Fish in Pregnancy in India: Which Fish Are Safe and Which to Avoid

Quick answer: Yes, most Indian fish are safe in pregnancy if they are fresh and cooked right through. Rohu, catla, pabda, sardine, small mackerel (bangda) and prawns are generally low in mercury. Avoid shark, swordfish, marlin and king mackerel, which are high in mercury, and avoid raw or undercooked fish. Aim for about two to three palm-sized servings a week.

Why fish is worth eating in pregnancy

Fish gives you protein, iodine and omega-3 fats. The omega-3 fat called DHA helps your baby's brain and eyes develop. That is why health bodies such as the NHS and the US Food and Drug Administration (FDA) encourage pregnant women to eat fish, rather than to avoid it. The aim is to choose fish that are low in mercury and to cook them safely.

Why some fish are a problem

Mercury is a metal that builds up in fish. Large fish that live a long time and eat other fish collect the most. In high amounts, mercury can harm a baby's developing nervous system. Small fish and fish that feed on plants carry much less.

The second risk is germs. Raw or undercooked fish and shellfish can carry bacteria such as listeria, which can cause miscarriage, stillbirth or serious illness in a newborn, according to the NHS.

Indian fish in pregnancy: a quick guide

The FDA and NHS lists were made for fish sold in the US and UK, so not every Indian fish is named. Where a fish is not listed, this guide matches it to a close relative or to its size and diet. Treat it as a guide, and ask your doctor if you are unsure.

Lower-mercury fish you can eat in the usual amount

• Sardine (mathi, tarli). The FDA lists sardine as a lower-mercury choice. It is also an oily fish, rich in omega-3.
• Small mackerel (bangda, ayala, bangude). Indian mackerel is a small fish. The FDA lists the small Atlantic and Pacific chub mackerel as lower-mercury choices, and Indian mackerel is a similar small species. It counts as an oily fish.
• Catfish (pabda, magur, singhi). The FDA lists catfish as a lower-mercury choice.
• Anchovy (netholi, nethili, mandeli) and mullet. Both are on the FDA lower-mercury list.
• Prawns, shrimp, crab and squid. The NHS says cooked shellfish are safe in pregnancy. Cook prawns until they are pink and steaming hot.
• Hilsa (ilish). Hilsa is a type of shad, and the FDA lists shad as a lower-mercury choice. It is oily, so count it towards your oily fish limit, and take out the many fine bones with care.

Fish to eat in smaller amounts

• Rohu, catla and other carp (mrigal, common carp). The FDA places carp in its "good choices" group, which means about one serving a week from that group. Freshwater carp feed low in the food chain, so mercury is not the main worry. Buy from a seller you trust and cook thoroughly, because pond and river fish can carry germs and parasites.
• Seer fish (surmai, vanjaram, neymeen). It is sold as "kingfish" in many places. It is a large fish in the mackerel family, and it is related to the king mackerel that the FDA tells pregnant women to avoid. Larger fish hold more mercury, so keep seer fish to an occasional portion, or choose a smaller fish.
• Tuna. The NHS says to have no more than 4 cans or 2 tuna steaks a week. The FDA puts bigeye tuna in its avoid list.
• Dried and salted fish (karuvadu, sukka bombil, sukha machhli). It is very salty, and sun-dried fish stored in warm, damp places can carry bacteria or mould. If you eat it, wash it well, cook it fully and keep portions small.

Fish to avoid

• Shark, swordfish and marlin, named by the NHS as fish to avoid in pregnancy.
• King mackerel, bigeye tuna, orange roughy and Gulf of Mexico tilefish, which are on the FDA's avoid list because of their high mercury.
• Raw fish and raw shellfish, including sushi made with raw fish, ceviche and raw oysters. The NHS says freezing does not make raw fish in sushi safe.
• Cold-smoked and cured fish, such as smoked salmon, unless it is cooked until steaming hot.

