Dear Liisa,

This is a very interesting question. Since I was unable to locate anything in the literature, I discussed this issue with my colleagues. To begin answering your question, it appears that the main concern with eating sushi, prepared with raw fish, is that it may not be fresh, and that it may have been obtained from a place where the water is polluted. There is a concern in this case that raw fish could contain parasites or high levels of bacteria.

In regard to your question about toxomplasmosis, if a mother is infected, it is safe, and important (because of antibodies passed through her milk) to continue breastfeeding. Toxoplasmosis can be contracted by eating uncooked or undercooked meat, but I not sure if it is of concern when eating fresh raw fish.

In Japan, sushi is a regular part of many women's diets. I am not aware of any studies/warnings to nursing mothers who consume sushi on a regular basis. If you are still concerned about the safety of eating sushi during lactation, I would recommend you continue to enjoy sushi prepared without raw fish. You might try a vegetarian sushi or sushi prepared with cooked fish.

If you decide to eat raw fish, it would be wise to frequent a sushi-bar/restaurant where you trust that the food is very fresh and well-prepared. Don't feel uncomfortable about inquiring as to the source of their fish, the method of delivery and its freshness. Enjoy!

Warmly,
Debbi