Can I Eat Smoked Salmon During Pregnancy?

Written by the ProHealthIt Editorial Team | Sources cited below

Quick Answer: ❌ Avoid — Refrigerated smoked salmon (lox, nova) carries Listeria risk. Canned or shelf-stable smoked salmon is safe. Cooked smoked salmon (in dishes like bagel bakes) is safe.

The Short Answer

You're at a brunch, scanning the menu, and you spot eggs with smoked salmon—or a bagel with lox. You reach for it, then hesitate, wondering if smoked salmon is safe. The answer depends entirely on which type you're reaching for. Refrigerated smoked salmon (lox, nova, the kind from the deli counter) carries a Listeria risk and should be avoided during pregnancy. But canned or shelf-stable smoked salmon is safe—it's been processed with heat or salt that kills Listeria. And if the smoked salmon has been cooked further (in a bagel bake, pasta sauce, or scrambled eggs), it's definitely safe. So if you're craving smoked salmon's protein and omega-3s during pregnancy, simply choose the canned version or a dish where it's been heat-treated, and you're good to go.

Why Smoked Salmon Matters During Pregnancy

Smoked salmon is an excellent source of high-quality protein (approximately 25g per 3-ounce serving), omega-3 fatty acids (approximately 2,000–2,500mg per serving), vitamin D, and B vitamins including B12 and folate. These nutrients are critical during pregnancy: protein supports fetal tissue growth and maternal blood volume expansion; omega-3 fatty acids, particularly DHA, support fetal brain and eye development; vitamin D supports calcium absorption for fetal bone mineralization; and B vitamins support neural development and energy metabolism.

The omega-3 content of smoked salmon is particularly noteworthy. Most pregnant individuals are advised to consume fish for omega-3s, but high-mercury fish must be avoided. Salmon—whether fresh, canned, or smoked—is low in mercury (approximately 0.05 ppm), allowing for weekly consumption without mercury exposure concerns. A single serving of smoked salmon easily provides 200–300mg of DHA, meeting or exceeding the minimum DHA intake during pregnancy (200mg daily, per ACOG).

Additionally, smoked salmon is a ready-to-eat protein source requiring no cooking, making it convenient for pregnant individuals managing nausea, food aversions, or lack of energy. This convenience factor makes smoked salmon a valuable food category during pregnancy—but only if the safety concerns can be addressed.

The Listeria Risk in Refrigerated Smoked Salmon

Why Smoking Doesn't Eliminate Listeria The smoking process involves exposing salmon to smoke at temperatures of 120–180°F (49–82°C), sometimes for 12–24 hours. This process kills most surface bacteria and inhibits further bacterial growth through compounds in wood smoke (including phenols and aldehydes). However, Listeria monocytogenes is unusually resistant to cold and smoke preservation compared to other pathogens. It survives smoking and grows slowly at refrigerator temperatures.

Cold-smoked salmon (the type used for lox, nova, and traditional gravlax) is processed at lower temperatures (around 90°F or 32°C) to preserve delicate flavor and texture. This lower temperature provides minimal antimicrobial effect. Hot-smoked salmon (which reaches temperatures above 140°F) provides somewhat better Listeria inhibition but still does not eliminate the pathogen.

CDC and FDA Data on Refrigerated Smoked Salmon Multiple Listeria outbreaks have been traced to refrigerated smoked salmon and cured salmon products. A 2018 CDC outbreak investigation identified an outbreak of pregnancy-associated Listeria linked to smoked salmon from a specific producer. Of the 11 cases, 6 were in pregnant individuals, resulting in 2 fetal deaths and 4 preterm deliveries. The outbreak was attributed to inadequate antimicrobial processing and insufficient attention to cold-chain temperature control.

According to FDA surveillance data, refrigerated cured and smoked fish products account for approximately 8–10% of Listeria cases in pregnant individuals—a disproportionate percentage given how often these products are consumed. This risk is real and documented.

Why Risk Persists in Refrigerator Once a package of smoked salmon is opened and stored in the refrigerator (35–40°F), Listeria begins growing slowly. At refrigerator temperature, Listeria doubles approximately every 24–48 hours. After 2 weeks of refrigeration, bacterial counts can exceed safe thresholds. This means that a package of smoked salmon that appears fresh and tastes normal may harbor hazardous Listeria levels if stored for 2–3 weeks.

How to Safely Enjoy Smoked Salmon During Pregnancy

Option 1: Canned Smoked Salmon Canned smoked salmon has been heat-processed in the can (retort processing) to achieve shelf stability, reaching internal temperatures of 250°F (121°C). This processing completely eliminates Listeria and any other pathogens. Canned smoked salmon is safe to eat directly from the can during pregnancy. Brands include Chicken of the Sea, Bumble Bee, and store brands.

Nutritionally, canned smoked salmon is nearly identical to fresh smoked salmon, with 20–24g protein, 1,500–2,000mg omega-3s, and significant vitamin D and B12 content per 3.5-ounce serving. The main difference is the texture (softer, flaked) and sodium content (higher, 400–600mg per serving due to canning preservative). Despite the sodium, canned smoked salmon is a nutritious option during pregnancy.

Option 2: Shelf-Stable Smoked Salmon Some producers offer shelf-stable smoked salmon that is packaged using high-temperature processing or with sufficient salt to prevent bacterial growth. These products are found in the shelf-stable grocery aisle (not the refrigerated section) and are safe during pregnancy. Check the label: if it states "shelf-stable" or "shelf-stable until opening," it has been processed to eliminate Listeria. Once opened, follow storage instructions on the label (usually refrigerate and consume within 3–5 days).

