Pica During Pregnancy: Signs, Causes & Treatment

Pica during pregnancy refers to the craving or consumption of non-food substances like dirt, chalk, or paper. This condition can be associated with nutritional deficiencies or psychological factors. Understanding its signs, potential causes, and available treatment options is key to ensuring a healthy pregnancy. If you notice these cravings, seeking medical advice early can help manage pica effectively and safeguard both your health and that of your baby.

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Cravings are common during pregnancy, but if you feel a persistent urge to eat non-food items like soil, chalk, or paper, this might be a sign of pica. While it's still not fully understood why this happens, pica could be linked to nutritional deficiencies, hormonal changes, or psychological factors. It’s important to recognize the signs early, explore the possible causes, and take action to prevent any potential risks. The good news is that there are ways to manage pica with the right treatment and support from a healthcare professional.

Understanding pica, its causes, and treatment options is essential. Working with your healthcare expert can help you address any underlying health issues, including nutritional deficiencies, and find a treatment approach that suits you.

What is Pica?

Pica is a condition where you may crave and consume non-food items, such as soil, chalk, ice, or paper, for a period lasting at least one month. Unlike typical pregnancy cravings, which are often related to food, pica cravings involve substances that provide little to no nutritional benefit.
These non-food items can potentially cause harm to your body, as they may contain harmful bacteria, parasites, or toxins. Eating ice (pagophagia) is sometimes considered a variant of pica, but it is less risky than consuming other non-food substances.
If you find yourself regularly craving or consuming these substances, it's important to speak with a healthcare expert, as they can help identify the causes and potential risks associated with pica.

Signs and Symptoms of Pica

It’s important to understand what pica means, including its cravings and behaviours, so you can take the right steps.
  • Cravings for non-food items
Pica often involves strong, constant cravings for substances like dirt, clay, chalk, paper, or even ice. These cravings persist over time and might become increasingly difficult to control.
  • Eating non-food items for over a month

If you’ve been eating non-food substances consistently for at least a month, it’s likely a sign that pica is present. This behaviour may continue throughout the pregnancy and may need medical intervention.
  • Digestive problems
Consuming non-food items may lead to stomach discomfort, constipation, nausea, or other gastrointestinal issues. If these symptoms occur after eating non-food substances, it’s important to seek guidance from a healthcare professional.
  • Nutritional deficiencies

Pica can sometimes indicate that your body is lacking important nutrients, such as iron or zinc. Blood tests can help identify these deficiencies, and treating them may help reduce the cravings.
  • Psychological symptoms
Anxiety, stress, or feelings of being out of control can also accompany pica. If you feel overwhelmed by your cravings or unable to stop eating non-food items, it’s worth discussing these emotional challenges with a healthcare expert.
If you experience these signs, consulting with a healthcare professional is important to determine the underlying causes and receive appropriate guidance.

Potential Causes of Pica During Pregnancy

The exact causes of pica during pregnancy are not fully understood, though several factors may contribute.
  • Nutritional deficiencies

One of the primary reasons pica develops is a deficiency in essential nutrients, particularly iron or zinc. When the body lacks these nutrients, it may trigger cravings for non-food substances, which could be perceived as a way to address these deficiencies.
For example, cravings for ice could indicate an iron deficiency, while cravings for dirt may signal a zinc deficiency.
However, it's important to understand that the connection between nutrient deficiencies and pica is still being studied. Iron-deficiency anaemia is the most commonly associated nutritional deficiency in pica cases. If you suspect a deficiency is behind your cravings, a blood test can confirm whether you’re lacking specific nutrients.
  • Cultural and psychological factors

In some cultures, eating non-food items, such as clay or soil, is seen as a traditional or medicinal practice. Psychological factors, such as stress, anxiety, or depression, may also contribute to pica cravings. Some individuals may turn to non-food substances as a way to cope with these emotional challenges.
Hormonal changes during pregnancy, which can alter taste and smell, might also play a role in the development of pica. If your body is craving specific items, it might be due to these hormonal shifts influencing your taste preferences.
  • Hormonal changes

Pregnancy-induced hormonal fluctuations can affect the way your body processes nutrients and can alter your sense of taste and smell. These changes may lead to cravings for non-food substances as your body adjusts to the increased demands of pregnancy.

Risks Associated with Pica

Pica poses several risks to both you and your baby. It’s best to understand it to be prepared well and control your cravings.
  • Health risks for the birthing parent

Consuming non-food items can expose you to harmful bacteria, parasites, and toxins, especially if the substances you eat are contaminated. For example, eating soil could expose you to bacteria or parasites that may lead to infections or digestive issues. If you're in a region where old lead paint or contaminated soil is common, there's a significant risk of lead poisoning.
Additionally, consuming hard substances like chalk or ice can cause damage to your teeth, leading to enamel erosion or dental issues.
  • Health risks for the baby

If pica leads to malnutrition or a lack of important nutrients, it can have indirect effects on the developing baby. If you are eating non-food items instead of nutrient-dense foods, your baby may not be receiving the necessary vitamins and minerals for healthy growth.
This can increase the risk of complications such as low birth weight, premature birth, or developmental issues.

