Introducing Fish

First serve

Well-cooked salmon with every bone removed, flaked and mashed with a little water or breast milk into a soft, moist paste, offered alone or in a familiar puree.

Build up like this:

Day 1: a small taste (about ¼ teaspoon of mashed cooked fish) mixed into a familiar food, early in the day; watch for 2 hours.
If no reaction, repeat with a slightly larger amount over the next several days.
Build to a regular serving — about an ounce of flaked fish per sitting, rotating among low-mercury species.

Then keep it going: Once tolerated, serve fish about twice a week, favoring low-mercury choices like salmon, cod, and sardines — the same rhythm the FDA/EPA fish advice recommends for young children.

What a reaction can look like

• Hives or redness, often around the mouth, soon after eating
• Vomiting within about 2 hours
• Swelling of the lips, face, or eyes
• Coughing, wheezing, or labored breathing — treat as an emergency

Trouble breathing, tongue or lip swelling, widespread hives with vomiting, or a pale, floppy baby means call 911 now. See the emergency guide.

Good to know

• Stick to low-mercury fish (salmon, cod, sardines) and skip high-mercury species like shark, swordfish, king mackerel, and bigeye tuna for young children.
• Check flaked fish carefully with your fingers for pin bones before every serving.
• Serve every new allergen early in the day so you can observe for the next 2 hours, and introduce one new allergen at a time with about 3 days before the next one.

Foods that deliver it

Salmon →Cod →Sardines →