Smoked Salmon During Pregnancy: Is It Safe to Eat?

Salmon is one of the most popular foods in many households, and many pregnant women wonder if they can safely eat smoked salmon. Unfortunately, the answer is not a simple yes.

According to food safety authorities, pregnant women should avoid cold-smoked salmon and gravlax (cured salmon) due to the risk of listeria. Hot-smoked salmon, on the other hand, is considered safe. Here you'll find a complete overview of what is safe and what to avoid.

Quick Answer: What Is Safe and What Is Not?

Why Is Smoked Salmon Risky for Pregnant Women?

The risk is related to the bacterium Listeria monocytogenes. Listeria can survive and multiply in the refrigerator, unlike most other foodborne bacteria.

What Is Listeria?

Listeria is a bacterium found in soil, water, and in animals. It can contaminate foods during production and survives:

• Refrigerator temperature (40°F / 4°C)
• Vacuum packaging — can grow without oxygen
• Salting and smoking — survives cold-smoking and curing

Listeriosis During Pregnancy

Pregnant women are 10–20 times more likely to develop listeriosis than the general population, according to the CDC. This is because the immune system is naturally suppressed during pregnancy.

Symptoms can include:

• Fever and flu-like symptoms
• Muscle pain and headache
• Nausea and diarrhea
• Can occur up to 70 days after infection

Consequences for the Baby

Listeriosis during pregnancy can lead to serious complications:

• Premature birth
• Infection in the newborn
• In the worst case, stillbirth

Important: Listeriosis is fortunately rare. The CDC registers relatively few cases annually, and only a fraction occur in pregnant women. It is about taking sensible precautions.

Different Types of Smoked Salmon — What Is the Difference?

There are several types of smoked salmon available in stores, and the differences are important for pregnant women.

Cold-Smoked Salmon (Avoid)

Cold-smoked salmon is smoked at low temperatures (below 30°C / 86°F). This process creates wonderful flavor, but the temperature is not high enough to kill listeria bacteria. Most vacuum-packed smoked salmon in stores is cold-smoked.

Hot-Smoked Salmon (Safe)

Hot-smoked salmon is smoked at temperatures above 60°C (140°F), usually 70–80°C (160–175°F). This temperature kills listeria effectively. Hot-smoked salmon has a firmer texture and more intense smoky flavor than cold-smoked.

How to tell the difference: Check the package. It should say "hot-smoked." If you are unsure, ask at the fish counter.

Gravlax (Avoid)

Gravlax is cured with salt, dill, sugar, and pepper, but never heat-treated. Although the curing inhibits some bacterial growth, it is not sufficient to eliminate listeria.

Fermented Fish (Avoid)

Fermented fish is not cooked. Pregnant women should avoid fermented fish entirely for the same reason as gravlax.

How to Make Salmon Safe

Salmon is an excellent source of nutrients for pregnant women. According to the WHO and AAP, pregnant women should eat 2–3 portions of fish per week. The key is to prepare it correctly.

Always Safe

• Pan-fry the salmon until cooked through (at least 70°C / 160°F internal temperature)
• Bake in the oven at 180–200°C (350–400°F) for 15–20 minutes
• Boil or poach — salmon in broth or oven-baked in foil
• Stir-fry on high heat until the salmon is cooked through

Safe with Conditions

• Smoked salmon on hot pizza — if the pizza is freshly made and fully heated through
• Smoked salmon in hot pasta — if heated until fully warm throughout
• Salmon omelet — fully cooked with smoked salmon inside

Always Avoid

• Cold-smoked salmon straight from the package — on bread, in salad
• Gravlax — regardless of preparation
• Sushi with raw salmon — any raw fish
• Ceviche — marinade does not kill listeria
• Salmon tartare — raw salmon

What About Other Fish and Seafood?

