Is cottage cheese safe during pregnancy?

Made with pasteurized milk, it is one of the safer cheeses. The US Centers for Disease Control and Prevention lists cottage cheese made that way among the safer cheese choices for avoiding Listeria, the bacterium that makes cheese a pregnancy question at all. CDC outbreak analysts call commercial cottage cheese generally safe. The risk that remains is contamination after pasteurization, and a 2026 US outbreak with 15 cases, 14 hospitalizations and one death included requesón, a Latin-style cottage cheese, among the recalled products.

Established. Pasteurized commercial cottage cheese is on the CDC list of safer choices. That rests on agency guidance and outbreak records. No trial or systematic review has studied cottage cheese safety in pregnant women.

What the trials found

We found no randomized trial of cottage cheese on its own in pregnancy. The only randomized evidence that used it is the Canadian BHIP trial, where cottage cheese, Greek yogurt and milk were the protein foods in a program that also included counseling and walking. Any result belongs to the whole package, and the cheese cannot be separated from it.

In 241 pregnant women, the program did not make staying within the recommended weight gain significantly more likely. The odds ratio was 1.51, but its confidence interval of 0.81 to 2.80 includes no effect. Pregnancy and infant birth outcomes were similar in the 119 women on the program and the 122 on usual care.

Two small follow-ups of the children found differences. In 74 infants, those whose mothers had the program scored higher on expressive language at 12 months, while cognitive, receptive language, motor and social-emotional scores did not differ. At 22 months, 57 children of program mothers had fewer behavior problems as reported by their parents, with medium to large effect sizes. Parents knew which group they were in, the samples were small, and many outcomes were measured.

A 2019 systematic review of 17 studies, most of them observational, found a trend linking milk intake in pregnancy to higher birth weight and length. It found too few studies to say anything about other dairy foods, cottage cheese included.

Who should be careful

Every pregnant woman is in the group this question is about. An umbrella review of 9 systematic reviews states that listeriosis is more likely in pregnancy and can lead to miscarriage, preterm birth, stillbirth and infection of the newborn. That is why cheese safety in pregnancy is a question about Listeria.

Not for everyone. Pasteurized milk does not guarantee a safe fresh cheese. The CDC analysts write that some soft cheeses made with pasteurized milk, particularly Latin-style soft cheeses, were contaminated in facilities with poor processing, and that a buyer cannot tell this from the label. Requesón, sold as cottage cheese, was among the products recalled in the 2026 US outbreak.

Europe has a matching case. In 2012 in Bizkaia, Spain, a listeriosis outbreak that included a mother and her newborn was traced to a Latin-style fresh cheese made from pasteurized milk in Portugal. That is one outbreak with two confirmed cases, and the cheese was not a classic cottage cheese.

Contamination has also been measured outside the US. In an Ethiopian survey of 391 food samples, Listeria monocytogenes was found in 1 percent of local cottage cheese samples and 13 percent of raw milk samples. The survey does not say whether that cheese was made from pasteurized milk. Cottage cheese with no label saying the milk was pasteurized is outside the CDC safer list.

What expert bodies say

The CDC lists cottage cheese, cream cheese, string cheese, feta and mozzarella among safer choices when they are made with pasteurized milk. We found no sentence from the FDA or ACOG that names cottage cheese in pregnancy. Their pregnancy food safety pages speak about soft cheese and pasteurization in general, and we found nothing that disagrees with the CDC.

How we searched

What would change this answer

• A Listeria risk estimate per serving of cottage cheese from the FDA or USDA. Outbreak counts say which foods have caused harm. They do not say how likely one portion is to cause it.
• An outbreak traced to mainstream pasteurized cottage cheese, as opposed to Latin-style requesón. That would move it off the safer list.
• For any benefit, a trial that tests dairy protein foods in pregnancy without counseling and exercise mixed in. None is registered.

Sources

1. ev-ccpg-01 · Randomized controlled trial(s) · randomized controlled trial (two-arm superiority) · n = 241
   Although the intervention compared to control group was more likely to achieve GWG within recommendations (OR = 1.51; 95% CI (0.81, 2.80)) and total GWG was lower by 1.45 kg (95% CI: (-11.9, 8.88)) neither reached statistical significance.
   
