Questions & Answers from the FDA/EPA Advice about Eating Fish for Those Who Might Become or Are Pregnant or Breastfeeding and Children Ages 1 to 11 Years
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FDA and EPA have issued advice regarding eating fish. This advice can help those who might become or are pregnant or breastfeeding as well as parents and caregivers who are feeding children make informed choices when it comes to the types of fish and shellfish (collectively referred to as fish) that are nutritious and safe to eat. This advice supports the recommendations of the Dietary Guidelines for Americans.
The advice features a chart that makes it easy to choose dozens of healthy and safe options and includes information about the nutritional value of fish. A set of frequently asked questions & answers (below) provides more information on how to use the chart and additional tips for eating fish.
II. SERVINGS
III. CHILDREN
VI. WHAT ABOUT TUNA?
VII. FISH CAUGHT BY FAMILY AND FRIENDS
VIII. ADDITIONAL TIPS FOR EATING FISH
IX. REFERENCES
I. USING THE CHART
1. How do I use the chart?
Fish provide protein, healthy fatty acids, and many vitamins and minerals—and lower mercury fish are a good choice for everyone. This advice is specifically for those who might become or are pregnant or breastfeeding and children, but everyone can follow this advice.
Use the chart to help you choose which fish to eat or feed your child each week. Eating a variety of fish is better for you and your child than eating the same type of fish every time.
As an adult who is or might become pregnant or is breastfeeding, you should eat 2 to 3 servings a week of fish in the “Best Choices” category, based on a serving size of four ounces, in the context of a total healthy diet.
You can eat 1 serving a week of fish in the “Good Choices” category, but no other fish that week.
You should not eat fish in the “Choices to Avoid” category, and parents and caregivers should not feed them to children. However, if you do eat or serve fish in the “Choices to Avoid” category, choose fish with lower mercury levels going forward.
2. How did you decide which fish went in each category?
We took a cautious and highly protective approach in determining which types of fish belonged in each category. We calculated how many servings the average person who was pregnant could eat in a week using information on mercury content of each fish type from FDA’s database for commercial fish and other sources. If that fish type could be eaten at least three times a week, then we listed it in the “Best Choices” category. If that fish type could be eaten only once or twice a week, but not three times a week, then we listed it in the “Good Choices” category. If a serving of that fish type could not be eaten once a week, then we listed the fish in the “Choices to Avoid” category.
For more information, please see our technical page.
3. How can some fish types be in more than one category?
There are different types (or species) of tuna, such as albacore, bigeye, and yellowfin. Some types of tuna that are bigger or live longer tend to have higher mercury levels, and that is why they are in different categories. So, canned light tuna is in the “Best Choices” category, albacore (or white) tuna and yellowfin tuna are in the “Good Choices” category, and bigeye tuna is in the “Choices to Avoid” category. In addition, fish from the same species that are caught in different geographic locations can vary in mercury content. For example, tilefish are in two categories because tilefish in the Gulf of Mexico have higher mercury levels than those in the Atlantic Ocean.
4. Why are some fish types not on the chart?
If you are looking for a species of fish that is not on the chart, such as mussels, that means we did not have enough reliable mercury data to include it. We plan to update the website if more data become available and as resources permit.
5. How can I find out more details on the mercury levels in fish?
Go to our more detailed table that shows the average mercury levels in commercial fish.
II. SERVINGS
1. What is a serving?
For adults, a typical serving is 4 ounces of fish, measured before cooking. Our advice is to eat 2 to 3 servings of a variety of cooked fish, or about 8 to 12 ounces, in a week. Please see III. CHILDREN below for information specific to children.
2. How can I tell how much 4 ounces is?
Four ounces is about the size and thickness of an adult’s palm.
3. What happens if I eat less fish than the 2 to 3 servings a week you recommend?
You could miss out on the protein, healthy omega-3 and omega-6 fatty acids, minerals, and vitamins present in fish that are beneficial to overall health. Omega-3 and omega-6 fatty acids, vitamin D, iron, zinc, iodine, and choline found in fish are particularly important for those who are pregnant or breastfeeding and children. If you do not eat the recommended amount one week, try to eat the recommended amount from a variety of fish in the following weeks. However, it is possible to meet your nutrient needs through other foods that are sources of these nutrients. A healthy eating pattern consists of choices across all food groups (vegetables, fruits, grains, dairy, and protein foods which can include nutritious options other than fish).
4. What happens if I eat more than 3 servings of fish in a week?
Try to vary the fish you eat. If you eat more than 3 servings in a week, eat fish in the “Best Choices” category. If some choices are fish with higher mercury levels, try to eat fish with lower mercury levels in the following weeks.
