Pregnancy Cravings: When You Gotta Have It!

Pregnancy and food cravings go hand in hand; 3 experts offer suggestions for healthy cravings.

Medically Reviewed by Louise Chang, MD on October 07, 2008
7 min read

Pickles and ice cream. Cheese Whiz on steak. Brownie mix -- straight from the bowl. While these may not exactly seem like gourmet fare, if you're pregnant they can seem like heaven on a plate.

The reason: Pregnancy cravings - those seemingly unquenchable longings for oftentimes eclectic combinations of foods that you might never otherwise even dream of eating!

But what's behind these mysterious food fantasies, and can they ever be harmful? Doctors say the answers depend a lot on what you are craving.

"No one really knows why pregnancy cravings occur, though there are theories that it represents some nutrient that the mother may be lacking -- and the crave is the body's way of asking for what it needs," says Andrei Rebarber, MD, associate director of the division of maternal-fetal medicine at NYU Medical Center in New York.

When that overwhelming desire for pickles or processed cheese hits, Rebarber says it could be the body asking for more sodium. That aching for a Big Mac and a plate of fries may be your need for more protein, sodium, or potassium. The burning in your belly for a double helping of chocolate double latte ice cream may be signaling a need for more calcium or fat.

"It's not that the body actually needs the specific food you are craving, but it may need something in that food. And your taste buds just interpret it as a craving for something specific," says Rebarber.

What's more, many experts say our taste buds do actually play a role in how we interpret our body's needs. Studies show that the high hormone levels present during pregnancy can alter both a woman's sense of taste and smell. So certain foods and odors can not only be more enticing but in some cases more offensive; a problem that often plays out as a pregnancy food aversion.

"Food aversions are most often associated with early pregnancy -- when they are likely to touch off a bout of morning sickness -- with nausea and vomiting," says Rebarber.

While some pregnancy cravings can certainly seem a bit odd, in most instances, they don't represent any real threat to mother or the baby. This, however, can change dramatically, when the craving is for a nonfood item. The condition, known as pica, can lead to an overwhelming desire to consume any number of substances, some of which can be extremely harmful to both mother and baby.

"During pregnancy a woman can crave -- and eat -- things like dirt, laundry starch, crayons, ground up clay pots, ice scraped from the freezer. As bizarre as it seems, the desire can be overwhelming," says Peter S. Bernstein, MD, MPH, medical director of obstetrics and gynecology at the Comprehensive Family Care Center of Montefiore Medical Center in Bronx, N.Y.

While pica -- eating non-nutritive substances -- is not well understood, Bernstein says sometimes these cravings represent a nutritional deficiency, particularly a need for iron, though he says there are no studies to prove this is always the case.

In some instances, Bernstein tells WebMD that the cravings can also have a cultural or ethnic component, one which actually fosters eating these dangerous nonfood items.

"The craving is there, and then fulfilling it is encouraged within certain cultural communities," says Bernstein.

Among the most dangerous aspects of pica is the consumption of lead -- particularly when women eat dirt or clay. This can lead to infant and child developmental problems with low verbal IQ scores, impaired hearing and motor skill development. Other research has shown an increased risk of learning disabilities and attention deficit disorders in infant exposure to lead before birth.

"I've had women and their babies develop lead poisoning from eating dirt during pregnancy; the neurological damage can be overwhelming," says Bernstein.

If you do find yourself craving any nonfood item, experts say see your doctor immediately and be tested for iron deficiency anemia or other nutritional deficiencies such as zinc, which has also been linked to pica.

For most women, pregnancy food cravings fall into just a few categories: sweet, spicy, salty, or occasionally sour. Surveys show only a scant 10% of pregnant women crave fruits and veggies during pregnancy, with a desire to gobble down foods such as peaches, blueberries, or broccoli not high on the "must have" scale.

And in fact, that's one reason doctors sometimes raise a red flag about pregnancy cravings.

"My biggest concern is when food cravings replace good nutrition -- in other words, a woman will fill up on the foods she craves and skip the nutritious foods her body and her baby really need," says Rebarber.

