Pregnancy cravings and food aversions: what helps and when to see a doctor

Pregnancy cravings are a well-known symptom, but HealthHub says nobody knows exactly what causes them. You can usually have a small portion of what you crave. Regular meals and less-sweet drinks keep it in check. A craving for ice, soil or chalk is different: it's called pica, so tell your gynae.

How to handle pregnancy cravings, step by step

1. Eat three main meals and two or three small snacks a day. HealthHub says regular meals stop the dips in blood sugar that can set off a craving.
2. Build your meals on HPB's My Healthy Plate: half fruit and vegetables, a quarter wholegrains and a quarter protein.
3. Have a small portion of what you crave instead of cutting it out. A KKH dietitian suggests one cookie a day rather than the whole packet.
4. Order drinks and desserts less sweet. HealthHub suggests kopi or teh siu dai or kosong, bubble tea at 50% sugar or lower, and ice kachang with less syrup.
5. Go easy on tea and coffee. KKH's early pregnancy advice is no more than one cup a day, and our coffee while pregnant guide works out the caffeine in kopi and teh.
6. Skip raw and undercooked food, even when you crave it. KKH lists sashimi and raw or partly cooked eggs as foods to avoid.
7. Wait out a strong urge. The KKH dietitian suggests a walk or a call to a friend to take your mind off food.
8. Swap in other foods when old favourites put you off. KKH suggests smaller, more frequent meals of foods you enjoy.
9. Tell your gynae about any craving for things that aren't food, such as ice, soil, chalk or starch.
10. Tell your doctor if you can't control your cravings and you're gaining a lot of weight. The KKH dietitian says they can then test you for gestational diabetes.

Why cravings and aversions happen

HealthHub says the exact cause of food cravings in pregnancy is still unknown. Researchers think hormone changes or short-term gaps in nutrients may play a part. But some women crave foods even when they're already getting the nutrients their baby needs.

HealthHub also calls it a myth that a craving means your baby is short of something, or that your baby's growth suffers if you don't give in. You can enjoy a craving, or let it pass.

KKH lists cravings and aversions with the early pregnancy symptoms. You may notice a strange taste in your mouth, a sharper sense of smell, new cravings, and foods or drinks you no longer like. KKH says 60% of pregnant women have food aversions, linked to changing hormones and mood. Nausea can play a part too, and the loss of appetite that goes with it usually comes in the first trimester and settles later in pregnancy.

If nausea is behind your aversions, our morning sickness remedies guide covers what helps. Our metallic taste in pregnancy guide covers taste changes and a poor appetite.

Craving swaps that fit a Singapore day

Most cravings can fit into a normal day of eating. KKH's advice is to eat a balanced diet and eat as you desire, but not to binge on high-calorie, high-fat food. The table pairs common cravings with what HealthHub and KKH suggest instead.

For snack ideas with HPB's portions, see our healthy pregnancy snacks list. Our foods to avoid during pregnancy guide has the full list of raw and risky foods, and eating well in pregnancy covers your everyday diet.

Sweet cravings, weight gain and gestational diabetes

HealthHub says giving in to high-calorie cravings too often can lead to too much weight gain. That raises your risk of gestational diabetes and high blood pressure.

Eating for two is a myth, HealthHub says. You need an extra 300kcal a day from the second trimester, and 450kcal from the third. Our pregnancy weight gain calculator shows a healthy range for your starting BMI.

HealthXchange, SingHealth's health site, says most women with gestational diabetes have no symptoms. It's usually found at a routine check. Most women take the oral glucose tolerance test between 24 and 28 weeks, and women at high risk may take it earlier. If you've been diagnosed, our gestational diabetes diet guide shows how sweet foods fit your meal plan.

Pica: craving ice, soil, chalk or starch

Pica means eating things that aren't food. Cleveland Clinic, a US hospital, says it tends to happen in pregnant women. It lists ice, chalk, clay or soil and laundry starch among the things people eat.

Cleveland Clinic says eating ice is common in pregnancy and harmless in itself. Other items carry risks, such as lead poisoning, or parasites from soil. It also says low iron, calcium and zinc are among the most common reasons for pica, and that pica in pregnancy usually goes away on its own.

Cleveland Clinic says people often feel embarrassed about pica, and it advises an honest talk with your doctor anyway. In Singapore, your gynae already checks for anaemia. SingHealth says a full blood count is done early in pregnancy and again between 24 and 28 weeks. It says iron deficiency is the most common cause of anaemia in pregnancy. So if you crave ice, ask about your last result. Our iron during pregnancy guide covers iron-rich hawker food and the blood tests.

When to see a doctor

See your gynae or a polyclinic doctor if you notice any of these. They're reasons to get checked, not a diagnosis.

• A craving for ice, soil, chalk, starch or anything else that isn't food. Cleveland Clinic advises an honest talk with your doctor.
• Severe vomiting, being unable to keep any food down, or losing more than 10% of your pre-pregnancy weight. KKH says to see your doctor immediately.
• Being unable to take in any fluids or food, or feeling dizzy, weak and more and more drained, as KKH lists.
• Feeling much thirstier, peeing more, and feeling hungrier or more tired than usual. HealthXchange lists these as possible signs of gestational diabetes.
• Cravings you can't control, with fast weight gain. The KKH dietitian says your doctor can test you for gestational diabetes.
• Tiredness, giddiness, headaches, a fast or irregular heartbeat, breathlessness or pale skin, which SingHealth lists as signs of anaemia.

For most of these, call your gynae's clinic. If it can't wait, KKH's Urgent O&G Centre is a 24-hour walk-in centre for urgent problems before 22 weeks. From 22 weeks, KKH asks you to go straight to its Delivery Suite on Level 2 of the Women's Tower with concerns such as bleeding or signs of labour. For significant abdominal pain or heavy bleeding, KKH says to get care right away at the centre or your nearest hospital emergency department. Our bleeding in early pregnancy guide lists the routes at other hospitals.

Frequently asked questions

When do pregnancy cravings start?

KKH lists cravings and food aversions among the early pregnancy symptoms, so many women notice them in the first trimester. KKH says the loss of appetite that comes with aversions usually settles later in pregnancy. Our first trimester checklist covers the rest of those early weeks.

Why do pregnant women crave certain foods?

Nobody knows for sure. HealthHub says hormone changes or short-term gaps in nutrients may play a part. But some women crave foods even when they're well nourished, so a craving isn't a sign your baby is missing something.

Are food aversions in pregnancy normal?

Yes. KKH says 60% of pregnant women have food aversions, and nausea can play a part. Eat smaller meals more often and swap in foods you can face. See your doctor if you can't keep any food or fluids down.

Is craving ice in pregnancy a sign of low iron?

It can be. Cleveland Clinic says eating ice is common in pregnancy and harmless in itself, but low iron is one of the most common reasons for pica. Tell your gynae, who can check your full blood count.

What is pica in pregnancy, and is it dangerous?

Pica means eating things that aren't food, such as soil, chalk or laundry starch. Cleveland Clinic says it usually goes away on its own in pregnancy, but some items can cause lead poisoning or parasite infections. Don't eat them, and tell your doctor.

Is it OK to give in to pregnancy cravings?

Usually, in small amounts. KKH says to eat a balanced diet and eat as you desire, without binging on high-calorie, high-fat food. Raw food such as sashimi and runny eggs stays off the menu, whatever you crave.