When Your Child Has a Food Allergy: Fish

Important information:

Fish is considered a major food allergen under the Food Allergen Labeling and Consumer Protection Act of 2006. All food products that contain fish as an ingredient must list the name of the fish on the product label.

If you are unsure about any product, confirm ingredients with the manufacturer or discuss with your allergist before using. For more information about food labeling laws, visit: https://www.foodallergy.org/

Patient instructions: Avoid these foods

Anchovies	Perch
Bass	Pike
Catfish	Pollock
Cod	Salmon
Flounder	Scrod
Grouper	Swordfish
Haddock	Sole
Hake	Snapper
Halibut	Tilapia
Herring	Trout
Mahi Mahi	Tuna
Mackerel

Some unexpected sources of fish:

• Caesar salad and Caesar dressing

• Worcestershire sauce

• Bouillabaisse

• Imitation or artificial fish or shellfish (surimi, also known as “sea legs” or “sea sticks,” is one example)

• Caponata, a Sicilian eggplant relish

• Fishmeal in fish food. Wash hands after feeding fish.

Instructions for safety:

• Fish protein can become airborne in the steam released during cooking and may be a risk. Stay away from cooking areas.

• Any food served in a seafood restaurant may have cross-contact with fish or shellfish during handling.

• Many ethnic restaurants commonly use fish and fish ingredients in their cooking.

• Studies show that omega 3/fish oil can be safely ingested for most fish allergic individuals.

• Allergy to iodine or contrast used in radiology procedures and fish allergy are NOT related. Fish allergic individuals do not have to worry about cross-reaction with radiocontrast or iodine.

• Scaled fish and shellfish are not the same. Ask your allergy team if it is safe to ingest shellfish.

Reviewed May 2024 by Megan Lewis, MSN, CRNP and Jonathan Spergel, MD, PhD