Coping with Cravings: Understanding and Managing Pica During Pregnancy

Pica is a medical condition characterized by cravings and consumption of non-food items. Sadly, it’s often misunderstood or hidden by women due to stigma. Depending on the habit, it can have significant health implications that require medical intervention and treatment.

What is pica in pregnancy?

The stereotype of pregnant women craving ice cream or pickles may be true, but there’s another common yet less talked about craving condition — pica.

Pregnant women can develop an oral fixation and snack on something relatively harmless, like ice, during pregnancy. However, it can become concerning when nonfood items like dirt, clay, or hair are consumed.

What causes pica?

Exact causes of pica are still unknown, but recent studies suggest that it might be due to a combination of physical, hormonal, psychological, and cultural factors, such as:

While pica is commonly seen during pregnancy, it's not exclusive to expectant mothers. The condition can manifest in other groups as well.

Although there is no one exact reason for this condition, nutritional deficiencies, geographical locations, and psychological conditions are the most studied.

Signs and symptoms

Some of the most common non-food pica cravings include soap, clay, dirt, starch, and ice chips. In worse scenarios, non-food items include hair, chalk, coins, sand, and paper.

Eating such items may result in fatigue, headaches, and dizziness. Over an extended period of time, more severe symptoms might appear, such as pale skin, an irregular heartbeat, and hair loss. In more severe cases, pica may lead to lead poisoning, which can result in muscle or joint pain, constipation, headaches, and difficulty sleeping.

In addition, eating certain items might also cause acute issues such as infections, stomach pain, constipation, and even damaged teeth. Unfortunately, many pregnant women still feel embarrassed about having pica cravings, so it may not always appear obvious to friends and family. If you think that a pregnant woman you know struggles with this issue, look for hidden signs, such as unusual substances at home or on clothing, or eating less food.

Is there a risk for the baby?

Depending on what non-food items and how often are eaten, there are potential risks for the baby when a mother has pica during pregnancy.

Nutrition deficiencies

Nonfood items can interfere with the absorption of nutrients and either exacerbate or create a nutritional deficiency. Eating non-nutritive substances might replace more nutritious foods, which can further reduce nutritional intake.

Iron deficiencies, for example, can impact fetal development by reducing the oxygen supply to the fetus. This can lead to:

• Premature birth
• Low birth weight
• Neural tube defects
• Developmental delays
• Prenatal and infant mortality

Toxins and pathogens

Some items may contain parasites or bacteria, such as soil or clay. Paint chips from older homes with lead might also harm developing babies with cognitive impairments or developmental delays.

Impact on mothers

Managing PICA during pregnancy is very important; otherwise, serious health issues may arise for mothers:

Treatment

Fortunately, treating pica is possible with a holistic approach that addresses the root cause and teaches coping methods. Treatment will most likely include:

• Safer items to chew on. To help satisfy an oral fixation for a specific texture, a healthcare professional will recommend alternatives. For example, chewing gum instead of clay or crunchy vegetables instead of copious amounts of ice.
• Occupational therapy. This therapy examines various emotional triggers and develops healthier coping strategies, such as relaxation techniques, ideas to alternate any environmental triggers, cooking skills, and experimenting with alternate sensory experiences.
  
• Nutrition supplements. If the pica is due to a deficiency, supplements might help reduce cravings and give the mother and baby the nutrients they need. Deficiencies should be closely monitored with a doctor.
• Medication. Often, if PICA is due to anxiety or obsessive-compulsive disorder, doctors prescribe relevant medication treatments.

When do you need a specialist's help?

Recognizing the signs and symptoms can help you take action more quickly, avoiding a worsening condition. But first, having the courage to speak to someone about it is crucial.

While many mothers feel a sense of shame or embarrassment, they should know pica is not uncommon, and treatment is available. If any of the symptoms listed above occur, it’s time to call the doctor. Other reasons to call a specialist include experiencing severe emotional distress or not responding well to previous treatment attempts.

Pica will likely be diagnosed if the mother is persistently eating non-food items for at least one month, which harms the development of the fetus, and if it occurs with another mental health disorder and is not part of a cultural practice.

Regarding more severe issues, you should go to the emergency room if you experience lead consumption, loss of consciousness, peculiar behavior after eating a non-food item, or the inability to pass stool.

Tips for managing pica during pregnancy

While pica during pregnancy might feel overwhelming and embarrassing, having the courage to speak about your cravings can help. These tips can help you cope and potentially reduce pica cravings:

• Educate yourself. Learn more about the risks, underlying causes, and steps you can take to manage PICA during pregnancy.
• Add more nutritious foods. If you have access to healthy foods, focus on increasing servings. For example, add half a cup of greens to your dinner or lunch, or have fruit for dessert after every meal. Pregnant women need about 1,800 calories per day in their first trimester, 2,200 calories in the second, and 2,400 in their third. You can reach this by adding servings of nutrient-dense foods like fruits, vegetables, legumes, whole grains, nuts, and seeds.
• Exercise. Get 30 minutes of daily activity through movement you enjoy. For example, in-person or online dance classes, yoga, or walking in nature. Exercise can help stabilize hormones, reduce stress, and improve mental health, which may reduce cravings.
• Hydrate. Often, our bodies confuse thirst with hunger. Aim for at least 10 cups of water or more if you exercise frequently or live in a warm climate.
• Find safe alternatives. If you need to chew on something, try healthier options like crunchy vegetables, pickles, hard candy, or chewing gum. Even ice chips are okay if consumed in moderation.
• Identify triggers. Observe your patterns of cravings to see if there are any external triggers. From there, you can work to create a safe environment by removing items or avoiding places or people that trigger cravings.
• Seek support. Talk to friends and join a support group for much-needed emotional support and a sense of community. Speaking to a group of people going through the same thing can be incredibly empowering and offer helpful tips. You can also consider individual therapy if the PICA is related to anxiety, depression, or past trauma.

Finally, always schedule regular check-ups with your doctor throughout your pregnancy. You’ll want to be tested for deficiencies and update them on your progress so they can take necessary precautions.