Fish: What Pregnant Women and Parents Should Know

Source: U.S. Food and Drug Administration

If you’re pregnant, you’ve no doubt been given a list of foods to avoid—undercooked meat, soft cheeses made from unpasteurized milk, and alcohol, to name a few. The good news is that there is a food you should have more of while pregnant and while breastfeeding: fish and shellfish. The latest science shows that eating fish low in mercury during pregnancy and in early childhood can help with growth and neurodevelopment. It can also be good for your health.

That’s why in June 2014 the Food and Drug Administration (FDA) and the Environmental Protection Agency (EPA)  issued draft revised advice encouraging pregnant women, those who might become pregnant, breastfeeding mothers and young children to eat more fish—and to eat a variety of fish lower in mercury.

It’s an important recommendation. An FDA analysis of data from U.S. pregnant women surveyed about seafood consumption showed that they ate far less fish than the 2010 Dietary Guidelines for Americans recommend. (The guidelines are the federal government’s most recent science-based advice for how to choose a healthy eating pattern.) In fact, 21 percent of the pregnant women surveyed said they ate no fish in the previous month. Of the women who ate fish in the previous month, 50 percent reported eating fewer than two ounces a week, and 75 percent reported eating fewer than four ounces per week.

“We’re updating our advice because the latest science strongly indicates that eating 8 to 12 ounces per week of a variety of fish lower in mercury during pregnancy benefits fetal growth and development,” says FDA’s Acting Chief Scientist Stephen Ostroff, M.D., noting that FDA reviewed research from the last decade.

Dr. Ostroff adds that 8 to 12 ounces is an excellent range to maximize the developmental benefits that fish can provide. “The science behind that recommendation was not available when we last issued fish consumption advice in 2004.”

The 2004 advice recommends eating up to 12 ounces of fish lower in mercury per week but doesn’t recommend a minimum amount to eat. The new draft advice does, recommending that women who might become pregnant along with pregnant and breastfeeding women eat at least eight ounces and up to 12 ounces weekly, which is two to three servings. This draft advice also extends to young children, although the amounts you serve them should be proportionally smaller.

Which Fish Should You Eat?

Fish and shellfish (collectively called “fish” for this advice) have high-quality protein, vitamins and minerals, and omega-3 fatty acids. Fish also are mostly low in saturated fat, and some have vitamin D. Eating fish during pregnancy, while breastfeeding, and in early childhood can be especially important for a child’s growth and development. Plus there is evidence that consuming fish can reduce your own risk of cardiac death.

The entire package of nutrients that fish provide may be needed to fully benefit fetal and child development. For this reason, consumers who avoid eating fish and instead take omega-3 supplements may be missing out on the full beneficial effect. Plus they miss out on other nutrients in fish that support overall health.

Eating a variety of fish helps ensure that most fish you eat will be lower in mercury. Most fish found in grocery stores are, in fact, lower in mercury, including many popular species such as shrimp, pollock, salmon, canned light tuna, tilapia, catfish and cod.

What About Mercury in Fish?

Fish do take in methylmercury (a form of mercury), and nearly all fish have traces of it. At high levels, methylmercury can be harmful, and developing fetuses can be especially sensitive to it. Young children may be sensitive as well. Some women may even limit or avoid fish because of this concern. That, however, is not what FDA and EPA recommend.

Eating a variety of fish, as FDA and EPA are recommending, will help ensure that most fish you eat will be lower in mercury. However, FDA and EPA are also recommending that women who might become pregnant, or who are pregnant or breastfeeding—along with young children—should try to avoid the four types of commercial fish with the highest levels of methylmercury: Tilefish from the Gulf of Mexico, shark, swordfish and king mackerel. This advice shouldn’t affect your eating patterns because these fish are not popular on the market.

Also remember that most fish found in grocery stores are lower in mercury, and it is these fish that have health benefits for you and your children.

Other Considerations

FDA and EPA continue to recommend that no more than six ounces of fish per week (of your 8 to 12 ounces weekly) should be white (albacore) tuna. Although canned light tuna is lower in mercury, albacore tuna has more of it. An easy way to follow this advice? Just vary the types of fish that you eat, per the overall recommendations.

And if you or someone you know goes fishing in a lake, stream, or river, follow local fish advisories. If local advice isn’t available, you should eat six ounces or less of these locally caught fish per week, and children should eat no more than one to three ounces per week. Then avoid eating other fish for the rest of the week.

The Bottom Line

“The science shows that eating fish has direct health benefits, so it’s important to get enough fish in your diet,” Ostroff says. “To obtain the health and nutrition benefits of fish, stick to the advice we’re offering, and have 8 to 12 ounces of fish lower in mercury per week as part of a balanced eating plan.”

This advice will be open for public comment, and FDA encourages feedback. See the notice of availability that published in the Federal Register for more information regarding how to submit comments.