Is It Safe to Eat Fish During Your Pregnancy?

a plate of fish garnished with lemon, tomatoes, and herbs
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Should you eat fish while pregnant, or avoid it altogether? Pregnant women get lots of conflicting messages about which foods they should and should not eat, especially when it comes to fish. We're here to set the record straight.

Why You Can Say "Yes" to Fish

While individual women will have varying dietary restrictions, by and large, fish can (and should) be a healthy part of a pregnant woman's diet. Fish are a healthy, lean source of protein. Plus, fish contains many other important nutrients, such as calcium, iodine, and vitamin D. Most importantly, many fish are high in docosahexaenoic acid (DHA), a type of omega-3 fatty acid that's essential for growing babies to ensure proper brain and eye development.

DHA and its omega-3 cousin eicosapentaenoic acid (EPA) are found primarily in fish and seafood. Plus, DHA from fish is precisely the type of omega-3 fatty acid that the majority of pregnant women need in their diets. 

Aren't There Plenty of Plant Sources of Omega-3s?

There are plant sources of omega-3s, which make good alternatives for people who follow a vegetarian or vegan diet or those who just don't like or can't eat fish for other reasons. Plant sources of omega-3 fatty acids include flaxseeds, pumpkin seeds, soy, and walnuts. Lesser amounts are found in other seeds and plant-based foods. However, the omega-3s found in fish are thought to be best for a baby's development.

The difference is that the plant form, called alpha-linolenic acid (ALA), isn't the type of omega-3 fatty acid that humans need. Instead, your body has to convert it to EPA or DHA, which is a less efficient way to get this nutrient. Most of the time, the body does an excellent job with this conversion. However, when you’re pregnant or breastfeeding, your body needs extra DHA and might not be able to convert enough from plant sources for both you and your baby. So, for pregnant or breastfeeding women, consuming DHA from fish is arguably a better, more efficient way to meet those dietary needs. 

Alternatively, a person can take DHA supplements, which are usually made from fish oil (or algae if you prefer a vegetarian/vegan version). But, when possible, the optimal way to get enough omega-3s is to eat low-mercury fish and seafood. 

Fish Is Safe for Pregnant Women

Fish is safe for pregnant women, as long as you choose the right fish. In the past, experts have told pregnant women not to eat fish and seafood for fear of mercury contamination. That fear is well-founded, but not all fish are high in mercury. Fish with low mercury concentration, such as salmon, shrimp, crab, and haddock, are safe and recommended for moms-to-be.

In fact, in 2014, the U.S. Food and Drug Administration and the U.S. Environmental Protection Agency drafted the following recommendation:

"Pregnant and breastfeeding women, those who might become pregnant, and young children should eat more fish that is lower in mercury in order to gain important developmental and health benefits."

Skip Undercooked, Raw, and Smoked Fish

That said, pregnant women are advised to only eat fish cooked up to 145 degrees in order to kill any bacteria or viruses that may be present in the fish that could make you and your baby sick. (Pregnant women should also avoid raw or undercooked meat and poultry for the same reasons.)

This means not eating raw or undercooked fish, such as raw or rare tuna. This ban includes sushi unless you choose options prepared with cooked fish, such as unagi, which is made with grilled eel.

Additionally, while canned smoked seafood is safe to eat (although often high in sodium), pregnant women should not eat uncanned smoked fish. The risk with uncanned smoked fish, such as lox or smoked trout, is that it may contain listeria, a bacteria that can be dangerous for you and your baby. While contracting listeriosis (the infection caused by listeria) is rare, it can cause serious complications including death, miscarriage, or stillbirth.

How Much Fish Should Pregnant Women Eat?

The joint FDA and EPA recommendation suggests that pregnant and nursing women eat 8 to 12 ounces of low-mercury fish each week. That’s about two to three servings of fish or seafood per week. The report says, "Choices lower in mercury include some of the most commonly eaten fish, such as shrimp, pollock, salmon, canned light tuna, tilapia, catfish, and cod."

When eating fish caught from local streams, rivers, and lakes, follow fish advisories from local authorities. If advice isn’t available, limit your total intake of such fish to 6 ounces for adults and 1 to 3 ounces for children per week.

Pregnant women (and everyone else, for that matter) should avoid some specific high-mercury fish, including tilefish from the Gulf of Mexico, shark, swordfish, and king mackerel. Plus, it's recommended to have no more than 6 ounces of white albacore tuna per week.

A Word From Verywell

Low-mercury fish and seafood make ideal meals for pregnant women as they are typically low in calories but high in protein, vitamins, and minerals. Even better, the fats they contain are stocked with highly beneficial omega-3s, which are vital for your healthy fetal development. Most meat-eaters would benefit from swapping out some of their red meat for fish.

When adding fish to your diet, the biggest concern is choosing low mercury varieties and ensuring safe cooking and storage methods. Beyond that, all you need to do is enjoy—both the fish and the knowledge that your growing baby is getting the omega-3s they need.

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