Is swordfish safe during pregnancy?

What does the evidence say about swordfish during pregnancy?

1. Swordfish is one of seven fish in the Choices to Avoid category, which FDA labels as carrying the highest mercury levels. 1
2. Swordfish averages 0.995 parts per million of mercury across 636 FDA samples, more than 70 times the 0.013 average measured in tilapia. 2
3. The full list to skip in pregnancy and while breastfeeding is bigeye tuna, shark, king mackerel, swordfish, marlin, tilefish from the Gulf of Mexico, orange roughy, and whale meat, all of them large, long-lived, fish-eating species. 3
4. Eating a fish from the Choices to Avoid list one time, or going over the recommended amount for a single week, is not likely to increase the chance of health problems for you or the pregnancy. 3
5. The neurodevelopmental benefit of eating fish in pregnancy holds specifically when the fish chosen is low in mercury, which is what separates the recommended species from the avoided ones. 4

Is swordfish safe in each trimester?

• First trimester. The advice is the same in every trimester, so there is no early window where swordfish is fine. If you ate it before you knew you were pregnant, that is a common story and a single meal is not the situation the guidance is built around. Mention it at your first visit so it is noted, then move on.
• Second trimester. Restaurant menus are where swordfish usually turns up, often as a grilled steak that reads like any other white fish. Marlin and shark sit in the same avoid category and appear on specials boards too. Asking what the fish of the day actually is takes a second and settles it.
• Third trimester. Methylmercury crosses to the baby, and the concern is with steady intake building up over time rather than with any one dinner. If swordfish has been a regular part of your diet, bring that up rather than trying to work it out yourself: your provider can decide whether anything further is worth doing.