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Can Fish Cause Allergies in Kids?

Written by Taylor Cossairt, medically checked by child nutritionist

About 0.5% of children have a fish allergy and it’s one of the top 8 most common food allergens. And unlike most other food allergies, children typically don’t outgrow fish allergies. Once you have a fish allergy, it’s there forever.

The good news is that it usually shows up in older children (ages 6 - 17) rather than younger ones (ages 0 - 5). This means it’s easier to manage and you can talk with your child about what’s safe to eat, and what’s not. And generally speaking, the most common types of fish allergies include:

  • Catfish
  • Cod
  • Salmon
  • Tuna

If you’re a parent or caregiver of a child with fish allergies, it’s important to know how to manage it. So let’s explore fish allergies, what they look like, and how to treat them.

Here’s what you’ll learn:

  • Fish allergy signs and symptoms in babies
  • When to call 911 for your child’s fish allergy
  • Top foods to avoid if your baby is allergic to fish
  • How to prevent and treat baby fish allergies
  • How to diagnose fish allergies in babies
  • FAQ: Everything you need to know about fish allergies in kids

Fish Allergy Signs and Symptoms in Babies

A fish allergy is an immune response. Your child’s body protects itself from what it thinks is an intruder. Instead of registering fish as something healthy, your child’s body sees it as something bad.

When your child eats fish, their body sends out antibodies to attack it. And when antibodies attack, physical symptoms of an allergic reaction show up. These symptoms usually appear within minutes or hours and range from mild to severe.

Mild fish allergy

  • Itchy mouth
  • Nausea

Moderate fish allergy

  • Rashes or hives
  • Swelling of the mouth
  • Vomiting
  • Diarrhea

Severe fish allergy

  • Difficulty breathing (wheezing, noisy breathing)
  • Swelling in the throat
  • Drooling
  • Faintness or dizziness
  • Loss of color (turning pale)
  • Anaphylaxis (rare but dangerous)

When to Call 911 for your Child’s Fish Allergy

In some cases, children with severe fish allergies may go into anaphylactic shock. It’s a condition characterized by the sudden onset of serious symptoms like:

  • Difficulty breathing
  • No breathing
  • Loss of consciousness
  • Severe swelling of the throat, face, or mouth
  • Severe abdominal pain
  • A sudden drop in blood pressure

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Remember: If you notice the signs of anaphylaxis, call 911 immediately

Anaphylaxis is dangerous and may be life-threatening in some cases. While you wait for emergency care, here’s what you can do:

  • Administer an epinephrine injection (also known as an auto-injector or EpiPen®)
  • Administer over-the-counter (OTC) antihistamines like Benadryl to manage their symptoms. Do this after giving your child an auto-injector.

Remember that sometimes allergy symptoms come in “waves.” This means after your child’s initial reaction, a second reaction could be around the corner. Keep an eye on your child while you wait for medical attention. And always seek emergency care if your child has a severe allergic reaction. Even if your child’s symptoms go away after a few minutes, talk to a professional.

Top Foods to Avoid if your Baby is Allergic to Fish

Children who are allergic to fish should avoid certain foods altogether. Here’s a list of foods your kid should avoid if they have a fish allergy:

  • Anchovies
  • Bass
  • Bouillabaisse
  • Caponata, a Sicilian eggplant relish
  • Catfish
  • Caviar and fish roe (fish eggs)
  • Cod
  • Deli meats (for example, bologna or ham)
  • Dishes made with fish sauce (for example, some Thai curries)
  • Eel
  • Fish flavoring
  • Fish oil
  • Fish sticks
  • Flounder
  • Fried rice
  • Frito Misto
  • Gelatin
  • Grouper
  • Gumbo
  • Haddock
  • Hake
  • Halibut
  • Herring
  • Hot dogs
  • Mahi-mahi
  • Marshmallows
  • Paella
  • Perch
  • Pike
  • Pollock
  • Salad dressing (for example, Caesar dressing)
  • Salmon
  • Scrod
  • Snapper
  • Sole
  • Soups and sauces
  • Spring rolls
  • Sushi
  • Swordfish
  • Tilapia
  • Trout
  • Tuna

NOTE: Everything listed in the table above is a guideline. It is in no way a substitute for medical advice. Always talk with your doctor about what’s best for your child.

