Is Thai Food Safe During Pregnancy? Papaya Salad, Bean Sprouts and What to Order

Thai food is cooked fast at very high heat, which is one of the safest ways food can be prepared. Most of the menu needs no thought at all in pregnancy.

The exceptions are the handful of dishes built on raw or fermented ingredients, and they are easy to identify once you know which ones they are.

Som Tam and the Fermented Crab

Green papaya salad is the dish worth knowing about, because the version you get depends on how the restaurant makes it.

The Thai-style version, sometimes called som tam pu pla ra, includes raw fermented crab and fermented fish sauce. Fermenting is not cooking. Raw fermented crab is a recognised source of foodborne illness and parasites in Thailand, and it is not something to eat in pregnancy.

Most restaurants outside Thailand serve the milder version, som tam Thai, which is papaya, carrot, green beans, peanuts, lime, chilli and fish sauce, with dried shrimp rather than raw crab. That version has no raw crab in it.

The question to ask: does the papaya salad contain fermented crab. Staff know immediately, because it changes the dish substantially. If the answer is yes, order the Thai version instead.

Commercial fish sauce itself is fine. It is a fermented, bottled product used as a seasoning, not a raw ingredient, and it appears throughout the menu.

The Green Papaya Question

Worth addressing separately, because it is the thing people have usually read about.

Unripe, green papaya contains more latex and an enzyme called papain than ripe fruit does. Some animal studies have suggested that concentrated unripe papaya latex may have effects on the uterus, which is where the traditional advice to avoid it in pregnancy comes from.

The honest position is that the evidence is limited and mostly not from humans, and the amount of green papaya in a shared salad is modest. Ripe papaya is a different matter entirely and is a genuinely good fruit in pregnancy, high in vitamin C and folate.

If you would rather not think about it, order something else, and there is plenty else. If you love som tam and the restaurant makes it without fermented crab, an occasional portion is not something to lose sleep over. The raw crab is the part that actually matters.

The Menu, Item by Item

Menus vary, so use the pattern rather than only the list.

Larb, and Raw Meat Dishes

A short section, because the answer is usually reassuring.

Larb is a minced meat salad with lime, chilli, herbs and toasted rice powder. In the overwhelming majority of restaurants outside Thailand the meat is cooked before it is dressed, and the dish arrives warm or at room temperature.

Some traditional northeastern versions use raw meat, usually described as larb dib. These are rare on Western menus and would normally be labelled, but it is a fair question, and minced raw meat is the category that needs cooking right through.

The same applies to any dish described as raw, or as "cooked" only by lime juice. Citrus does not kill bacteria or parasites the way heat does, which is why ceviche sits on the avoid list too.

Herbs, Garnishes and the Side Plate

Thai dishes arrive with things added raw at the end, and they are not all the same.

Raw bean sprouts are the one to deal with. Sprouts are grown in warm, humid conditions that suit bacteria, and contamination can sit inside the seed where rinsing cannot reach. Both UK and US guidance advise against raw sprouts in pregnancy. The easy answer with pad thai or a noodle soup is to stir them into the hot food and leave them a minute, which cooks them.

Fresh coriander, Thai basil, mint and lime are a much milder consideration. They are raw and should have been washed, so the usual rule applies: fine when fresh and crisp, worth leaving if they look tired.

Crushed peanuts, dried shrimp and fried shallots are all fine.

Chilli in vinegar and the condiment tray on the table are fine too. These are acidic, salty preserved condiments rather than fresh food.

One practical note on ordering in a group, since Thai food is usually shared. Dishes arrive together and sit on the table while everyone serves themselves, which means the food cools across the meal. Taking your portion early, while everything is properly hot, is the same habit that matters at any shared table, and it is the single easiest adjustment to make without anyone noticing.

Takeaway, Delivery and Leftovers

Most Thai food in the UK and US is eaten at home from a bag, which changes the timing rather than the food.

The clock starts when the dish is cooked, not when it arrives, so eat it promptly rather than leaving it while you finish something else. If it turns up lukewarm, reheat it until steaming rather than eating it as it is.

Rice deserves the usual care. Cool it quickly, keep it no more than a day, and reheat once until piping hot, for the reasons our rice leftovers guide explains.

Curries and stir fries keep for a couple of days and reheat well. Anything with raw garnish is better eaten fresh, and the sprouts are best left out of a container that is going in the fridge. Our takeaway guide covers delivery timing, and our eating out guide has the questions that work on any menu.

Spice, Heartburn and the Myths

Thai food is often very hot, which raises the usual questions.

Spicy food does not harm your baby, cause miscarriage or bring on labour. Those are persistent myths with nothing behind them.

It will make heartburn worse, and heartburn gets worse anyway as pregnancy progresses. So the honest answer is that a hot green curry is safe and may be uncomfortable later. Asking for mild is not a defeat, and most Thai kitchens will adjust the heat without changing the dish. Our heartburn guide ranks the triggers.

One genuinely useful point in the other direction: ginger and galangal, which appear throughout Thai cooking, help some people with nausea. A tom kha or a ginger stir fry can be one of the easier things to eat in the first trimester, for the same reason a clear broth is.

Ordering With Nausea

Thai food suits first trimester eating better than most cuisines, which is worth knowing when very little appeals.

Clear soups work. Tom yum is sour, salty and hot, and plenty of people find that combination easier than solid food. If chilli is too much, most kitchens will make it mild.

Plain jasmine rice is among the gentlest things on any menu, and a side of rice with a mild chicken stir fry is a reasonable meal on a bad day.

Ginger and lime both help some people, and both appear throughout the menu rather than needing to be asked for.

What tends to be harder is anything deep fried, very rich in coconut milk, or strongly fishy. Cooking smells are often the trigger rather than the food, so a collection order eaten at home can work when sitting in the restaurant does not.

Later in pregnancy the problem flips to heartburn and capacity. A smaller dish eaten earlier beats a large curry late, and asking for mild makes more difference than any single ingredient swap. Our bland dinner guide covers the wider approach.

What to Order for Nutrition

Thai food does well here once the few cautions are handled.

Tom yum and tom kha are warm, savoury and hydrating, which suits first trimester eating better than almost anything.

Cashew and peanut dishes bring plant protein, iron and healthy fats. Peanuts are safe in pregnancy unless you are allergic, and the old advice to avoid them was withdrawn years ago.

Prawn and fish dishes are cooked and low in mercury, and oily fish is actively encouraged in pregnancy. Our prawn guide covers the detail.

Vegetable-heavy stir fries deliver fibre, which matters more than usual when pregnancy slows digestion.

The two things to watch are sodium, which is high in fish sauce and soy and shows up as swollen fingers by evening, and the sugar in sweeter dishes like pad thai and mango sticky rice. Our swelling guide covers the first.

If you would rather cook a version at home, our fakeaway guide includes a pad thai made with the egg fully scrambled through and the sprouts cooked in, which removes both considerations at once.

This article is general information and does not replace advice from your midwife, GP or obstetrician. If you develop a fever or stomach symptoms after eating something you are unsure about, contact your maternity team.