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Comment & Response
January 14, 2019

Fish Consumption During Pregnancy—Reply

Author Affiliations
  • 1Retired former Director, Office of Seafood in the US Food and Drug Administration's Center for Food Safety and Applied Nutrition
  • 2Division of General Internal Medicine, Department of Medicine, University of Minnesota, Minneapolis
  • 3Division of General Pediatrics and Adolescent Medicine, Department of Pediatrics, University of Minnesota, Minneapolis
  • 4Retired former Director, US Food and Drug Administration's Center for Food Safety and Applied Nutrition
JAMA Pediatr. 2019;173(3):292-293. doi:10.1001/jamapediatrics.2018.4923

In Reply The letter from Grandjean et al agrees with our Viewpoint1 that fish eaten during pregnancy benefits the developing brain but disagrees that consumption beyond what most people eat is necessary to cause harm from mercury. Consumption advice from the US Food and Drug Administration and Environmental Protection Agency in 2017 omitted any mention of this important benefit. It only advised that fish consumption benefits growth and development generally, as with other high-protein foods. The takeaway was that benefits from fish are obtainable from other foods without mercury-based consumption limitations that the 2017 advice recommends for fish. We question whether this advice can motivate fish consumption during pregnancy. Most pregnant women underconsume fish. It was hoped that new advice would help correct that shortfall.