Fish for babies: best choices, mercury and bones

When babies can start fish

Fish can be one of your baby’s first foods, from around 6 months, once they’re showing the signs of readiness. The FDA and the NHS both include fish in early weaning.

Fish gives your baby protein, omega-3 fats (DHA and EPA), vitamin B12, selenium and iodine, and oily fish like salmon and sardines also provide vitamin D.

Fish is also a common allergen. There’s no benefit in delaying it, so offer it around the same time as other first foods, following the steps below.

Best choices, good choices, and fish to avoid

All fish contain some mercury. Small amounts are fine, but the NHS warns that the high levels in some fish can affect a child’s nervous system. The FDA and EPA sort fish into three groups by mercury level.

Best choices (lowest in mercury). Choose from this list most of the time. Common ones include:

• salmon, sardines, trout (freshwater), herring and Atlantic mackerel
• cod, haddock, pollock, hake, sole, flounder, plaice, whiting and tilapia
• catfish, perch and whitefish
• canned light tuna (including skipjack)
• shrimp, crab, scallops, clams and lobster

Good choices (more mercury). These include albacore (white) tuna, yellowfin tuna, halibut, snapper, grouper, mahi mahi, rockfish, Chilean sea bass and Spanish mackerel. They’re higher in mercury. For children, the FDA’s advice is 2 servings a week from the Best choices list, so stick to that list for your baby and toddler.

Choices to avoid (highest in mercury). Don’t give children:

• shark, swordfish or marlin (the NHS says babies and children under 16 should avoid them)
• king mackerel, orange roughy, bigeye tuna, or tilefish from the Gulf of Mexico

Albacore (“white”) canned tuna has about three times more mercury than canned light tuna, so light tuna is the better everyday pick.

Fish caught by family or friends: check local fish advisories. If there’s no advice for that water, the FDA says children under 6 should have no more than 1 to 2 oz of that fish in a week, and no other fish that week.

How much and how often

For children aged 1 to 3, the FDA suggests 2 servings of fish a week from the Best choices list, with a serving of about 1 oz (28 g).

The FDA doesn’t give a serving size for babies under 12 months. Start with a small amount, a few flakes, and let your baby decide how much to eat. Breast milk or formula is still their main food.

In the UK, the NHS sets weekly limits on oily fish (salmon, trout, mackerel, sardines, herring, pilchards and sprats) because of pollutants that can build up in the body. It suggests up to 4 portions a week for boys and no more than 2 portions a week for girls. On the NHS fish page a portion is about 140 g (5 oz), an adult serving, so babies and toddlers eat much less each time. See the US and UK section below.

Cooking fish safely

Young children are more likely to get seriously ill from food poisoning, so fish for babies and toddlers should always be fully cooked.

• Cook fish to 145°F (63°C) in the thickest part, or until it’s opaque all the way through and flakes easily with a fork.
• Cook shellfish until the flesh is pearly or white and opaque, or until shells open.
• Never serve raw or undercooked fish or shellfish, such as sushi, sashimi, poke, ceviche or raw oysters.
• Skip smoked fish like smoked salmon and lox. It’s high in salt, and cold-smoked fish isn’t cooked. The one exception is from 12 months: a small amount cooked into a hot family dish now and then. The FDA says children should avoid refrigerated smoked seafood except in a cooked recipe, such as a casserole.
• No added salt. Bake, steam, grill or poach fish without salt. Choose canned fish packed in water with no added salt, and drain it. The NHS notes that baked, steamed or grilled fish is a healthier choice than fried or battered fish.

Thaw frozen fish in the fridge overnight, and keep raw fish away from cooked and ready-to-eat food.

Bones: check every flake

Fish bones are a choking hazard, and pin bones are thin and easy to miss.

• Feel every flake with your fingers before serving, even fillets sold as boneless.
• Remove the skin for babies.
• Canned salmon and sardines contain bones. Boneless, skinless canned salmon is easiest, but still check every flake. Otherwise, lift out the backbone and any larger bones, mash only the small soft bones completely flat with a fork, and remove any bone that is still hard.
• In mixed dishes like fish pie, pasta or fish cakes, check the fish before you mix it in.

Serving fish by age

6 months+: large, soft flakes, or fish cakes shaped like a finger, about 6–8 cm long and 2 cm wide (2½–3 × ¾ in). You can also mash flaked fish into potato or another food your baby already eats. The fish should squash easily between your thumb and finger. Shellfish like shrimp, scallops, clams and lobster are firmer: never serve them whole, and finely chop or mash them into another soft food.

9 months+: small, boneless flakes of fish, or finely chopped shellfish, no bigger than about 1 cm (just under ½ inch) for your baby to pick up, or stirred into rice or pasta.

12 months+: bite-sized pieces about 1 cm (just under ½ inch), fish cakes, or fish in family meals. Keep checking for bones.

For a full walkthrough of one fish, see salmon.

Introducing fish as an allergen

• Pick a day your baby is well, at home, when you can watch them for a couple of hours afterward.
• Offer a small amount of one type of fish on its own first. The FDA suggests watching for signs of allergy for several days before giving fish a second time.
• If your baby reacts to one fish, talk to your pediatrician before offering others. People allergic to one fish often react to other kinds.
• Shellfish is a separate allergen from fish. Introduce it on its own, on another day, fully cooked and finely chopped.

Fish can also cause FPIES, a delayed reaction that causes repeated vomiting a few hours after eating, often with paleness or floppiness. If your baby vomits once or twice a few hours after fish and is alert and like themselves, call your pediatrician or GP. Call 911 or go to the emergency room if your baby is vomiting again and again, or is pale, floppy, very sleepy or hard to wake.Call 999 or go to A&E if your baby is vomiting again and again, or is pale, floppy, very sleepy or hard to wake.Call your local emergency number (such as 112 in Europe or 000 in Australia) or go to the emergency department if your baby is vomiting again and again, or is pale, floppy, very sleepy or hard to wake. See FPIES. For hives, swelling or trouble breathing, see signs of anaphylaxis. For all the common allergens, see how to introduce allergens.

Where US and UK advice differs

• Which fish to limit. The FDA uses three mercury lists (Best, Good, Avoid). The NHS names fewer fish: children under 16 should avoid shark, swordfish and marlin.
• How much. The FDA suggests about 1 oz of fish, twice a week, for ages 1 to 3, and doesn’t give a serving size for babies under 12 months. The NHS limits oily fish to up to 4 portions a week for boys and 2 for girls, using a 140 g adult portion. Treat these as a maximum number of small servings, not as 140 g portions.
• Girls and oily fish. The NHS gives girls a lower limit than boys because pollutants in oily fish can build up in the body and may affect a baby in a future pregnancy. US advice doesn’t separate boys and girls.
• Tuna. The FDA lists canned light tuna as a Best choice and albacore as a Good choice. The NHS says tuna doesn’t count as oily fish.