Although sushi is suitable to eat while breastfeeding, women should continue to avoid certain types of fish that are high in mercury. Many other types of fish, both cooked and raw, offer health benefits for both the woman and baby.
In this article, we explain the safety and risks of eating sushi and raw fish while breastfeeding.
Is sushi safe to eat while breastfeeding?
Women can eat sushi while breastfeeding.
Sushi is safe to eat while breastfeeding, as long as women eat from a reputable restaurant that uses high-quality fish from reliable sources.
If the source of the fish is not clear, it is best to ask the restaurant staff for more information.
Pregnant women need to avoid raw fish as bacteria and parasites pose a risk to the fetus.
However, there is little to no risk of these pathogens passing to a baby through breast milk, which means that sushi is safe to consume while breastfeeding.
Breastfeeding women should avoid eating any fish that contains high levels of mercury, regardless of whether that fish is raw or cooked. It is possible for some mercury to pass to a baby through breast milk.
Although the quantity of mercury reaching the breast milk would be very small, infants are particularly susceptible to toxins. Mercury can affect a growing baby's brain and nervous system.
Cooked fish and breastfeeding
Cooked fish provides many health benefits for breastfeeding women and breastfed babies. Cold-water fish, in particular, is rich in vitamin D and omega-3 fatty acids. It is also high in protein and low in saturated fat.
The health benefits of fish for infants are due primarily to its omega-3 content, which promotes good vision and cognitive development.
The Dietary Guidelines for Americans 2015–2020 recommend that breastfeeding women eat at least 8 ounces (oz) of seafood, including fish and shellfish, per week.
Best and worst fish to eat
The FDA advise that not all fish are safe for breastfeeding women to eat.
According to the United States Food and Drug Administration (FDA), some of the best fish choices for pregnant and breastfeeding women are:
- tuna, canned
The FDA recommend eating 2–3 servings per week of these fish. An adult-sized serving of fish is 4 oz.
Pregnant and breastfeeding women should avoid eating types of fish that contain high levels of mercury, such as:
- king mackerel
- orange roughy
- tilefish (from the Gulf of Mexico)
- tuna, bigeye
Women who eat large amounts of canned fish should monitor their sodium intake to ensure that it remains below the recommended limit. Even some of the fish that are safe to eat, such as anchovies, may be high in sodium when canned.
Listeria and cross-contamination
One of the mains risks of eating raw sushi is that it increases the possibility of getting a foodborne illness, such as listeriosis. Listeriosis results from infection with Listeria monocytogenes bacteria.
Symptoms of listeria infection include:
Pregnant women who get listeriosis can pass the pathogen to the developing baby through the placenta, which can result in stillbirth, pregnancy loss, or preterm labor.
Listeria is less of a concern for breastfeeding women because the bacteria do not pass through the breast milk to the baby.
Cross-contamination is another risk associated with eating sushi. Cross-contamination occurs when the people working in restaurant kitchens use the same tools to prepare cooked and uncooked fish.
People who order cooked fish may get sick due to bacteria and pathogens that have transferred to their meal from raw fish.
Alternatives to fish sushi
Women who want to avoid eating fish can have vegetarian sushi rolls.
For women who enjoy sushi but do not want to eat raw fish while breastfeeding, vegetarian sushi options provide a tasty alternative.
For example, women can choose vegetable maki rolls containing avocado, cucumber, and pickled daikon and top them with wasabi and soy sauce to taste.
Other vegetarian choices include vegetable nigiri and inari.
It is worth noting that these vegetarian options do not contain certain nutrients, such as omega-3 fatty acids or vitamin D, but these nutrients are available from other sources.
Avoiding food-related illness while pregnant or breastfeeding
Pregnant and breastfeeding women can reduce their risk of becoming unwell from eating sushi or other foods by doing the following:
- Eating at reputable restaurants.
- Asking restaurant staff where they source their fish and how they handle their foods.
- Practicing safe food-handling techniques when preparing food at home by using different utensils and surfaces for raw and cooked foods.
- Washing the hands thoroughly after touching fish or meat that is raw.
- Avoiding foods with expired use-by dates.
- Keeping the refrigerator at the correct temperature and cleaning it out regularly to avoid bacterial growth.
Pregnant women who miss having sushi can have small balls of sticky rice and vegetables without fish.
Once the baby is born, women no longer have to avoid sushi as it is safe to eat while breastfeeding.
Eating fish, whether raw or cooked, can provide several benefits to both a breastfeeding woman and the breastfed baby.
In particular, omega-3 fatty acids and vitamin D are essential for developing infants.
Breastfeeding women should aim to eat at least 8 oz of fish each week. However, it is vital to avoid eating fish that is high in mercury, as this heavy metal can pass through breast milk to the infant and cause harm.
When eating sushi at a restaurant, it is wise to ask about the source of the fish and the restaurant's safe-handling policy to reduce the risk of cross-contamination or listeria infection.