At what age can children be introduced to raw or undercooked foods, such as raw fish (sashimi) and rare (bloody) steak?

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Last updated: April 23, 2025View editorial policy

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From the Guidelines

It's generally recommended to wait until a child is at least 5 to 7 years old before introducing raw or undercooked foods like sushi, raw fish, or rare/bloody steak. Before this age, children's immune systems are still developing and they're more vulnerable to foodborne illnesses that can be present in raw foods 1. Even after age 7, it's essential to ensure any raw fish has been previously frozen to kill parasites, and that all raw foods come from reputable sources with proper food handling practices.

When introducing these foods, start with small amounts and watch for any adverse reactions. The concern with raw foods isn't about choking hazards but rather about pathogens like bacteria, viruses, and parasites that cooking would normally destroy. Children under 5 are particularly susceptible to serious complications from foodborne illnesses like E. coli, Salmonella, and Listeria 1. For safety, always ensure proper food handling and consider serving fish that's been lightly cooked instead of completely raw for younger children.

Some key points to consider:

  • Avoid cross-contamination of foods by washing hands, cutting boards, counters, knives, and other utensils thoroughly after contact with uncooked foods 1.
  • Produce should be washed thoroughly before being eaten 1.
  • Poultry and meat are safest when adequate cooking is confirmed by thermometer 1.
  • There is no specific evidence to support delaying introduction of solid foods, including potentially allergenic foods, beyond 4 to 6 months of age 1. However, this does not apply to raw or undercooked foods, which pose a risk of foodborne illness.

In real-life clinical practice, it's crucial to prioritize caution and consider the individual child's health status and immune system development when introducing raw or undercooked foods 1.

From the Research

Food Safety Considerations

  • The Centers for Disease Control and Prevention estimates that each year, one in six Americans will experience a foodborne illness, highlighting the importance of proper food handling and cooking practices 2.
  • Common causes of foodborne illnesses in the United States include viruses, bacteria, and parasites, which can be found in raw or undercooked foods.

Risks Associated with Raw Foods

  • Raw fish and bloody steak can pose a risk of foodborne illness, particularly for children, due to the potential presence of pathogens such as Salmonella, Escherichia coli, and Listeria 2.
  • There is no specific age recommendation provided in the available studies for introducing raw foods like raw fish and bloody steak to children.

Lack of Direct Evidence

  • The available studies do not provide direct evidence or guidelines for introducing raw foods to children, and the age at which it is safe to do so is not specified 2, 3, 4.
  • Study 3 discusses the properties of Salmonella typhimurium, while study 4 presents a case of renal cell carcinoma, neither of which provides relevant information for determining the appropriate age for introducing raw foods to children.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Diagnosis and Management of Foodborne Illness.

American family physician, 2015

Research

Renal cell carcinoma in a patient successfully treated for Wilms's tumor.

AJR. American journal of roentgenology, 1977

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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