It’s also recommended that you check food labels for hidden fish ingredients like:

  • Artificial or imitation fish
  • Barbecue sauce
  • Cap
  • Imitation crab meat (“krab”)
  • Orange roughy
  • Some foods fortified with omega-3 fatty acids
  • Taramasalata
  • Worcestershire sauce​

Fish allergies and cross-contamination

Even if your child avoids fish, cross-contaminated foods may cause a reaction. Cross-contamination happens when foods that are OK to eat come in contact with foods that aren’t OK to eat. For example, ground beef that’s manufactured in the same facility that processes fish.

Cross-contamination is most common in kitchens and restaurants. And it’s especially common in seafood restaurants. The same surfaces, utensils, and oils prepare fish and other foods on the menu. So when they aren’t cleaned between use, your child may ingest cross-contaminated food. This can also happen with commercially processed foods.

How to Prevent and Treat Baby Fish Allergies

If your child has a fish allergy, there are a few ways to effectively manage it and keep them safe. Talk with a doctor or allergist about which treatment method is right for you and your child. Here are some common fish allergy treatment approaches they may recommend:

Allergy action plans
  • Outline how to manage your child’s fish allergy with an allergy action plan
  • It’s a document that lists symptoms, emergency contact information, and what to do in case of a reaction
  • Your child’s action plan may include details about how to administer an auto-injector or when to call 911
  • Work with your child’s doctor to develop an appropriate action plan
  • Share the action plan with your child’s teachers, caregivers, and family members
Medications
  • Some OTC and prescription medications can manage mild fish allergy symptoms
  • These include auto-injectors or antihistamines
  • Talk with your doctor about which medications are safe for your kid’s fish allergy
Food label monitoring
  • Check food labels for fish and hidden fish ingredients. You can review a list here
  • Avoid cross-contamination in restaurants and kitchens The EU and UK require most commercial food labels to list common allergens
  • Look for ingredients in the bold or highlighted text on food labels. Also, look for notes like “may contain fish”
Chef cards
  • A “chef card” outlines your child’s fish allergy. It also includes special instructions for food preparers.
  • If you visit a restaurant, give a chef card to your server. Tell them to give the card to the cook, chef, or food handler who will be preparing your child’s meal

How to Diagnose Fish Allergies in Babies

Fish allergies are easy to mistake for other seafood-related reactions like:

  • Scombroid poisoning
  • Shellfish allergies
  • Anisakis allergies
  • Seafood allergies

Each one is a unique condition, but they share overlapping symptoms. This is why it’s important to talk with a doctor or allergist about getting your child tested. They can definitively diagnose a fish allergy with tests like:

Skin test

A doctor or allergist uses small pricks along the skin to expose your child to a small amount of fish. If your baby has a reaction (like hives), it’s likely they have a fish allergy.

Blood test

Elimination diet (oral food challenge)

FAQ: Fish Allergy in Babies

Is a fish allergy the same thing as a seafood allergy?

They’re similar, but fish allergies and seafood allergies aren’t 100% the same. Fish and shellfish both trigger seafood allergies. Whereas only fish triggers a fish allergy.

Do children outgrow fish allergies?

Are fish allergies genetic?

Is it OK to eat fish if I’m breastfeeding or formula feeding?

Can my child be allergic to only certain kinds of fish?

If my child has an allergy to fish, do they have to avoid all seafood?

Can I introduce allergens if my baby has a fish allergy?

Can you be allergic to the smell of cooking fish?

Should I avoid dining out if my child has a fish allergy?