Is It Safe to Eat Fish During 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 people get lots of conflicting messages about which foods they should and should not eat, especially when it comes to fish. So we're here to set the record straight.

Say "Yes" to Fish

While individuals will have varying dietary restrictions, by and large, fish can (and should) be a healthy part of a pregnant person's diet. This is because fish is 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 essential for proper brain and eye development in babies. DHA and its omega-3 cousin eicosapentaenoic acid (EPA) are found primarily in fish and seafood.

How the Body Uses Omega-3s

DHA from fish is precisely the type of omega-3 fatty acid that most pregnant people need in their diets. However, there are plant sources of omega-3s, which make good alternatives for people who follow a vegetarian or vegan diet or 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 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, consuming DHA from fish is arguably a better, more efficient way to meet those dietary needs for pregnant or breastfeeding people. 

Alternatively, you can take DHA supplements, 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. 

Eat Safer Fish

Fish is safe in pregnancy as long as you choose the right fish. In the past, experts have suggested avoiding fish and seafood during pregnancy for fear of mercury contamination. That fear is well-founded, but not all fish are high in mercury. Fish with low mercury concentrations, such as salmon, shrimp, crab, and haddock, are safe and recommended for parents-to-be.

The U.S. Food and Drug Administration (FDA) and the U.S. Environmental Protection Agency (EPA) recommends eating low-mercury fish and other protein-rich foods because they can help fetal growth and development.

Avoid Certain Fish

That said, pregnant people are advised only to eat fish cooked to 145 degrees F to kill any bacteria or viruses present in the fish that could make you and your baby sick. (Pregnant people 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, made with grilled eel.

Additionally, while canned, smoked seafood is safe to eat (although often high in sodium), pregnant people 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.

Limit Your Fish Consumption

The joint FDA and EPA recommendation suggests eating eight to 12 ounces of low-mercury fish each week if you are pregnant or breastfeeding. That’s about two to three servings of fish or seafood per week. 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 advisories from local authorities. If advice isn’t available, limit your total intake of such fish to four ounces for adults (one to two ounces for children) per week.

Whether or not you're pregnant, 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 four ounces of white albacore tuna per week.

A Word From Verywell

Low-mercury fish and seafood make ideal meals for pregnant people 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 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.

1 Source
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  1. U.S. Food and Drug Administration. Advice about eating fish.

Additional Reading

By Shereen Lehman, MS
Shereen Lehman, MS, is a healthcare journalist and fact checker.