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:
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
Moderate fish allergy
- Rashes or hives
- Swelling of the mouth
Severe fish allergy
- Difficulty breathing (wheezing, noisy breathing)
- Swelling in the throat
- 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
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:
- Caponata, a Sicilian eggplant relish
- Caviar and fish roe (fish eggs)
- Deli meats (for example, bologna or ham)
- Dishes made with fish sauce (for example, some Thai curries)
- Fish flavoring
- Fish oil
- Fish sticks
- Fried rice
- Frito Misto
- Hot dogs
- Salad dressing (for example, Caesar dressing)
- Soups and sauces
- Spring rolls
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
- Imitation crab meat (“krab”)
- Orange roughy
- Some foods fortified with omega-3 fatty acids
- 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||
|Food label monitoring||
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:
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.
A sample of your child’s blood is sent to a lab. The sample is tested against certain criteria. This may reveal whether they have a fish allergy.
Elimination diet (oral food challenge)
Your doctor or allergist builds a food elimination diet. It outlines which foods to eliminate and then reintroduce to your baby’s diet. If your child reacts to certain foods as they’re reintroduced, it’s likely they have an allergy.
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?
Although children can outgrow some allergies with age, a fish allergy isn’t one of them. Usually, a child who has a fish allergy has it their entire life.
Are fish allergies genetic?
Kids who have a family history of fish allergies are more likely to develop one. But it’s not a 100% guarantee. So even if you and your partner both have fish allergies, there’s a chance your child won’t develop one.
Is it OK to eat fish if I’m breastfeeding or formula feeding?
Fish is high in protein, vitamin D, and omega-3 fatty acids. All of these are important for your health as a mother. And when you breastfeed, you pass along these nutrients to your child. If your child has a fish allergy, there’s also a chance you’ll pass along fish protein which may cause a reaction.
Some doctors suggest breastfeeding mothers limit fish if their baby has an allergy. While others suggest that passing along enough fish to trigger a reaction is rare.
Either way, most doctors agree that foods high in mercury aren’t great for breastfeeding. Mercury is an element that’s toxic and impacts the nervous system. It's commonly found in seafood and it can pass through breastmilk.
Seafood low in mercury
- Canned light tuna
Can my child be allergic to only certain kinds of fish?
If your kid has a fish allergy, it’s possible they aren’t allergic to every type of fish. For example, your child may be allergic to salmon, but not trout.
However, if your baby is allergic to a certain type of fish, talk with an allergist or doctor. They can help you identify whether they’re allergic to other types of fish or seafood.
If my child has an allergy to fish, do they have to avoid all seafood?
Fish allergies and seafood allergies aren’t the same things. Children with seafood allergies have to avoid fish and shellfish. But children with fish allergies only have to avoid fish.
Talk with your doctor or allergist to find out whether your child has a fish allergy or a seafood allergy.
Can I introduce allergens if my baby has a fish allergy?
Some doctors recommend introducing allergens to a baby’s diet as they start solid foods. These allergens usually include eggs, peanuts, dairy, wheat, and fish. If you aren’t sure whether your child has a fish allergy or not, talk with an allergist or doctor. They’ll be able to test your child and properly diagnose them.
Can you be allergic to the smell of cooking fish?
If you’re allergic to fish, you’re actually allergic to the proteins found in fish. As fish gets cooked, its odors are released. And while the smell can be strong, it’s nearly impossible for an odor to carry proteins and thus trigger a reaction.
But, if you have a severe allergy, it’s recommended you stay away from fish entirely — even while it's prepared. For example, splattering oil that’s frying fish could make contact with your skin, eyes, or mouth.
Should I avoid dining out if my child has a fish allergy?
If your child has a fish allergy, you should avoid dining out at seafood restaurants. Even if your kid eats a dish without fish, the risk of cross-contamination is high. If your child comes in contact with fish, it could trigger a reaction. This could be through cross-contamination or touching fish on another person’s plate.