Fish During Pregnancy: What's Safe to Eat

Fish can be one of the healthiest foods you eat during pregnancy—rich in protein, omega-3 fatty acids, and nutrients essential for your baby's brain development. But some fish contain mercury or other contaminants that can harm your developing baby. The key isn't avoiding fish entirely—it's choosing the right kinds.

Let's cut through the confusion: eating fish during pregnancy is recommended, as long as you choose wisely and watch your portions.

Why Fish Is Good for Your Baby FDA

Fish provides nutrients that are especially important during pregnancy:

Omega-3 fatty acids (DHA and EPA):

• Critical for baby's brain and eye development
• May reduce risk of preterm birth
• Support your own brain health during pregnancy
• Hard to get sufficient amounts from other foods

High-quality protein:

• Supports baby's growth
• Helps build new tissue
• Easy to digest

Other important nutrients:

• Vitamin D (many people are deficient)
• Iodine (essential for thyroid function and baby's brain)
• Iron, zinc, and B vitamins
• Low in saturated fat

What research shows:

• Children of mothers who ate fish during pregnancy score higher on cognitive tests
• The omega-3 DHA is concentrated in the brain and eyes
• Benefits outweigh risks when low-mercury fish are chosen
• Avoiding fish entirely may deprive baby of important nutrients

The Mercury Problem EPA

Mercury is the main concern with fish during pregnancy. Here's what you need to know:

Where mercury comes from:

• Industrial pollution enters waterways
• Small fish absorb mercury
• Bigger fish eat smaller fish, concentrating mercury (bioaccumulation)
• Largest predatory fish have the highest levels

Why mercury matters in pregnancy:

• Crosses the placenta to reach your baby
• Can harm developing brain and nervous system
• Effects may include learning difficulties and developmental delays
• Your body clears mercury slowly

The good news:

• Most fish are low in mercury
• Choosing the right fish lets you get benefits without significant risk
• Guidelines make it simple to choose safely
• You don't need to avoid fish—just certain types

Fish to Eat: Best Choices (Low Mercury) FDA

Eat 2-3 servings (8-12 ounces) per week from this list:

Best choices (lowest mercury):

• Salmon (wild-caught is excellent)
• Sardines
• Anchovies
• Herring
• Shrimp
• Pollock
• Tilapia
• Catfish
• Cod
• Crab
• Crawfish
• Oysters
• Scallops
• Clams
• Trout (freshwater)
• Squid
• Canned light tuna (limit to 2-3 servings/week)

Why these are safe:

• Smaller fish = less mercury accumulation
• Shorter-lived fish = less time to accumulate mercury
• Farm-raised fish are often lower in mercury (but check sources)

Fish to Limit: Good Choices (Moderate Mercury) FDA

Limit to 1 serving per week:

• Albacore (white) tuna
• Yellowfin tuna
• Mahi mahi
• Grouper
• Snapper
• Halibut
• Chilean sea bass

Note on tuna:

• Light canned tuna = lower mercury, okay 2-3 times/week
• Albacore/white tuna = higher mercury, limit to 1 serving/week
• Fresh tuna steaks = treat like albacore, limit to 1/week

Fish to Avoid Completely FDA

Do NOT eat during pregnancy:

• Shark
• Swordfish
• King mackerel
• Tilefish (Gulf of Mexico)
• Marlin
• Orange roughy
• Bigeye tuna

Why these are dangerous:

• Large, long-lived predatory fish
• Highest mercury levels
• No safe amount during pregnancy
• Not worth the risk when alternatives exist

Raw Fish: What About Sushi? ACOG

Raw fish carries additional concerns beyond mercury:

Risks of raw fish:

• Parasites and bacteria
• Listeria contamination
• Food poisoning more dangerous during pregnancy
• Your immune system is suppressed

The recommendation:

• Avoid raw fish and sushi with raw fish
• Cooked sushi rolls are generally safe
• Vegetable rolls are fine
• Smoked fish should be heated to steaming

If you love sushi:

• Choose vegetable rolls (cucumber, avocado)
• Choose cooked rolls (shrimp tempura, crab, eel)
• California rolls with imitation crab are fine
• Save sashimi for after pregnancy

How Much Fish to Eat FDA

The recommendation:

• 2-3 servings per week (8-12 ounces total)
• One serving = about 4 ounces (size of your palm)
• Mix up your choices for variety
• More is not necessarily better—stick to recommended amounts

What counts as a serving:

• 4 ounces of fish (about the size of a deck of cards plus)
• A typical restaurant portion is often 6-8 ounces
• A can of tuna is usually about 2 servings

If you don't eat fish:

• Consider fish oil supplements (talk to your doctor)
• Algae-based DHA supplements are an alternative
• Some eggs are enriched with omega-3s
• Walnuts and flaxseed have plant omega-3s (less efficiently used)

Local and Recreational Fish EPA

If you eat fish caught by family or friends, additional considerations apply:

Check local advisories:

• Local waters may have specific contamination issues
• Your state issues fish consumption advisories
• Check before eating locally caught fish
• Advisories vary by water body and fish type

General guidelines for local fish:

• Follow state/local advice over general guidelines
• If no advice is available, limit to 1 serving/week
• Avoid fish from waters with known pollution
• Remove skin and fat before cooking (some contaminants concentrate there)

Preparing Fish Safely

How you cook fish matters for food safety during pregnancy:

Safe preparation:

• Cook fish to internal temperature of 145°F (63°C)
• Fish should be opaque and flake easily
• Don't eat raw or undercooked fish
• Avoid refrigerated smoked fish unless heated

What to skip:

• Raw sushi/sashimi
• Ceviche (raw fish "cooked" in acid)
• Refrigerated smoked salmon (unless heated to steaming)
• Raw oysters and clams (cooked are fine)

Common Questions

"I ate swordfish before I knew I was pregnant. Did I harm my baby?"
A single exposure is unlikely to cause harm. Mercury damage comes from ongoing high exposure. Just avoid high-mercury fish going forward.

"Is canned fish as healthy as fresh?"
Yes! Canned salmon, sardines, and light tuna are excellent, affordable options. They count toward your recommended servings.

"What if I can't stand the smell of fish while pregnant?"
Try milder-tasting fish (cod, tilapia) or take a fish oil supplement instead. Food aversions are common—don't force yourself to eat fish if it makes you nauseous.

"Is fish oil as good as eating fish?"
Fish oil provides omega-3s but lacks the protein and other nutrients of actual fish. It's a good alternative if you don't eat fish, but eating fish when you can is ideal.

"Are fish sticks okay?"
Yes, most fish sticks are made from low-mercury fish like pollock. They count toward your recommended intake.

The Bottom Line

Fish is one of the best foods you can eat during pregnancy—when you choose wisely. The benefits of omega-3s for your baby's brain development are significant, and most fish are safe.

Simple rules:

• Eat 2-3 servings (8-12 oz) of low-mercury fish weekly
• Choose salmon, sardines, shrimp, cod, and canned light tuna most often
• Limit albacore tuna and other moderate-mercury fish to once a week
• Never eat shark, swordfish, king mackerel, or tilefish
• Cook all fish thoroughly—avoid raw fish during pregnancy

Clara is here to help you make healthy food choices throughout your pregnancy.