhaps some people, knowing that infants less than a year of age should not eat honey, have extrapolated that to mean that pregnant women also should not eat honey. This is not the case.

Perhaps, because infants are at risk of infant botulism from eating honey, some assume that adults can also be at risk of botulism from eating honey and therefore honey should be avoided in pregnancy. This is also a misunderstanding.

Infant and food-borne botulism

Clostridium botulinum that make botulism toxin. The thicker bowling-pin-shaped ones are inactive spores while the straight rods are growing bacteria (not present in honey).
Clostridium botulinum that make botulism toxin. The thicker bowling-pin-shaped ones are inactive spores while the straight rods are growing bacteria (not present in honey).

The reason that honey can, in very rare cases, cause infant botulism (FAQ on this here) in young infants is due with the fact that infants’ intestines are not yet fully colonized by normal gut microbiota – those healthy bacteria that inhabit all of our intestines and perform critical functions contributing to our health. This is just one reason not to take antibiotics when not required – any antibiotic will kill of some of these very useful bacterial inhabitants. These helpful bacteria not only assist with our metabolism of food, but they prevent more harmful bacteria from settling down and thriving in our intestines.

Unlike infants, adults’ intestines have been colonized by bacteria since before their first birthday and therefore adults cannot develop infant botulism (hence the “infant” in the name). Food-borne botulism that adults can get is a different beast. Food-borne botulism is a serious and potentially fatal condition that develops after consuming rotten food that is contaminated with large doses of botulin toxin. C. botulinum can thrive in some improperly prepared, stored or packaged foods, releasing large amounts of toxic botulin toxins. Note that this is the same toxin used in botox injections. Honey cannot give you food-borne botulism because Clostridium botulinum cannot grow in honey – it can only exist in honey in its inert spore form, not metabolizing, growing, or producing any toxins at all while in the honey.

“Raw” Food

Steak tartare: a raw food you may want to avoid in pregnancy
Steak tartare: a raw food you may want to avoid in pregnancy

Perhaps the idea that raw honey is taboo in pregnancy is an association with the word “raw” and hazards of infection during pregnancy.

Raw honey poses no special risk for pregnant women. Of note, pasteurizing honey has no effect on the C. botulinum bacterial spores that can cause infant botulism. Pasteurized honey is not safer in any way than raw honey, it simply doesn’t ferment as the natural yeasts have been killed during pasteurization. I won’t ask you to take my word for this, but you might be interested in what the world-renown Mayo Clinic has to say on the risk of eating raw honey (relating to immune compromised individuals, but relevant to pregnant women if they are worried about botulism or infections, or concerned by the word “raw”):

“’Pasteurization’ of honey actually has no technical meaning, and heating honey doesn’t provide any food safety advantage. Producers may heat honey to keep it from crystallizing but there is nothing safer about honey calling itself ‘pasteurized’ honey versus ‘raw’ honey.

Therefore, you will not find any research or government advice indicating the need for immune compromised patients to use ‘pasteurized’ honey. Food-borne pathogens actually do not survive in honey, so there is no additional risk in consuming it raw. [emphasis is mine]”1

Unlike raw honey, raw salad poses a non-zero risk of infection
Unlike raw honey, raw salad poses a non-zero risk of infection

Aside: raw fish

Not as clear-cut as raw honey safety, I couldn't find any evidence that properly prepared raw fish poses a risk in pregnancy
Not as clear-cut as raw honey safety, I couldn’t find any evidence that properly prepared raw fish poses a risk in pregnancy

When my wife was pregnant, issues like this became more immediate. I love sushi. I wasn’t prepared to give up raw fish while my wife was pregnant, but would have felt a bit guilty eating sushi around her if she had to abstain from raw fish since she is also a sushi lover. A little research did not turn up any evidence that eating sushi in pregnancy is hazardous. Not surprising given that Japanese people tend to eat a fair bit of sushi on average and don’t have the idea that it should be avoided in pregnancy. Consumption of predators like tuna ought to be limited (in pregnancy and otherwise) due to the concentration of pollutants in their flesh, especially mercury. (Due to tuna over-fishing, I try to restrict my tuna consumption anyway). I couldn’t find anything indicating that properly prepared raw fish specifically presented a hazard to expectant moms. I’m not interested in convincing anybody, especially pregnant people, what they should or shouldn’t eat, but I did present the information I found to my wife, so that we might continue to enjoy eating sushi together. She chose not to, which, of course, was fine: I got to enjoy her share of sushi at Japanese omakase tasting menus.

Gestational Diabetes

This is one pregnancy-associated condition where people should be careful about eating honey. The hormonal changes in pregnancy can cause some women to develop a form of diabetes during pregnancy. Like other forms of diabetes, the body does not regulate blood sugar levels appropriately in gestational diabetes (also called “diabetes of pregnancy”). Prolonged high blood sugars can have adverse effects on the developing fetus, so woman with gestational diabetes (and those at high risk of developing gestational diabetes) should monitor their blood sugars in consultation with their physician.

Honey is a carbohydrate and can raise blood sugars. While honey has a lower glycemic index (GI) and does not cause the same insulin or blood sugar spikes that processed sugars do, eat honey only with caution and careful monitoring if you have gestational (or any form of) diabetes.

Finally

My intent is not to convince pregnant individuals that they should eat honey: what each person feels comfortable eating is completely up to her. I simply hope to dispel a persistent negative myth about raw honey.

Like any topics, we welcome any comments or questions on this topic to info@wendellestate.ca. If you know of other reasons why pregnant women should not eat honey, we’d love to hear them.

Good news! You can enjoy raw honey while pregnant. No need to give up honey on rhubarb, cheese (my favourite), fruit, or even sauerkraut (like my grandmother used to).
Good news! You can enjoy raw honey while pregnant. No need to give up honey on rhubarb, cheese (my favourite), fruit, or even cooked sauerkraut or canned tomatoes (My grandmother used to add honey to cooked sauerkraut and also canned tomatoes).
  1.  The assertion that food-borne pathogens cannot survive in honey seems to contradict the well-known fact that honey may contain Clostridium botulinum spores. I think the two statements can be reconciled when one considers that spores are not metabolically active. They only become a pathogen when they emerge out of the inert spore state in an infant’s intestine. The C. botulinum bacteria form spores in honey precisely because they (the active bacteria) cannot survive in raw honey.

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