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Pregnancy Do’s and Don’ts: All About Fish

There are plenty of fish in the sea – even low-mercury varieties that are safe during pregnancy.
Written by the Theralogix team of Registered Dietitians
You want the best for your baby, but sometimes it’s not always clear, especially when it comes to fish and shellfish.

Unfortunately, you don’t get a “Pregnancy Rule Book” when you find out you’re pregnant. You want the best for your baby, but sometimes it’s not always clear, especially when it comes to seafood (fish and shellfish).  

Should you eat fish during pregnancy? Is it beneficial? Is it safe? Set the record straight once and for all, and find out the best ways to include seafood in your diet to support a healthy pregnancy.  

What are the benefits of eating fish?  

Fish may not make a regular appearance on your dinner table, but maybe it should. Here’s why:  

  1. It’s a great source of protein. Think of proteins as the building blocks of your body – they help build, repair, and maintain your tissues. Protein also helps support your immune system, so you stay healthy.  
  1. It’s a rich source of iodine. Iodine is a nutrient that helps produce thyroid hormone and supports brain and nervous system development. Iodine needs increase during pregnancy, and fish is an excellent way to include more iodine in your diet.  
  1. It’s chock-full of omega-3 fatty acids, particularly eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). These fatty acids are vital during pregnancy. They play a huge role in brain and eye development, and also help support healthy gestational length and birth weight. In addition, healthy levels of omega-3s may help support your mental health throughout pregnancy and the postpartum period.  

Is fish safe during pregnancy? 

Many varieties of fish are safe during pregnancy (if they’re properly cooked, of course), and the benefits of eating fish are well documented. However, certain fish may contain higher levels of environmental toxins, like mercury. Too much mercury can affect the brain and nervous system, especially in developing babies.  

While mercury is a natural part of the environment, human industrial activity has caused mercury levels to rise over the years. This mercury eventually finds its way into rivers, lakes, and the ocean, and fish absorb it from their food. Mercury “bioaccumulates” in fish, which means that fish that are higher on the food chain typically have higher levels of mercury.  

Luckily, the Food and Drug Administration (FDA) and Environmental Protection Agency (also known as EPA, but not to be confused with eicosapentaenoic acid) developed a chart to help you make safe choices when it comes to seafood.  

This chart is divided into three sections:  

  1. Best choices. These options have the lowest level of mercury. Only fish that you can safely eat three times per week made it into this category. Aim to eat 2-3 servings of these varieties each week.  
  1. Good choices. These options contain a safe level of mercury if eaten only once per week. If you choose a fish from the “good choices” category, try not to eat any other fish that week.  
  1. Choices to avoid. These types of fish are typically large, predatory fish with long lifespans. They have the highest mercury levels and should be avoided.  

You’ll notice that different species of certain fish are in multiple categories (ex: canned light tuna, albacore tuna, and bigeye tuna). Some types of tuna are bigger or live longer, so they tend to have higher mercury levels. Geographic location can also affect the mercury content of fish. This is the case with tilefish – tilefish caught in the Gulf of Mexico tend to have higher mercury levels than those caught in the Atlantic.  

Source: EPA

How much fish should you eat during pregnancy?  

The 2020-2025 Dietary Guidelines for Americans (DGA) recommend that pregnant women eat 8-12 ounces of low-mercury fish per week. 

There are plenty of ways to include omega-3 rich seafood in your diet:  

  • Whip up a simple tuna salad with canned light tuna, Greek yogurt, and your favorite seasonings.  
  • Impress your tastebuds with this easy nut crusted salmon recipe.  
  • Top your pasta or salad with grilled or air fried shrimp.  

What if you don’t eat the recommended amount of fish per week?  

Maybe fish slips your mind when you’re making your weekly grocery list, or maybe you just don’t enjoy seafood. Regardless, if you find yourself eating less than 8-12 ounces of fish per week, you’re not alone. According to the 2020-2025 DGA, most pregnant women only eat around 5 ounces of seafood per week.  

But, if you don’t get enough fish, you’re missing out on the incredible benefits of DHA and EPA. There are two other ways your body can get these important fatty acids.  

  1. Plant foods like walnuts, flaxseeds, and soybeans contain another type of omega-3 fatty acid called alpha-linolenic acid (ALA). Your body can convert ALA to EPA and DHA, but this conversion isn’t very efficient. Foods rich in ALA are still great, nutrient-packed choices to support a healthy pregnancy, but they’re not a reliable way to get enough EPA and DHA.  
  1. Omega-3 fish oil supplements can provide EPA and DHA, and many prenatal vitamins include fish oil. If you don’t enjoy fish or struggle to eat 8-12 ounces of fish weekly, make sure your prenatal vitamin provides DHA and EPA, or talk with your healthcare provider about adding a high-quality fish oil to your daily routine. 

There are plenty of fish in the sea – even low-mercury varieties that are safe during pregnancy. Fill your plate with 8-12 ounces of low-mercury fish each week to reap the benefits for you and your growing baby. If you’re concerned about your fish intake, ask your healthcare provider about taking a high-quality fish oil supplement to make sure you get enough EPA and DHA to support a healthy pregnancy.   

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