Refrigerated smoked salmon, whether hot-smoked or cold-smoked, should be avoided during pregnancy unless it is cooked in a hot dish (or it is canned or shelf-stable) due to the risk of listeria, according to the FDA and CDC. Gravlax (cured salmon) should be avoided too.
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Open the journalFully cooked salmon, pan-fried, baked, or poached, is always a safe and nutritious choice. Here you'll find a complete overview of what is safe and what to avoid.
Can pregnant women eat smoked salmon? The short answer: not straight from the refrigerated package. The FDA and CDC advise pregnant women to avoid refrigerated smoked seafood, hot-smoked or cold-smoked, unless it is cooked in a dish such as a casserole. Canned or shelf-stable smoked salmon is okay. Fully cooked salmon, pan-fried, baked, or poached, is always a safe and nutritious choice during pregnancy. The salmon cook temp for pregnancy is 63°C (145°F) for fresh salmon, or until the flesh is no longer translucent and separates easily with a fork. For reheated or smoked salmon in a cooked dish, aim for 74°C (165°F) throughout, or until steaming hot.
Quick Answer: What Is Safe and What Is Not?
| Type of salmon | Safe for pregnant women? | Reason |
|---|---|---|
| Hot-smoked salmon, refrigerated | Only in a cooked dish | Sold refrigerated, ready to eat |
| Cold-smoked salmon (lox, nova) | Only in a cooked dish | Not heat-treated, sold refrigerated |
| Canned or shelf-stable smoked salmon | Yes | Does not need refrigeration |
| Gravlax (cured salmon) | No | Not heat-treated, only cured |
| Cooked/pan-fried salmon | Yes | Fully heated through |
| Oven-baked salmon | Yes | Fully heated through |
| Sushi with raw salmon | No | Raw fish |
| Salmon in hot stir-fry | Yes | Fully cooked |
| Smoked salmon on pizza | Yes, if fully heated | Cooked dish, fully heated |
The main rule from food safety authorities: Pregnant women should avoid all fish and seafood that has not been thoroughly heated, and refrigerated smoked fish unless it is cooked in a dish. This means that smoked salmon heated to at least 74°C (165°F) internal temperature, or until steaming hot, in a cooked dish is safe.
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. It is sold refrigerated, and the FDA and CDC advise pregnant women to avoid refrigerated smoked seafood unless it is cooked in a dish.
Hot-Smoked Salmon (Avoid Unless Cooked in a Dish)
Hot-smoked salmon is smoked at temperatures above 60°C (140°F), usually 70–80°C (160–175°F). It has a firmer texture and more intense smoky flavor than cold-smoked. It is still refrigerated smoked seafood, so the same FDA and CDC advice applies: avoid it unless it is cooked in a dish such as a casserole. Listeria can grow in vacuum-packed products, even in the refrigerator.
How to tell what you can eat: What matters is how the package is kept, not only how it was smoked. Smoked salmon labeled nova-style, lox, kippered, or smoked in the refrigerated section is refrigerated smoked seafood. A can or sealed, airtight pouch that does not need to be kept refrigerated before opening is shelf-stable and okay to eat. 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 (63°C / 145°F internal temperature, or until the flesh is no longer translucent and separates easily with a fork)
- 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 heated until steaming hot
- Smoked salmon in hot pasta, if heated until steaming hot (74°C / 165°F) throughout
- Salmon omelet, fully cooked with smoked salmon inside
- Canned or shelf-stable smoked salmon, such as a can or sealed pouch that does not need refrigeration before opening
Always Avoid
- Refrigerated smoked salmon, hot- or cold-smoked, straight from the package, on bread, on a bagel, in salad
- Gravlax, regardless of preparation
- Sushi with raw salmon, any raw fish, see our sushi during pregnancy guide
- Ceviche, marinade does not kill listeria
- Salmon tartare, raw salmon
Freezing does not kill listeria! Even if fish has been frozen, listeria can survive and multiply again when the fish thaws. Only heating to 74°C (165°F), or until steaming hot, reliably kills the bacteria.
What About Other Fish and Seafood?
Safe for Pregnant Women (Fully Heated)
- Cod, haddock, pollock, white fish is excellent
- Mackerel, fully cooked (smoked mackerel only in a cooked dish, or canned or shelf-stable)
- 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
- Refrigerated smoked trout and mackerel, hot- or cold-smoked, same risk as refrigerated 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 refrigerated smoked salmon.
- Monitor yourself over the coming weeks for symptoms (fever, muscle aches, nausea)
- Contact a doctor if you develop a fever above 38°C (100.4°F) with flu-like symptoms
- Listeriosis is treated with antibiotics that are safe during pregnancy
- Most people who eat contaminated food do not get sick, the immune system handles it
According to food safety authorities, only a small proportion of cold-smoked salmon actually contains listeria. Food authority recommendations follow the precautionary principle, not because every package of smoked salmon is dangerous.
Practical Tips for Everyday Life
At the Grocery Store
- Check the expiration date carefully
- Choose canned or shelf-stable smoked salmon if you want a smoked salmon flavor, or cook refrigerated smoked salmon into a hot dish
- 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 the smoked salmon is served cold or cooked into a hot dish
At Social Gatherings
- It is perfectly fine to decline gravlax or smoked salmon that is served cold
- Explain briefly: "I'm avoiding refrigerated 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?
Not unless it is cooked in a hot dish or is shelf-stable. Vacuum-packed smoked salmon is sold refrigerated, and the FDA and CDC advise pregnant women to avoid refrigerated smoked seafood, hot-smoked or cold-smoked, unless it is cooked in a dish such as a casserole. Canned or shelf-stable smoked salmon, which does not need to be kept refrigerated before opening, is okay to eat.
Can pregnant women eat smoked salmon that has been heated?
Yes, if the smoked salmon has been heated to at least 74°C (165°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
- FDA, Listeria (Food Safety for Moms-to-Be)
- CDC, Listeria (Listeriosis)
- CDC, Preventing Listeria Infection
- WHO. Nutrition in Pregnancy
- AAP. Dietary Guidance for Pregnant and Breastfeeding Women
- USDA, Food Safety for Pregnant Women
- USDA FSIS, Safe Minimum Internal Temperature Chart
- FoodSafety.gov, Cook to a Safe Minimum Internal Temperature
Helpful tools
- Due Date Calculator. Calculate your estimated due date
- Contraction Timer. Track your contractions during labor
- All Baby Tools. Browse all free tools for pregnancy and baby care
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