5. Should I make any changes to the advice based on my weight?
The advice provided here is intended as a general guideline. For adults who weigh less than the average used to develop our advice (165 pounds), eating smaller portions or eating just two servings of fish a week from the “Best Choices” category can keep your mercury intake within the limits of our advice. For example, you could eat 2.5 ounces three times a week or you could eat 4 ounces two times a week. Please see below for advice for children.
6. How much fish does the Dietary Guidelines for Americans recommend?
The Dietary Guidelines for Americans recommends at least 8 ounces of fish per week (based on a 2,000 calorie diet) and less for children. Those who might become or are pregnant or breastfeeding should eat between 8 and 12 ounces of a variety of fish per week, from choices that are lower in mercury.
III. CHILDREN
1. Should children eat fish and if so, how much?
Yes. Fish have important nutrients that can help your child’s growth and development. We recommend children eat 2 servings of fish per week from a variety of “Best Choices,” but the portion sizes should be smaller than adult portions and right for your child’s age and body weight. On average, a serving size is about 1 ounce for children ages 1-3 years, 2 ounces for children ages 4-7 years, 3 ounces for children ages 8-10 years, and 4 ounces for children 11 years and older.
For some children, the healthy dietary patterns in the Dietary Guidelines for Americans (Tables A3-1 and A3-2) include more fish than our advice. To consume those higher amounts, children should only be fed fish from the “Best Choices” list that are even lower in mercury – these fish are anchovies, Atlantic mackerel, catfish, clams, crab, crawfish, flounder, haddock, mullet, oysters, plaice, pollock, salmon, sardines, scallops, shad, shrimp, sole, squid, tilapia, trout, and whiting.
2. When can I start giving my child fish?
According to the Dietary Guidelines for Americans, you can introduce nutritious foods like fish to complement human milk or infant formula in your baby’s diet once they are about 6 months of age. Starting around that time, complementary foods are necessary to ensure adequate nutrition and exposure to flavors, textures, and different types of foods. Give your baby age-and developmentally-appropriate foods to help prevent choking (advice from CDC and USDA). Signs that your baby is ready for complementary foods include:
- Being able to control head and neck
- Sitting up alone or with support
- Bringing objects to the mouth
- Trying to grasp small objects, such as toys or food
- Swallowing food rather than pushing it back out onto the chin.
3. How should I start giving my child fish?
Fish is a common food allergy. Introduce fish and shellfish while watching for signs of an allergy for several days before feeding your child fish a second time. If there is a history of food allergy in the family or your child develops any signs of food allergy, consult with your child’s doctor or nurse. There is no evidence that delaying introduction of allergenic foods, beyond when other foods are introduced, helps to prevent food allergy.
IV. NUTRIENTS IN FISH
1. What nutrients are in fish and why are they good for you?
Most fish are an excellent source of protein. Most of the fat that is present in fish is healthy polyunsaturated fat. The polyunsaturated omega-3 fatty acids, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), and omega-6 fatty acids are present in many types of fish and - along with iron, iodine, and choline - are among the key nutrients needed for the rapid brain development that occurs in early childhood. Fish are important sources of selenium, zinc, and other minerals needed by the body. Fish are also natural sources of many B vitamins, like vitamin B12, and oily fish provide vitamins A and D. Iron and zinc also support children’s immune systems, and choline also supports development of the baby’s spinal cord.
2. Why does the Dietary Guidelines for Americans recommend fish as part of a healthy eating pattern?
Strong evidence shows that eating fish, as part of a healthy eating pattern, may provide heart health benefits. Moderate scientific evidence shows that eating patterns relatively higher in fish but also in other foods, including vegetables, fruits, legumes, whole grains, low- or non-fat dairy, lean meats and poultry, nuts, and unsaturated vegetable oils, and lower in red and processed meats, sugar-sweetened foods and beverages, and refined grains, are associated with the promotion of bone health, decreased risk of becoming overweight or obese, and decreased risk for colon and rectal cancers. Fish intake during pregnancy is recommended because moderate evidence shows it can help the baby’s cognitive development.
3. Can I get the same benefits from omega-3 supplements than from eating fish?
Omega-3 fatty acids are among the key nutrients needed for the rapid brain development that occurs in early childhood. However, omega-3 supplements do not provide the protein, omega-6 fatty acids, vitamins, or minerals found in fish that are also important to your health and your child’s development. Taking supplements instead of eating fish means that you would be missing out on those additional nutrients present in fish that are beneficial to you and/or a child. The research is still underway on the health benefits of omega-3 supplements.
