Navigating infant food allergies requires so much extra time and effort because getting to baseline’s tough. You don’t realize the variety of foods you eat until you have to remove entire categories, like dairy or fish.
Fish questions come up a lot because of confusion around seafood, shellfish, and finned fish. Which one affects your baby in which way? Like everything with food allergies, these questions feel enormous.
Don’t fear; we’re here to clear it up. We know fish proteins can cause an allergic reaction. We want you to feel more prepared and confident to navigate this tricky issue.
Let’s dive into the murky waters surrounding fish allergies. Learn more about symptoms, diagnosis, treatment, and resources for your family.
What’s Considered a Fish Allergy?
While dieticians often recommend fish for its many health benefits, it ranks as a top allergen for the adult population. Let’s start by straightening out what’s considered fish, shellfish, and seafood.
Finned Fish, Shellfish, Seafood, Oh My!
Maybe it’s obvious, maybe not. As a food allergy parent trying to nail down triggers, it’s important to know what food categories to completely eliminate and what you can keep on your menu.
Finned fish have fins (*gasps in shock*) and a backbone that helps them propel through the water. Over 20,000 species of fish exist! Examples include salmon, tuna, halibut, pollock, cod, perch, and snapper.
Shellfish do not have bones and aren’t actually fish. They’re categorized as two different species entirely: crustaceans and mollusks. Examples include shrimp, crab, lobster, oysters, octopus, and squid.
Where does seafood fit into the mix? It’s all of it! This umbrella term allows restaurants and stores to easily identify proteins from the ocean. Simple as that.
Your baby might only be allergic to finned fish (or even only one type), so you can still enjoy lobster or oysters (or other finned fish, talk about weird). Sometimes your child might react to both. That’s just part of your journey — and a major reason we offer one-on-one consults.
What Data Shows About Ethnicity & Fish Allergies
Most data on food allergies involve IgE-mediated food allergies since it shows up on blood and skin prick test. One study comparing 817 children shows African American kids have a significantly higher chance of being allergic to wheat, corn, soy, fish, and shellfish. 
This same study shows huge differences in the rates different ethnic groups respond to fish and reports:
3.4% White, 16.16% Hispanic, and 34.39% African American kids suffer from a fish allergy, respectively. This data gives us more to work with in the puzzle of food allergies. Genetics and environmental factors play a role in how children respond to potential allergens.
Evidence suggests fish allergies aren’t outgrown very often, but it also shows that fish allergies often develop later in life.  Don’t lose hope if your baby seems to react to seafood. Only time will tell the future of your little one’s allergies.
Symptoms, Diagnosis, & Treatments for Fish Allergies
Symptoms of Fish Allergies 
Hives or a skin rash
Nausea, stomach cramps, indigestion, vomiting, and/or diarrhea
Stuffy or runny nose and/or sneezing
Like with every other baby food allergen, fish symptoms are no different — making it harder to find the culprit. Keep in mind, your baby’s unique, so check out the full list of infant food allergy symptoms here.
Parents always want to know how long fish allergy symptoms will last, and it’s a valid question. Sadly, the answer varies on your child’s sensitivity levels. Hang in there. It gets better!
Diagnosis of Fish Allergies
The 3 ways to test for fish allergies:
Skin Prick Test (SPT)
Oral Food Challenge (OFC)
If you’re not entirely familiar with these, you can read more in-depth information here. Each testing option has pros and cons. It also depends if your child has IgE-mediated food allergies or non-IgE-mediated food allergies.
Our consults help families cope during the testing process. It’s one of the scariest times for many families. Reintroducing allergens to your child brings up strong feelings of fear and guilt. We hate to wonder, “what if a reaction happens?”
But remember, a reaction gives you information to move forward with. It means you’re child can’t tolerate that food and although it’s heartbreaking to watch them suffer, you get more knowledge to work with.
Treatment For Fish Allergies
A better term is “management” because “treatment” options remain slim. You’ve got strict avoidance (for the child) or an elimination diet (strict avoidance for both parent and child, and maybe the entire family).
When fish or shellfish cause an allergic response, you’ve got to avoid it. It’s as simple as that. The immune system recognizes and attacks those proteins as invaders. This causes reactions in different parts of the body.
Don’t Get Caught Up Wondering If Your Baby Has A Fish Allergy! Let Free To Feed Guide You
We don’t want you or anyone in your family to struggle a second longer than you have to. We know the pain it causes for everyone. As leading experts in the field of baby food allergy, we’re prepared to help you — wherever you are on your journey.
Figuring out if your favorite salmon dish causes a reaction in your baby can impact your life, and we understand that. You need help getting to baseline and nourishing yourself to keep providing for your family.
We’re here with tons of food allergy experts to personally help you — or try our Food Allergy Support Package with 3 months of resources, deep dives, and 2 one-on-one consults!
Reminder: You’re Doing A Great Job