How much fish a week?

The FDA advises 2 to 3 servings a week from its lower-mercury list, and one serving is about 4 ounces, roughly the size of your palm (around 110 g cooked). The NHS says to have no more than 2 portions of oily fish a week. Oily fish include sardine, mackerel, salmon, trout and herring. Fish you eat from different groups all count towards the total, so a week might be one oily fish meal, one catfish or prawn meal and one carp meal.

How to cook fish safely in pregnancy

• Cook fish until it is opaque and flakes easily, and until it is steaming hot in the middle. Curries, steaming, grilling and baking all work.
• Do not eat fish that smells strong or sour, or that has been left out in the heat.
• Keep raw fish away from other foods, and wash your hands, knife and board after handling it.
• Buy from a seller you trust, keep fish on ice or in the fridge, and cook it the same day or freeze it.
• Reheat leftover fish until it is steaming hot, and do not keep it for more than a day.

What if I feel sick or put off by fish?

Strong smells are hard to bear in the first trimester. You do not have to eat fish to have a healthy pregnancy. Other foods carry protein and iodine, such as eggs, dairy and pulses, and your doctor can advise whether a DHA supplement suits you. Do not start fish oil or cod liver oil capsules on your own, because some contain a lot of vitamin A, which is not advised in pregnancy.

When to see a doctor

Get medical advice promptly if you have vomiting, diarrhoea, fever or stomach cramps after eating fish or shellfish, or a rash, swelling of the lips or trouble breathing, which can signal an allergy. Mention a fever to your doctor straight away in pregnancy, even if it seems mild.

Dr. Kavitha Lakshmi Easwaran sees expectant mothers for antenatal care at our clinic in Kasturi Nagar, Bangalore. Our guide to foods to avoid during pregnancy covers the rest of your plate, and you can book an appointment for personal diet advice.

Frequently asked questions

Is rohu fish safe in pregnancy?

Yes, in moderate amounts. Rohu is a freshwater carp. The FDA places carp in its "good choices" group, which means about one serving a week from that group. Buy it fresh and cook it thoroughly, and remove the bones with care.

Is catla fish good for pregnancy?

Catla is also a freshwater carp, so the same advice applies. It gives protein and some omega-3. Eat it well cooked and from a trusted seller, and count it towards your weekly fish total.

Can I eat bangda (Indian mackerel) during pregnancy?

Yes, in the usual amount. Bangda is a small mackerel, and small mackerel are generally lower in mercury than large predator fish. It is an oily fish, so keep to no more than 2 oily fish portions a week. Do not confuse it with king mackerel, which is on the avoid list.

Is pabda fish safe during pregnancy?

Pabda is a small freshwater catfish. The FDA lists catfish as a lower-mercury choice. Cook it fully and watch for the fine bones.

Can I eat hilsa (ilish) while pregnant?

Yes, if it is well cooked. Hilsa is a type of shad, which the FDA lists as lower in mercury. It is oily, so count it towards your two oily fish portions a week.

How much fish can I eat in a week during pregnancy?

About 2 to 3 palm-sized servings (roughly 110 g each) from the lower-mercury list, with no more than 2 oily fish portions. Skip shark, swordfish, marlin and king mackerel entirely.

Are prawns and dried fish safe in pregnancy?

Fully cooked prawns are safe. Dried fish is very salty and may carry bacteria or mould if stored badly, so wash it well, cook it fully and keep portions small.

Is fried fish all right?

Fully cooked fried fish is safe, but frying adds fat and calories. Grilled, steamed or curried fish is a lighter choice, especially if you have gestational diabetes or weight concerns. Do not reuse frying oil many times.

This guide is general information and does not replace a medical consultation. Ask your doctor about your own diet, especially if you have gestational diabetes, a fish allergy or a high-risk pregnancy.

Sources

• NHS: Foods to avoid in pregnancy
• US FDA: Advice about eating fish