V. CONTAMINANTS IN FISH
1. What are mercury and methylmercury?
Mercury is an element that occurs naturally in the environment and is also released to the environment through many types of human activity. It can collect in streams, lakes, and oceans, and is turned into methylmercury in the water or sediment. It is this type of mercury that is present in fish. Methylmercury can be harmful to the brain and nervous system if a person is exposed to too much of it over time.
2. Is there methylmercury in all fish?
Nearly all fish contain at least traces of methylmercury. Fish absorb methylmercury from the food they eat. It tends to build up more in some types of fish than others, especially in larger fish that eat other fish and those fish that live longer.
3. Should I not eat fish in order to avoid mercury?
No. Fish can contribute to a healthy diet. Studies with people who were pregnant found that the nutritional benefits of fish were important for their child’s brain development. While it is important to limit mercury in the diets of those who are pregnant or breastfeeding and children, many types of fish are both nutritious and lower in mercury. Most individuals, including those who are pregnant or breastfeeding and children, eat less than the recommended amount of fish. On average, individuals who are pregnant eat only 4.2 ounces and those who are breastfeeding eat only 7 ounces of fish a week, rather than the recommended amount of 8 to 12 ounces per week. Almost all children do not eat the recommended amount of fish. The chart in this advice shows which fish are the “Best Choices” for those who might become or are pregnant or breastfeeding and for children.
4. Can cleaning or preparing (e.g., cooking) my fish reduce the amount of mercury that might be present?
No. Mercury is found throughout the tissue in fish, so cleaning or cooking will not reduce the amount of mercury. The way to reduce the amount of mercury is to eat the fish shown on the chart identified as the “Best Choices.”
For fish purchased whole in stores please see additional information in the response to Question V.6.
5. Should I be concerned if I eat one serving of the fish listed in the “Choices to Avoid” category?
No, but going forward, you should choose from fish from the “Best Choices” or “Good Choices” categories. Try to avoid eating the “Choices to Avoid” fish or feeding them to children. We recommend you eat a variety of fish from the “Best Choices” and “Good Choices” categories on the chart.
6. Are there other contaminants in fish?
Yes, however, FDA has found that the levels of other contaminants in commercial fish generally do not raise human health concerns. For many years, FDA has sampled and tested commercial fish for pesticides and industrial chemicals as well as other heavy metals besides mercury and the results are available on FDA’s website:
Levels of other contaminants vary by location and fish species. State and local health departments or fish and game agencies provide advice on other contaminants, such as polychlorinated biphenyls (PCBs) in fish from particular bodies of water. People who catch their own fish for recreation or as a source of protein in their diets should check for fish and shellfish advisories for both fresh and marine waters.
It is a good idea to remove skin, fat, and internal organs where other types of harmful pollutants may accumulate for fish you and your friends catch before you cook these fish. This is particularly true because fish from some local waters may be more likely to contain other contaminants.
And remember - eat a variety of fish, not just the same type every time you eat fish. There are plenty of fish shown on the chart to choose from, so there are fish for every taste.
VI. WHAT ABOUT TUNA?
1. What is the difference between albacore (white) tuna and canned light tuna?
Albacore, or white tuna, is larger and lives longer than the fish generally used in canned light tuna. Meanwhile, canned light tuna can be a mix of a variety of generally smaller tuna species, most often skipjack.
2. I eat a lot of tuna, especially canned light tuna because it is particularly affordable. Is this okay?
Yes. Canned light tuna is in the “Best Choices” category and it is fine to eat 2 to 3 servings per week. We recommend that you eat a variety of fish. You may wish to try other affordable fish in the “Best Choices” category such as canned salmon or sardines, frozen fish, or fresh fish that are at a reduced price.
3. I eat a lot of tuna but prefer to eat albacore tuna. Is this okay?
Albacore tuna, also known as white tuna, typically contains three times more mercury than canned light tuna. When you eat albacore or any of the other fish from the “Good Choices” category, have only 1 serving and no other fish that week.
VII. FISH CAUGHT BY FAMILY AND FRIENDS
1. What if I eat fish caught by family and friends?
When eating fish you or others have caught, pay attention to fish advisories on those water bodies. There are waters where there may have been little or no monitoring and, therefore, the extent of potential mercury contamination is unknown. If advice isn’t available, you should limit your consumption of that fish to one serving per week and not eat any other fish that week. Adults should eat no more than 6 ounces that week, children under the age of six should limit their consumption of these fish to 1 to 2 ounces per week, and older children (ages six to twelve) should limit their consumption to 2 to 3 ounces per week. Again, neither adults or children should eat other fish that week.
