An OB/GYN's Guide to Pregnancy Cravings

Chocolate. Pickles. Curry. Almost everyone experiences cravings. While the cause is not quite clear, some theories suggest pregnancy hormones can heighten sense of smell and taste, creating both cravings and aversions. Other theories suggest that it’s the body’s way of compensating for deficiencies – craving ice cream when you need calcium, fruit for vitamin D and so on.

“In any case, cravings can be sweet, salty, sour or spicy,” says Arnaldo Torres, MD, chair of OB/GYN at Northwestern Medicine Central DuPage Hospital. “And individual cravings can vary significantly over the course of a woman’s pregnancy.”

Still, nutrition doesn’t go out the window when you’re eating for two. In fact, it’s even more important to eat well while allowing for a little indulgence. So don’t ignore your cravings. Rather, opt for healthier alternatives as much as possible. 

“If you are craving chocolate, try small portions of dark chocolate,” suggests Dr. Torres. “Aim for frozen yogurt or sherbet instead of full fat ice cream. Be careful with spicy foods, as heartburn could be a side effect. If you’re craving salt, try flavorful salt-free seasonings such as garlic powder, balsamic vinegar, or a salt-free Italian seasoning. A good alternative to potato chips is thinly sliced roasted potatoes flavored with a salt-free seasoning.”

Restrictions, Weight Gain and the Plain Weird

Even with healthy substitutions, Dr. Torres advises that it’s not a free-for-all:  “Women should not give in to cravings that could impact any necessary diet restrictions. For example, high sodium or high carbohydrate foods.” 

Excessive weight gain and improper nutrition can have real impacts on the health of you and your baby. On average, women only need an additional 200-300 calories during the second and third trimesters. This is usually reflected in a healthy weight gain during pregnancy. Underweight women may gain 28 to 40 pounds while healthy weight women can gain 25 to 35 pounds. Overweight women are recommended to keep weight gain between 15 and 25 pounds, while women with obesity should aim for 11 to 20 pounds

“Gaining too much weight can lead to an increased risk of a cesarean delivery, delivery complications, gestational diabetes and hypertension in pregnancy,” says Dr. Torres. “The baby could be at risk for a heavy birth weight, childhood obesity and adult obesity later in life.”

While that may mean resisting that chocolate bar, it goes without saying you should withhold from the more unusual cravings.

“Some cravings can cause pregnant women to want to eat items that are not considered food, such as dirt, clay, soap and ice. This is known as pica,” says Dr. Torres. “Eating some of these items can be harmful to your health. Pica is an eating disorder characterized by an appetite for substances that lack any nutritional value. Women who lack calcium or iron in their diet may feel the need to eat these non-food items. If you crave these types of items, it is best to see your doctor to rule out vitamin deficiencies.”

Simple Strategies When Cravings Strike

Don’t eat too much chocolate. Don’t eat dry wall. (Don’t worry - pica is rare!) Navigating pregnancy cravings will mostly be intuitive, but Dr. Torres also offers a few tips to adjust your healthy diet to compensate for those cravings:

• Eat a variety of foods.
• Plan smaller meals and snacks every couple of hours.
• Get your extra calories from nutritious foods, such as lean meats, nuts, low-fat or fat-free dairy products, fruits, vegetables, and whole grain breads and cereals.
• Drink approximately 12 cups of water or other beverages (caffeine-free or 100% fruit juice) throughout the day.

And for those nine months, your nutrition isn’t the only aspect of your healthy lifestyle susceptible to adjustment. Learn what else to expect and how to prepare during the first trimester, and nutrition tips for breastfeeding.