   Who: Pregnant women in southern Ontario, Canada, randomized at 12-17 weeks to intervention (119) or usual care (122)
   Effect: OR 1.51 (95% CI 0.81 to 2.80) for gestational weight gain within IOM range; protein intake +15.0 g/day (95% CI 8.1 to 21.9) at 26-28 weeks; pregnancy and birth outcomes similar
   Certainty: Cottage cheese is one of three protein sources (with Greek yogurt and milk) plus counseling and walking; there is no separate effect of the cheese. The 10,000-step goal was not reached.
   Nutrients, 2022 · checked 2026-10-07 · we read the abstract
2. ev-ccpg-02 · Randomized controlled trial(s) · randomized controlled trial (two-arm superiority) · n = 241
   Pregnancy and infant birth outcomes were similar between groups.
   
   Who: Pregnant women in the BHIP trial, Ontario, Canada
   Effect: pregnancy and infant birth outcomes similar between groups
   Certainty: No difference in a small RCT, not proof of safety; the products were pasteurized store-bought.
   Nutrients, 2022 · checked 2026-10-07 · we read the abstract
3. ev-ccpg-03 · Randomized controlled trial(s) · follow-up of a randomized controlled trial · n = 74
   However, mean cognitive, receptive language, motor, and social-emotional scale scores did not differ between groups.
   
   Who: Infants of BHIP mothers enrolled by 12 weeks, BMI under 40 (intervention 42, control 32)
   Effect: higher expressive language and general adaptive scores (medium effect sizes); cognitive, receptive language, motor and social-emotional scores did not differ
   Certainty: Subsample, many endpoints; the effect of the diet + walking complex, not cheese.
   J Dev Orig Health Dis, 2023 · checked 2026-10-07 · we read the abstract
4. ev-ccpg-04 · Randomized controlled trial(s) · follow-up of a randomized controlled trial · n = 57
   Children exposed to the BHIP intervention exhibited medium to large effect size reductions in pregnant person and partner reported externalizing [effect size ƞ2pmother = 0.08, 95% confidence interval of the difference (0.05, 7.14); ƞ2ppartner = 0.17 (1.68, 9.65)], internalizing [ƞ2pmother = 0.08 (0.09, 5.32); ƞ2ppartner = 0.13 (0.84, 8.88)], and total behavior problems [ƞ2pmother = 0.09 (0.72, 11.87); ƞ2ppartner = 0.17 (3.17, 17.88)] relative to control participants' children.
   
   Who: Offspring of BHIP participants at about 22 months (intervention 29, control 28)
   Effect: medium to large reductions in mother and partner reported externalizing, internalizing and total behavior problems
   Certainty: Small sample, parent report (not blind to group), multicomponent intervention.
   Am J Clin Nutr, 2025 · checked 2026-10-07 · we read the abstract
5. ev-ccpg-05 · Observational data · systematic review of observational and intervention studies · n = 17 studies
   Although the number and types of studies prevent definite conclusions, there appears to be a trend that maternal milk intake during pregnancy is positively associated with infant birth weight and length.
   
   Who: Healthy pregnant and lactating women in 17 studies (6 prospective cohorts, 3 intervention, 3 retrospective cohorts, 3 cross-sectional, 2 case-control)
   Effect: trend toward higher birth weight and length with maternal milk intake; no conclusions possible for other dairy products
   Certainty: Mostly observational; about milk, not cottage cheese; axis 9: there are no separate data on cheese.
   Adv Nutr, 2019 · checked 2026-10-07 · we read the abstract
6. ev-ccpg-06 · Observational data · retrospective observational analysis of national outbreak surveillance data · n = 17 outbreaks
   Soft cheeses made with pasteurized milk, including commercial cottage cheese, cream cheese, and processed mozzarella, are generally considered safe. However, some soft cheeses made with pasteurized milk, particularly Latin-style soft cheeses, have been produced in facilities with improper processing conditions, resulting in L. monocytogenes contamination. Consumers cannot evaluate the conditions under which a cheese was made on the basis of labeling or other attributes of the product.
   
