Understanding Pregnancy Cravings (and Aversions)

One day you can't stop thinking about pickles and ice cream. The next, the smell of your favorite coffee makes you gag. Welcome to the wild world of pregnancy cravings and aversions—a nearly universal experience that can range from amusing to overwhelming.

While scientists don't fully understand why pregnancy rewires our food preferences so dramatically, these changes are real, powerful, and usually nothing to worry about. Here's what's happening and how to navigate it.

Why Pregnancy Changes Food Preferences ACOG

Several factors contribute to cravings and aversions.

Hormonal changes:

• hCG (pregnancy hormone) peaks in first trimester—when aversions are worst
• Estrogen and progesterone alter taste and smell perception
• Hormones affect the reward centers in your brain
• Changes can be sudden and intense

Heightened senses:

• Smell becomes much more sensitive
• Taste perception changes
• Evolutionary theory: may help avoid potentially harmful foods
• Why strong smells suddenly become unbearable

Nutritional needs:

• Body may signal needs through cravings (though research is mixed)
• Craving red meat might signal iron needs
• Craving dairy might signal calcium needs
• But craving ice cream probably isn't a calcium signal—it's just delicious

Emotional factors:

• Comfort foods provide... comfort
• Stress and anxiety can increase cravings
• Food becomes more emotionally significant
• Cultural associations with pregnancy foods

Common Cravings ACOG

If you're craving these, you're in good company.

Frequently craved foods:

• Sweets (ice cream, chocolate, candy)
• Salty and crunchy (chips, pretzels, pickles)
• Sour foods (citrus, sour candy)
• Carbohydrates (bread, pasta, potatoes)
• Specific fruits (watermelon, citrus)
• Red meat
• Dairy products
• Spicy foods

Strange but common combinations:

• Pickles and ice cream (the classic)
• Peanut butter on everything
• Hot sauce on unexpected foods
• Specific brand obsessions
• Foods you didn't like before pregnancy

What research shows:

• About 50-90% of pregnant women experience cravings
• Most common in first and second trimesters
• Can change throughout pregnancy
• Cultural factors influence what women crave

Common Aversions ACOG

Aversions can be even more powerful than cravings.

Frequently avoided foods:

• Coffee and caffeine
• Meat (especially chicken)
• Eggs
• Spicy foods
• Strong-smelling foods
• Vegetables
• Foods with strong textures

Why aversions happen:

• Protective mechanism (avoiding potentially harmful foods)
• Heightened smell sensitivity
• Nausea association
• Hormonal changes affecting taste

Managing aversions:

• Don't force yourself to eat trigger foods
• Find alternatives for nutrition (can't eat meat? try beans)
• Cold foods often have less smell
• This usually improves after first trimester
• Talk to provider if aversions are severely limiting diet

Cravings You Can Safely Indulge ACOG

Most cravings are fine to satisfy in moderation.

Go ahead and enjoy:

• Sweet fruits
• Cheese and dairy
• Salty snacks (in moderation)
• Ice cream (occasionally)
• Pickles
• Comfort carbs
• Specific flavor combinations that sound good

The moderation principle:

• Satisfy cravings in reasonable portions
• Balance treats with nutritious foods
• Don't eat exclusively craved foods
• Listen to your body, but use judgment

Healthy swaps:

• Craving ice cream? Try frozen yogurt or fruit smoothie
• Craving chips? Try air-popped popcorn
• Craving sweets? Try fruit with nut butter
• But also—sometimes you just need the real thing

Cravings to Be Careful With ACOG

Some cravings require extra attention.

Limit these:

• Raw or undercooked foods (sushi, rare meat)
• High-mercury fish (shark, swordfish, king mackerel)
• Unpasteurized dairy and juices
• Deli meats (unless heated)
• Excessive caffeine
• Very high sodium foods

Talk to your provider about:

• Intense cravings for very specific foods (may signal deficiency)
• Cravings that are controlling your diet
• Inability to eat anything but craved foods
• Excessive weight gain from indulging cravings

When Cravings Signal a Problem: Pica ACOG

Pica is the craving for non-food items—and it needs medical attention.

What pica looks like:

• Craving dirt, clay, or soil
• Craving ice (pagophagia)
• Craving laundry starch or cornstarch
• Craving chalk
• Craving other non-food substances

Why it happens:

• Often signals iron deficiency anemia
• May indicate other nutritional deficiencies
• Has cultural components in some communities
• Can be harmful if acted upon

What to do:

• Tell your provider immediately
• Don't be embarrassed—it's more common than you think
• Get tested for nutritional deficiencies
• Treatment usually resolves the craving

Ice craving specifically:

• Very common in pregnancy
• Strongly associated with iron deficiency
• Often resolves with iron supplementation
• Worth mentioning to your provider

Managing Cravings Practically ACOG

Strategies for living with your new food brain.

When cravings hit:

• Ask yourself if you're actually hungry
• Try a small portion first
• Wait 15-20 minutes—it may pass
• Drink water (sometimes thirst mimics cravings)
• Find a healthier version if possible

Planning ahead:

• Keep healthy snacks available
• Stock some craved foods in reasonable portions
• Have backup options for common aversions
• Meal prep when you're feeling good

At restaurants:

• Don't be embarrassed about unusual orders
• Ask for modifications
• Bring your own snacks if needed
• It's temporary—enjoy it

Aversions and Getting Adequate Nutrition ACOG

When aversions limit your diet, get creative.

If you can't eat meat:

• Beans, lentils, and legumes
• Eggs (if tolerated)
• Dairy products
• Nuts and nut butters
• Tofu and tempeh

If you can't eat vegetables:

• Fruit (similar nutrients)
• Vegetable-based soups (easier to tolerate)
• Smoothies with hidden veggies
• Prenatal vitamins become even more important

If you can't eat much of anything (severe nausea):

• Eat whatever you can keep down
• Small, frequent meals
• Cold foods often better tolerated
• Talk to provider about medication if severe

The Emotional Side of Cravings ACOG

Food changes during pregnancy can be emotionally loaded.

Normalize your experience:

• Cravings and aversions are real, not "in your head"
• You're not weak for wanting certain foods
• Your body is going through massive changes
• This is temporary

When partners/family don't understand:

• Explain that these are physical, not just preference
• Ask for support without judgment
• Sometimes you just need the food—not a lecture
• Humor helps

If you have a history of disordered eating:

• Pregnancy food changes can be triggering
• Work with your provider and a therapist
• Focus on nourishment, not restriction
• Give yourself extra grace

When Do Cravings and Aversions End? ACOG

Good news: they usually don't last forever.

Typical timeline:

• Aversions: Often worst in first trimester, improve by second
• Cravings: Can occur throughout but often peak mid-pregnancy
• Some resolve after delivery
• Some persist during breastfeeding

After pregnancy:

• Most cravings fade
• Some taste changes persist temporarily
• Coffee usually becomes appealing again
• You might miss some of your pregnancy foods!

The Bottom Line

Pregnancy cravings and aversions are normal, usually harmless, and one of the stranger ways your body signals that something amazing is happening. Indulge reasonable cravings in moderation, work around aversions creatively, and talk to your provider about anything unusual—especially cravings for non-food items. ACOG

Remember:

• Cravings and aversions are physically real
• Most are safe to indulge in moderation
• Work around aversions creatively
• Pica (non-food cravings) needs medical attention
• This is temporary

Clara is here when you have questions about pregnancy cravings or nutrition.