Safe for Pregnant Women (Fully Heated)

• Cod, haddock, pollock — white fish is excellent
• Mackerel — hot-smoked mackerel is safe
• Shrimp — cooked shrimp is safe
• Mussels — fully cooked
• Tuna — in moderate amounts (max 2 cans per week due to mercury)

Should Be Avoided

• Raw sushi and sashimi — all raw fish and raw seafood
• Undercooked scallops — must be cooked through
• Tube caviar — may contain listeria
• Cold-smoked trout and mackerel — same risk as cold-smoked salmon

Limit the Amount of

• Tuna, swordfish, shark — high mercury content
• Pike — high mercury content
• Fish liver — high content of vitamin A and environmental contaminants

Read our complete guide on foods pregnant women should avoid for a full overview, and see our pregnancy nutrition guide for what you should eat more of.

Why Is Salmon Good for Pregnant Women?

Despite the restrictions, salmon is one of the best foods for pregnant women — as long as it is fully cooked:

• Omega-3 fatty acids — important for the baby's brain development
• Protein — building blocks for the baby's growth
• Vitamin D — many people don't get enough, especially in winter
• Iodine — important for the thyroid and the baby's development
• Selenium — antioxidant

The WHO and AAP recommend that pregnant women eat fish 2–3 times per week, and salmon is an excellent choice as long as it is prepared safely.

What Should You Do If You Have Already Eaten Smoked Salmon?

First of all: don't panic. The chance of getting sick from listeria is small, even if you have eaten cold-smoked salmon.

1. Monitor yourself over the coming weeks for symptoms (fever, muscle aches, nausea)
2. Contact a doctor if you develop a fever above 38°C (100.4°F) with flu-like symptoms
3. Listeriosis is treated with antibiotics that are safe during pregnancy
4. Most people who eat contaminated food do not get sick — the immune system handles it

Practical Tips for Everyday Life

At the Grocery Store

• Check the expiration date carefully
• Choose hot-smoked salmon if you want a smoked salmon flavor
• Fresh salmon for pan-frying is always safe
• Frozen salmon is just as nutritious as fresh

At a Restaurant

• Ask if the salmon is fully heated through
• Avoid sushi with raw fish — ask for a heat-treated alternative
• Salmon dishes prepared in the oven, stir-fry, or stew are safe choices
• Ask whether cold-smoked or hot-smoked salmon is used

At Social Gatherings

• It is perfectly fine to decline gravlax or cold-smoked salmon
• Explain briefly: "I'm avoiding cold-smoked fish while pregnant"
• Feel free to bring your own food to gatherings if you are unsure

Frequently Asked Questions

Can pregnant women eat vacuum-packed smoked salmon?

Most vacuum-packed smoked salmon is cold-smoked and should be avoided. Check the package for "hot-smoked" — then it is safe. If it just says "smoked salmon" without further specification, it is most likely cold-smoked.

Can pregnant women eat smoked salmon that has been heated?

Yes, if the smoked salmon has been heated to at least 70°C (160°F) internal temperature. Smoked salmon in a hot omelet, on a fully heated pizza, or in cooked pasta is safe. However, cold bread with smoked salmon that has been sitting out is not safe.

Is fresh sushi with salmon dangerous for pregnant women?

Food safety authorities recommend that pregnant women avoid all raw fish, including sushi with raw salmon. The risk includes both listeria and other parasites. Sushi with cooked shrimp, avocado, or fully cooked salmon are safe alternatives.

Is gravlax safe if it has been frozen first?

No. Freezing kills parasites (such as Anisakis) but does not kill listeria bacteria. Listeria survives freezing and begins to multiply again at refrigerator temperature after thawing.

Sources and References

• FDA — Fish: What Pregnant Women and Parents Should Know
• CDC — Listeria (Listeriosis)
• WHO — Nutrition in Pregnancy
• AAP — Dietary Guidance for Pregnant and Breastfeeding Women
• USDA — Food Safety for Pregnant Women