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Fish can be a healthy part of your child's diet soon after he begins to eat solid food, usually when he's around 4 to 6 months old. But if your baby has chronic eczema or a food allergy, talk to the doctor first.
You'll want to check with the doctor because fish is one of the top allergenic foods, and most doctors recommend starting with traditional first solids (such as baby cereal and pureed meat, fruits, or vegetables) before offering your baby fish.
The American Academy of Pediatrics (AAP) Section on Allergy and Immunology says that most babies – including those with mild eczema, or a family history of food allergies or asthma – can start eating foods like fish after introducing a few less allergenic foods (such as cereal, vegetables, and fruits) without causing an allergic reaction.
Some children should not start eating allergenic foods such as fish until the doctor has given the green light. Talk to the doctor if your baby:
- Has moderate to severe eczema after following a doctor's skin treatment plan
- Has had an immediate allergic reaction to a food in the past
- Was previously diagnosed with a food allergy
When introducing an allergenic food, the AAP recommends giving it to your baby at home, rather than at daycare or a restaurant. And as with any new food, serve it for three to five days before offering something else. That way you can monitor him for a reaction and know what's likely causing it.
Signs of a food allergy are facial swelling (including the tongue and lips), skin rash, wheezing, abdominal cramping, vomiting, and diarrhea. If your baby shows any of these signs – mild or severe – or has trouble breathing right after eating a new food, call 911 or your local emergency number immediately.
Besides an allergy, there are a few other things you'll want to watch out for:
- Mercury. Fish is rich in protein, vitamin D, omega-3 fatty acids, and other nutrients, but certain types of fish contain high levels of methylmercury, a metal believed to be harmful in high doses to a child's developing brain and nervous system. The U.S. Food and Drug Administration (FDA) recommends that you avoid feeding your child shark, swordfish, king mackerel, and tilefish – large predatory fish that contain the highest levels of mercury.
To keep mercury levels down, the AAP tells parents to limit the amount their child eats to less than 12 ounces per week. Types of fish that are low in mercury include canned light tuna (not albacore, or "white" tuna, which is higher in mercury), salmon, cod, catfish, flatfish, and pollock.
- Bacteria and viruses. Make sure fish is thoroughly cooked to kill the foodborne bacteria and viruses that thrive in raw or undercooked fish.
- Choking. To prevent choking debone, mince, and puree the fish.