Diagnosis of Pica

If you notice signs of pica, it’s important to get checked by a healthcare professional as soon as possible. Early diagnosis can help you get the right treatment and support a quicker recovery.

Medical history and physical examination

Your healthcare expert might ask about your cravings, eating habits, and any other symptoms you have. They may also do a physical examination to look for any related health issues. Providing clear and honest information is important for an accurate diagnosis.

Cultural and developmental considerations

Pica is only diagnosed when the behaviour is deemed atypical for your culture or developmental stage. For example, if consuming non-food substances is culturally accepted in your community, it may not be classified as pica.

Blood tests to check for nutritional deficiencies

Blood tests can identify whether you have deficiencies in iron, zinc, or other essential nutrients. If deficiencies are found, correcting them through diet or supplements may help reduce the cravings associated with pica.
It’s important to have an open conversation with your healthcare expert to discuss your symptoms and receive an accurate diagnosis.

Treatment Options for Pica

If you are experiencing pica during your pregnancy, treatment often involves a team approach. Your care may include your obstetrician or midwife, a dietitian, and a mental health professional. This helps ensure you get the right support for both your physical and emotional health.

Addressing nutritional deficiencies

If your cravings are linked to nutritional deficiencies, your healthcare expert may recommend dietary changes or supplements. For example, increasing iron-rich foods (such as spinach, beans, and lean meat) or zinc-rich foods (like nuts, seeds, and dairy) may help reduce your cravings.
Ensuring that you have a well-balanced diet during pregnancy can support your overall health and reduce the likelihood of pica cravings.

Behavioural support

If pica is driven by psychological factors, behavioural therapies such as Cognitive Behavioural Therapy (CBT) can be helpful. CBT helps you identify triggers for your cravings and develop strategies to manage or reduce the urges. Working with a therapist who specializes in eating disorders can provide additional support.
Nutritional advice
A dietitian can help create a personalized meal plan to ensure that your nutritional needs are met during pregnancy. By addressing any dietary gaps, they can help reduce cravings and improve your overall health.

After pregnancy

For many birthing parents, pica improves or stops after the baby is born. However, it is important to continue to follow up with your healthcare team if you still have symptoms or concerns.

Managing Pica Cravings

It is important that you manage your pica cravings wisely. This might make it easy for you to keep yourself in complete control and not consume non-food items.
  • Distraction techniques

Engaging in activities that capture your attention, such as reading, walking, or pursuing hobbies, can help distract you from cravings. Keeping busy with activities you enjoy can make it easier to manage the urge to eat non-food items.
  • Substituting cravings with safe alternatives

Instead of giving in to pica cravings, try substituting non-food items with safer alternatives. For instance, chewing sugar-free gum or eating crunchy vegetables can provide the same oral stimulation without the associated risks.
  • Seeking support from family and friends

Talking to friends and family about your cravings can provide emotional support. They can encourage you and help keep you on track. You might also consider joining a support group or online forum where others going through similar experiences can offer advice.

When to Seek Medical Advice

If your pica cravings persist or worsen, it’s important to seek medical advice. Early intervention can prevent potential complications and help you stay healthy throughout your pregnancy. Regular check-ups with your healthcare expert can ensure that any nutritional deficiencies are addressed and that your baby is developing well.
If you experience additional symptoms, such as abdominal pain, fatigue, or signs of infection after eating non-food substances, contact your healthcare expert immediately. Taking action early on can help protect both you and your baby.
Pica during pregnancy can be challenging, but with the right support and treatment, it’s possible to manage the condition and maintain a healthy pregnancy. By recognising the signs and understanding the causes of pica, you can work with your healthcare team to find a treatment plan that works for you. Early intervention is key to addressing nutritional deficiencies and minimizing potential risks for both you and your baby.

FAQs on Pica During Pregnancy: Signs, Causes & Treatment

  1. What are the common cravings associated with pica?
    Common pica-related desires during pregnancy include soil, clay, chalk, ice, paper, and other non-food substances.
  2. What can you do to manage your pica cravings safely?
    You might look for help from friends and family, use distraction strategies to replace cravings with safe substitutes like sugar-free gum, and adopt coping strategies. Personalised advice depends on consulting a medical expert.
Disclaimer: Medically approved by Dr Savitha Shetty Senior Consultant Obstetrician & Gynecologist at Apollo Hospitals Sheshadripuram