2. Where do I get information about the safety of fish caught by family or friends?
Check the applicable fishing regulations booklet or website for information about recreationally caught fish. Local, state, and tribal health departments and fish and game agencies also have information about advisories for consuming fish in their jurisdiction. The department that provides information about fish consumption advisories is often different from the one that has information on shellfish bed closures. Different agencies might also be responsible for information about freshwater (inland) fish and marine (coastal) fish. See also EPA’s website about fish consumption advisories and links to websites for state, territorial, and tribal fish advisories.
VIII. ADDITIONAL TIPS FOR EATING FISH
1. How does eating 2 to 3 servings of fish a week fit within a healthy eating pattern?
The Dietary Guidelines for Americans recommends that those who are pregnant or breastfeeding eat 8 to 12 ounces (2 to 3 servings) per week of a variety of fish lower in mercury. Fish should be eaten in place of other protein sources, such as some meat and poultry. This may also mean paying attention to how the fish are prepared. Broiled fish, for example, typically contain fewer calories than fried fish and can be healthier in other ways as well. Sodium and cholesterol content from the fish or from the cooking process should also be considered as with other aspects of healthy eating. If you are uncertain about what the right number of calories is for you, please visit www.myplate.gov for information regarding appropriate caloric intake (specific information available at MyPlate Plan). If you want more information, we recommend that you consult a nutritionist or your physician.
2. Is it true that those who are pregnant and children should avoid raw fish?
Yes. The Dietary Guidelines for Americans and FDA recommend that those who are pregnant and children should only eat foods with fish, meat, poultry, or eggs that have been cooked to safe internal temperatures to protect against microbes that might be in those foods. This includes not eating raw fish, like that found in some sushi or sashimi, available in many restaurants and food stores. Those who are pregnant and children often have weaker immune systems and are more at risk for foodborne illnesses.
3. What if I cannot or do not eat fish? Will my baby be okay?
Fish are one source of protein, omega-3 and omega-6 fatty acids, minerals, and vitamins that are beneficial to overall health. You can have a healthy baby even if you don’t eat fish. A healthy eating pattern consists of choices across all food groups (vegetables, fruits, grains, dairy, and protein foods which can include nutritious options other than fish).
4. I might have children in the future but I'm not pregnant. Why should I follow this advice?
If you might become pregnant in the next year, we encourage you to begin following this advice now. Eating 2 to 3 servings a week of a variety of fish lower in mercury can help your child’s growth and development during pregnancy, and following the recommendations for how often to eat the various fish types is also important. That’s because mercury in fish can accumulate in your body over time. While mercury is removed from the body naturally, the process can take several months. So, following this advice before pregnancy can benefit the developing child, especially during the important first trimester.
5. What advice do you have about eating fish for those who are not pregnant, will not become pregnant, or are not breastfeeding?
Fish are a source of many nutrients and part of a healthy eating pattern. This advice is specifically for those who might become or are pregnant or breastfeeding and children. The Dietary Guidelines for Americans recommends at least 8 ounces of fish per week (based on a 2,000 calorie diet) for adults. Eating fish may provide heart health benefits. Healthy eating patterns that include fish may have other benefits, too. Moderate scientific evidence shows that eating patterns relatively higher in fish but also in other foods, including vegetables, fruits, legumes, whole grains, low- or non-fat dairy, lean meats and poultry, nuts, and unsaturated vegetable oils, and lower in red and processed meats, sugar-sweetened foods and beverages, and refined grains are associated with the promotion of bone health, decreased risk of becoming overweight or obese, and decreased risk for colon and rectal cancers. Fish intake during pregnancy is recommended because moderate evidence shows it can help the baby’s cognitive development.
6. Does this advice consider fishery sustainability issues?
No. This advice focuses on the benefits of fish consumption and the number of fish servings per week that could be eaten based on mercury levels in fish. This advice does not reflect concerns about fishery sustainability issues. For more information, see the National Oceanic and Atmospheric Administration’s website at http://www.fishwatch.gov.
IX. REFERENCES
Dietary Guidelines for Americans, 2020-2025 available at https://www.dietaryguidelines.gov/
Dietary Guidelines Advisory Committee. 2020. Scientific Report of the 2020 Dietary Guidelines Advisory Committee: Advisory Report to the Secretary of Agriculture and the Secretary of Health and Human Services. U.S. Department of Agriculture, Agricultural Research Service, Washington, D.C. Available at https://www.dietaryguidelines.gov/2020-advisory-committee-report.