Introducing fish to your babies is essential once they are in the weaning stage (6 months and older). Not only are fish one of the nine main allergenic foods, but they are also the primary source of Omega 3-DHA. Similar to breastfeeding, when mothers were encouraged to consume foods to boost milk supply and milk quality, one of the foods often encouraged to consume regularly was fish for Omega 3-DHA. Babies need to learn to consume fish for brain development and vision acuity in babies as they gradually rely less on breast milk.

Some of the babies’ most common food allergies are milk, peanuts and eggs. Research has found no beneficial effect in withholding exposure to these foods until they are toddlers. As a matter of fact, it may be more harmful than beneficial due to the late exposure to these foods, even in babies with a higher risk of developing food allergies (higher-risk babies are babies who have a parent or sibling who has an allergy or allergic diseases such as eczema, asthma or hayfever). It is important to expose the immune system to allergen foods as early as 6 months old. It helps the immune system recognise and develop an immune tolerance towards these foods.

Thus, the recommendations for introducing solids are the same for babies at low and high risk of developing food allergies. One extra precaution you can take is to talk to your doctor before introducing solids if you already know your baby has an allergic disease, such as severe eczema or food allergy.

So, let’s take a closer look at how we can introduce fish to your little one.

Steps to introduce fish to our baby

#1 Canned or fresh fish?

In an ideal world, fresh would be best. However, convenience and practicality should also be considered. Since 6-month-old babies may eat very little, canned fish are small and convenient to use. If possible, choose a low-sodium canned fish. Canned skipjack tuna soaked in olive oil is a good choice to start with. Minimal cooking preparation is needed.

#2 Choose low-mercury fish

Low mercury fish are important as mercury exposure can harm the developing brain and nervous system. Some of the potential health conditions are attention deficit disorder, neurological damage, autism, anaemia and gastrointestinal dysfunction. Thus, it is important to minimise exposure to heavy metals in your little one.

Here is a table of low-mercury fish that is suitable to introduce to your little one.

Best choices

Eat 2-3 servings per week

Good choices

Eat 2 servings per week

Avoid

Sole

Grey Mullet

Salmon

Skipjack Tuna

Seabass

Pomfret

Cod

Anchovy

Threadfin

Hake

Sardine

Red Grouper

Red Snapper

Halibut

Carp

Golden Striped Snapper

Spanish Mackerel

Grouper

Monkfish

Swordfish

King Mackerel

Shark

Bigeye Tuna

#3 Remove fish bones

It would also be good to remove the bones in fish. Typically canned fish has much softer bones which somewhat disintegrates very easily when pinched or mashed with a spoon. These soft bones are completely fine for babies. If there are any hard bones in the fish, then it’s best to remove them before serving it to your little one.

#4 Portion sizes and preparation style

There isn’t any right or wrong portion size of fish. Starting with an ounce of fish is a good starting point. It’s all about introducing the texture, smell and flavour of the fish. If the fish is a white lean fish like tilapia, grouper or pomfret, it may be good to pour some soup or gravy or olive oil over it to make it moist. Make sure it’s soft and becomes flaky easily with a fork to ensure it’s not too tough or dry. Dry fish flakes can be a choking hazard.

#5 Frequency of introduction

Observing any allergic reactions for 2-3 days after introducing one new high-allergenic food to your baby is recommended. During this time, no other new foods should be introduced. It is fine to provide different foods previously tolerated well by your little one with the high-allergenic food introduced. You can introduce the new high-allergenic food multiple times during the 2-3 days of exposure. It would be good to keep a diary of the foods you introduce your little one to consume.

Once it is confirmed that it is safe and your baby tolerates it well, it is essential to continue feeding your little one with the fish at least twice a week. Some babies tend to lose their immune tolerance to such food as they grow up due to inadequate exposure.

Look out for allergic signs

Most allergenic reactions are mild to moderate. Here are some of the signs that you should be looking out for after your little one consumes orally:

Itch in mouth
Hives ( itchy, red, bumpy rashes that look like mosquito bites)
Swelling of the face
Swelling of the eyes
Swelling of the lips
Abdominal pain
Vomiting

Many of these symptoms typically occur within minutes up to 2 hours after eating the food. Do keep in mind that these symptoms can also occur when touching the food. In rare instances, symptoms can arise from breathing in fumes during cooking.

It is also important to note that regardless of the type of allergy you may suspect, please consult your doctor for advice if the symptoms persist and do not subside. If your little one starts wheezing, has swelling in the tongue, vomits, looks pale, looks unconscious, or coughs persistently, they may be signs of anaphylaxis. Call 995 for an ambulance immediately.

Author

Eunice Tan, In-house Dietitian

Eunice Tan graduated with a Bachelor of Science (Hons) in Dietetics with Nutrition from International Medical University. She is a certified Prenatal Dietitian, Accredited by Singapore Nutrition and Dietetics Association and also the in-house dietitian for Tian Wei Signature and ReLacto. With her expertise and interest in nutrition for women and diet planning, Eunice helps to support mothers get the key nutrients they need for recovery and lactation.

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