Option 3: Cooked Smoked Salmon Smoked salmon that is further cooked—heated to 165°F (74°C)—is rendered safe regardless of whether it was refrigerated or canned. Cooking methods include:

• In scrambled eggs: Mix cooked scrambled eggs with smoked salmon pieces
• In pasta sauce: Stir smoked salmon into a hot cream or tomato sauce just before serving
• In bagel bakes: Layer smoked salmon in a casserole with cream cheese and bake at 350°F for 15–20 minutes until heated through
• In quiches: Smoked salmon added to a quiche mixture before baking (quiches are baked to 160°F, eliminating Listeria)

If you want the convenience of ready-to-eat smoked salmon without cooking, this is not an option. But if you are willing to cook it, refrigerated smoked salmon becomes safe.

Option 4: Avoid Refrigerated Smoked Salmon The safest approach during pregnancy is to avoid refrigerated smoked salmon entirely. This eliminates the risk entirely and removes the burden of assessing whether an open package is still safe. This recommendation aligns with ACOG, CDC, and FDA guidance for pregnant individuals.

Nutritional Benefits and Alternatives

Alternatives Providing Similar Benefits

• Fresh salmon (cooked): 25g protein, 2,000–2,500mg omega-3, no Listeria risk
• Canned salmon with bones: 17g protein, 1,500mg omega-3, safe from Listeria
• Herring or sardines (canned): 18–25g protein, 1,500–2,500mg omega-3
• Trout (cooked): 26g protein, 900–1000mg omega-3
• Eggs (cooked): 6g protein, 100mg omega-3 (lower), but safe and convenient
• Fortified plant-based alternatives: Algae-based omega-3 supplements provide DHA without animal products

If you specifically crave the taste and texture of smoked salmon, canned smoked salmon or cooked preparations are your safest options. If other protein sources satisfy your nutritional and taste preferences, fresh salmon, canned salmon, or cooked fish provide comparable benefits without the Listeria concern.

Trimester-Specific Considerations

First Trimester (Weeks 1–13) Omega-3 intake supports neural tube closure, which occurs very early. While smoked salmon's omega-3s would be beneficial, the Listeria risk makes it a food to avoid. Alternative sources (fresh cooked salmon, sardines, supplements) provide the same benefit. If nausea is severe, focus on tolerable proteins; smoked salmon's convenience may not outweigh the risk.

Second Trimester (Weeks 14–27) Fetal brain and eye development accelerate. Omega-3 intake becomes increasingly important. This is an ideal time to focus on salmon consumption—fresh, canned, or cooked preparations that are Listeria-free. Canned smoked salmon is a convenient option if you want the smoked flavor with safety assurance.

Third Trimester (Weeks 28–40) Fetal brain development continues, and omega-3 intake remains important. Canned smoked salmon or cooked smoked salmon dishes are safe options. Avoid refrigerated smoked salmon.

FAQ

Q: I ate refrigerated smoked salmon before I knew it was risky. Should I be concerned? A: A single exposure carries low risk, particularly if the salmon was recently opened (within a few days of purchasing). Listeria has an incubation period of 2–30 days; if no symptoms develop within 4 weeks, infection is unlikely. Monitor for symptoms (fever, muscle aches, nausea, or diarrhea), and contact your healthcare provider if they occur. If significant time has passed with no symptoms, risk is minimal.

Q: Can I heat refrigerated smoked salmon to make it safe? A: Yes. Heating smoked salmon to 165°F (74°C) eliminates Listeria. If you have refrigerated smoked salmon you want to eat, heat it by adding to a hot dish (pasta, eggs, baked casserole). Do not consume cold.

Q: Is smoked salmon from a restaurant safe? A: Restaurant smoked salmon is typically refrigerated smoked salmon, the same type sold at retail. ACOG's guidance applies regardless of source. If you order a smoked salmon dish at a restaurant, confirm whether it is heated (in a bagel bake, pasta, or quiche) or served cold. If served cold, you are following the same risk as retail refrigerated smoked salmon.

Q: What about gravlax or cured salmon (not smoked)? A: Gravlax, cured in salt and dill, has a similar Listeria risk profile to smoked salmon. Both are processed without sufficient heat to eliminate Listeria and allow growth at refrigeration temperatures. Avoid cured salmon products during pregnancy.

Q: Is smoked salmon safe if I cook it immediately after opening the package? A: Cooking immediately after opening eliminates any Listeria that may have grown in the package. However, ACOG's recommendation is to avoid refrigerated smoked salmon during pregnancy regardless of cooking timing, as the risk—however manageable with cooking—exists. Canned or shelf-stable smoked salmon removes this concern entirely.

Q: Can I freeze refrigerated smoked salmon and then eat it? A: Freezing does not eliminate Listeria; it merely stops its growth temporarily. If you thaw the frozen smoked salmon and consume it without cooking, any Listeria present will resume growing at refrigeration temperature. Freezing does not make refrigerated smoked salmon safe.

Related Pregnancy Resources

Check more foods with our Pregnancy Safe Food Checker. Track healthy weight gain with our Pregnancy Weight Gain Calculator. Read our complete Pregnancy Nutrition Guide.

Sources

• ACOG (American College of Obstetricians and Gynecologists). (2023). Nutrition During Pregnancy. Committee Opinion 548.
• CDC (Centers for Disease Control and Prevention). (2018). Investigation of Listeria monocytogenes Associated with Smoked Salmon. Outbreak Investigation Report.
• FDA (U.S. Food and Drug Administration). (2022). Bad Bug Book: Listeria monocytogenes in Smoked and Cured Fish. Chapter 10.
• USDA. (2023). Recommended Safe Minimum Internal Temperatures. Food Safety and Inspection Service.

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