Is In-N-Out Safe During Pregnancy? Burgers, Animal Style, Shakes and What to Order

In-N-Out's menu fits on one board: three burgers, fries, shakes and drinks, plus a "not so secret" menu of ways to customize them. That simplicity makes it easy to check against pregnancy guidance, and the answers are mostly reassuring.

We went through In-N-Out's own food quality and nutrition pages, which list ingredients for every item. Here is what they tell you, and the couple of things worth knowing before you order.

The Menu, Item by Item

The Burgers: Fresh, Cooked to Order, and Worth a Quick Check

In-N-Out says its patties are made from fresh whole chucks ground at its own facilities, are never frozen, and that every burger is cooked fresh to order. That is about as good a starting point as fast food gets.

The pregnancy question with any burger is doneness. Ground beef needs to reach 160°F (71°C) all the way through, because grinding spreads bacteria from the surface of the meat into the middle. A thin patty cooked on a hot grill gets there quickly, which works in your favor.

Still, it's worth a glance before the first bite. If the center looks pink, ask for a new patty. That's a normal request, and any crew member will understand. Pregnancy adds toxoplasmosis to the usual reasons for caution with undercooked meat, which is why the advice is stricter than for everyone else at the table.

Is the Spread Safe?

Yes. In-N-Out's spread is a creamy, Thousand Island-style dressing, and its ingredient list includes whole eggs, which is why people ask.

The concern with egg-based sauces in pregnancy is raw egg, as in homemade mayonnaise or aioli. In-N-Out's spread is a commercially made dressing that also contains a preservative, sodium benzoate, according to the company's nutrition page. Commercial dressings and mayonnaise are made with pasteurized eggs, which is why our mayonnaise guide treats them as safe.

Animal Style adds extra spread, mustard grilled into the patty, pickles and grilled onions. All of that is fine.

The Pink Lemonade Is Fine (Unlike Some Chains)

This is worth spelling out, because lemonade is a genuine issue at some restaurants. Fresh-squeezed lemonade isn't pasteurized, and the FDA advises pregnant women to avoid untreated juice. That's why our Raising Cane's guide recommends skipping its freshly squeezed lemonade.

In-N-Out's Signature Pink Lemonade is different. According to its nutrition page, it's made from water and a commercial syrup containing lemon juice concentrate and a preservative. That's a commercially processed product rather than juice squeezed in the store, so it's fine. It's sweet, though: 33g of sugar in an 11-ounce cup. The Lite Pink Lemonade cuts that to zero.

Shakes Are Real Ice Cream, and Pasteurized

In-N-Out makes its shakes with an ice cream mix that lists pasteurized milk and cream among its ingredients. That rules out the raw milk concern, so the shakes are safe in pregnancy.

They are also substantial. A 15-ounce chocolate shake is 610 calories with 61g of sugar, according to In-N-Out's nutrition information. That's a treat rather than a snack, and worth splitting or skipping if you're managing gestational diabetes. Our fast-food desserts guide covers shakes and soft serve at other chains.

The Not So Secret Menu, Explained

In-N-Out lists a handful of popular custom orders on its website. Here is how each one looks in pregnancy:

• Animal Style: fine. The patty is grilled with mustard and topped with extra spread, pickles and grilled onions.
• Protein Style: fine. Lettuce instead of the bun, which helps with gestational diabetes.
• 3x3 and 4x4: fine from a safety point of view, with three or four patties. They are also a lot of sodium and saturated fat in one go, so think of them as an occasional order.
• Flying Dutchman: two patties and two slices of cheese, with no bun or vegetables. Fine, and very high in protein, but not much else.
• Grilled Cheese: fine. Cheese, lettuce, tomato and spread on a toasted bun, with no meat. Useful when meat aversion hits in the first trimester.
• Animal Fries: fine. Fries topped with melted cheese, spread and grilled onions.
• Well-done fries: fine, and crispier. Some people find them easier to eat on a queasy day.

Is In-N-Out Nutritious Enough in Pregnancy?

As fast food goes, it holds up reasonably well. A cheeseburger brings about 20g of protein according to In-N-Out's nutrition information, and the beef provides heme iron, the form your body absorbs most easily. Your iron needs rise to 27mg a day in pregnancy, which is why red meat in moderation is genuinely useful. Our iron guide covers the best sources.

What a burger and fries won't give you is much in the way of vegetables, fruit or calcium beyond the cheese. If In-N-Out is lunch, lean on fruit, yogurt or a salad later in the day to balance it out. One fast-food meal doesn't undo a good week of eating, and it doesn't need to be a source of guilt.

Sodium: The Real Thing to Watch

Nothing here is a safety problem. Sodium is the number that adds up, and In-N-Out publishes it for every item:

• Hamburger: 360 calories, 670mg sodium.
• Cheeseburger: 430 calories, 1,080mg sodium.
• Double-Double: 610 calories, 1,670mg sodium.
• French fries: 360 calories, 150mg sodium.

For comparison, the FDA's daily value for sodium is 2,300mg. A Double-Double alone is close to three quarters of that. You don't need to avoid salt in pregnancy, but if you're dealing with swelling or your blood pressure is being monitored, a single cheeseburger or hamburger is the easy swap. Our pregnancy swelling guide explains what actually helps.

Interestingly, the fries are low in sodium as served, at 150mg, and they bring 6g of fiber per serving.

With Gestational Diabetes

• Order Protein Style. The lettuce wrap removes the bun, which is most of the carbohydrate in a burger.
• Share the fries, or skip them if you've already had carbohydrates.
• Skip the shake and the regular lemonade. The Lite Pink Lemonade or unsweetened iced tea are the easy swaps.

Your care team will set your targets, and our gestational diabetes meal plan shows how a fast-food meal can fit into a day.

With Nausea or Heartburn

For nausea, a plain hamburger and fries is about as predictable as fast food gets. Leaving off the raw onion and spread takes away the strongest smells and flavors.

For heartburn, raw onion, tomato and rich sauces are common triggers. A hamburger with no onion, plus a smaller portion eaten earlier in the evening, usually goes down better. Our heartburn foods guide has more.

Three Easy In-N-Out Orders

• The everyday order: a Cheeseburger, fries and Pink Lemonade. Around 20g of protein, nothing pregnancy guidance restricts.
• The lower-sodium order: a Hamburger with fries and water. 670mg of sodium for the burger, against 1,670mg for a Double-Double.
• The lower-carb order: a Double-Double Protein Style with unsweetened iced tea or water.

Drive-Thru and Leftovers

In-N-Out food is best eaten straight away, and that also happens to be safest. Hot food is safe while it's hot, and the USDA's rule is that cooked food shouldn't sit at room temperature for more than 2 hours, or 1 hour above 90°F (32°C).

Burgers and fries don't reheat well, but if you do save some, get them into the fridge promptly and reheat until steaming hot, 165°F (74°C). Our leftovers guide has the full rules.

Comparing burger chains? Our Five Guys guide and Burger King guide cover two of the other big ones.

This article is general information and does not replace advice from your doctor, midwife or dietitian. Menus and recipes change, so check In-N-Out's current nutrition information if you're tracking something specific.