   Who: Soft-cheese listeriosis outbreaks, United States, 1998-2014
   Effect: pasteurized commercial cottage cheese generally considered safe; contamination after pasteurization documented mainly in Latin-style soft cheeses
   Certainty: Direct mention of cottage cheese. The risk is not the raw material but contamination at production after pasteurization.
   Emerging Infectious Diseases, 2018 (Jackson et al.) · checked 2026-10-07 · we read the fulltext
7. ev-ccpg-07 · Observational data · umbrella review of systematic reviews · n = 9 reviews
   Compared with the general population, the risk of being diagnosed with listeriosis increases during pregnancy. Listeriosis can lead to miscarriage, spontaneous preterm labour and preterm birth, stillbirth and congenital neonatal infections.
   
   Who: 9 systematic reviews covering 330 studies and 487 patients
   Effect: higher risk of diagnosis in pregnancy; outcomes include miscarriage, preterm birth, stillbirth, congenital infection
   Certainty: About listeriosis in general, not cheese; explains why the question of cheese safety in pregnancy is about Listeria.
   BJOG, 2022 · checked 2026-10-07 · we read the abstract
8. ev-ccpg-08 · Laboratory or animal data · outbreak investigation (case report) · n = 2
   The epidemiological investigation indicated that these two cases were associated with the consumption of Latin-style fresh cheese made from pasteurised milk in Portugal.
   
   Who: Two laboratory-confirmed listeriosis cases, Bizkaia, Spain, August 2012
   Effect: Listeria monocytogenes confirmed in several batches of a pasteurized-milk fresh cheese; product withdrawn
   Certainty: Latin-style fresh cheese, not classic cottage cheese; shows that pasteurizing the raw material does not guarantee the safety of the finished fresh cheese.
   Euro Surveill, 2012 · checked 2026-10-07 · we read the abstract
9. ev-ccpg-09 · Observational data · cross-sectional prevalence survey · n = 391 samples
   It was isolated mainly from raw milk (13%) and liquid whole egg (4.3%) followed by raw beef (2.6%) and cottage cheese (1%).
   
   Who: 391 food samples (cottage cheese, raw beef, raw milk, liquid whole egg), Addis Ababa, 2008-2009
   Effect: L. monocytogenes in 1% of cottage cheese, 13% raw milk, 4.3% liquid egg, 2.6% raw beef
   Certainty: Local (often unpasteurized) Ethiopian homemade cheese, not store-bought pasteurized; gives an order of magnitude of contamination.
   J Infect Public Health, 2011 · checked 2026-10-07 · we read the abstract
10. ev-ccpg-10 · Position of an expert body · agency guidance
    Cottage cheese, cream cheese, string cheese, feta, and mozzarella, when made with pasteurized milk
    
    Who: People at higher risk of listeriosis, including pregnant women; CDC Preventing Listeria Infection, last reviewed January 31, 2025
    Effect: pasteurized cottage cheese listed as a safer choice
    Certainty: T2, E. Web quote: WebFetch of the page + a separate WebSearch of the exact phrase restricted to cdc.gov, verbatim match.
    US CDC, Preventing Listeria Infection · checked 2026-10-07 · we read the section
11. ev-ccpg-11 · Position of an expert body · outbreak notice · n = 15
    requesón (cottage cheese), soft cheese, mild cheese, hard cheese, smoked cheddar cheese and flavored cheese
    
    Who: US multistate Listeria outbreak, 2026, 4 states; CDC outbreak notice updated August 26, 2026
    Effect: 15 cases, 14 hospitalizations, 1 death; Listeria found in six samples of requeson
    Certainty: T2, E. Requesón is a Latin-style fresh cheese sold as cottage cheese; ordinary store-bought cottage cheese was not part of the recall. curl blocked (252 bytes); confirmed by WebFetch + WebSearch of the exact phrase on cdc.gov.
    US CDC, Listeria Outbreak Linked to Soft Cheese, June 2026 · checked 2026-10-07 · we read the section