Not only can this cause serious deficiencies in both baby and mom, since oftentimes the foods we crave during pregnancy can be laden with empty calories, it can also lead to gaining too much weight; a problem that doctors say is on the rise.

Rebarber explains that because the population, as a whole, weighs more, it's not uncommon for overweight women to get pregnant -- meaning there is an even greater need to ensure they don't gain an excessive amount of weight during their pregnancy.

Indeed, a Scandinavian study of 600 pregnant women published in the journal Obstetrics and Gynecology in 2002 showed that excessive weight gain during pregnancy increased the risk of preeclampsia (a life-threatening condition often characterized by a rapid rise in blood pressure), as well as a series of labor and delivery problems.

According to the Institute of Medicine, if you are of normal weight before pregnancy, you should aim to gain between 25 and 35 pounds while pregnant. But if you're overweight at the time of conception, your goal pregnancy weight should be no more than 15 to 25 pounds.

Bernstein tells WebMD that how you handle your cravings could make a big difference.

"If you are craving high-fat premium ice cream and chocolate doughnuts and eating them all the time, you could see your weight blossom to an unhealthy level quite early on," he says.

If you are at risk for gestational diabetes (diabetes diagnosed during pregnancy that can affect the health of both baby and mom), giving in to high-sugar cravings could cause even more problems.

"With gestational diabetes you not only have to watch weight gain, but also what you eat -- so again, cravings can easily get out of hand," says Bernstein.

The good news is that you don't have to spend your pregnancy with a yen you just can't fill. Clinical nutritionist Samantha Heller, MS, RD, says it's easy to quench a pregnancy craving with healthy alternatives if you simply know what it is you really want.

"It's all about understanding what your craving is really for and then finding a more healthy version of that same food, and make a simple substitution," says Heller, a clinical nutritionist at NYU Medical Center in New York City.

Nutritionist Liz Lipski, PhD, CCN, agrees: "If the food you are craving is pretty healthful, I'd give in to the cravings; but if it's lacking healthful nutrients, I'd look for healthier alternatives."

The key say both experts, is to not automatically reach for the food you think you want -- but instead take a few minutes to understand what your body is telling you.

"If you crave, for, example, some yummy premium strawberry ice cream, try to break your craving down: Are you longing for something cold, smooth, creamy, and sweet, or is it the taste of strawberries you really want?" says Heller.

Once you understand what you really want, it's easier to choose a healthy alternative.

"Maybe a strawberry sorbet will fill your needs, or a dish of fresh strawberries with low-fat topping or maybe even a strawberry yogurt. If you just stop to think about what you're really craving, it can be easy to find something healthy and tasty," says Heller.

"If it's the calcium you are needing, you can take a calcium supplement or use other dairy products such as cheese, buttermilk, yogurt, and kefir to fill the bill," Lipski tells WebMD.

To help get you started thinking in the right direction, our experts offer these suggestions for healthy food fixes that can satisfy your craving and keep you well.

If you craveTry eating ...
Ice CreamNonfat frozen yogurt, sorbet, or sherbet
ColaMineral water with fruit juice or lime
Doughnuts/pastryWhole-grain bagel with fresh fruit jam
Doughnuts/pastryWhole-grain bagel with fresh fruit jam
CakeLow-fat banana or zucchini bread
Sugar-coated cerealWhole-grain cereal or oatmeal, with brown sugar
Potato chipsLow-sodium, low-fat chips, popcorn, or pretzels
Sour creamNo-fat sour cream or non-fat plain yogurt flavored with herbs
Sundae toppingsFresh berries or bananas
Canned fruits in heavy syrupFresh fruit, frozen unsweetened fruit, fruit packed in water, juice
Lunch meatsLow-fat or fat-free meats, turkey or soy Bologna, beef hot dogs
Whipped creamIce cold no-fat milk whipped with a hand-held immersion blender

Colette Bouchez is the author of Your Perfectly Pampered Pregnancy: Health, Beauty and Lifestyle Advice for the Modern Mother-To-Be.