Many changes occur in women during pregnancy and it’s not unusual for a woman to notice changes in her appetite and food preferences. In some rare cases, pregnant women can begin craving and consuming substances or items that are not foods like dirt, ice or chalk. This craving is known as pica and it is a diagnosable psychiatric condition involving eating non-food items for at least one month. Pica during pregnancy is not overly common, but it can impact the health of a mother and her baby.

Common Pica Cravings

There are many different types of pica cravings, ranging from common to more unusual. Although there are no definitions about what substances specifically fall under a pica diagnosis, pica cravings can usually be classified into three groups:

  • Geophagia – eating dirt or dirt-like substances
  • Amylophagia – eating chalky substances like baking soda
  • Pagophagia – eating ice or frost

Common pica cravings might be related to preferences of certain textures of the substances consumed. The type of craving experienced during pregnancy can vary from woman to woman, but some of the common non-food pica cravings include:

  • Soil
  • Chalk
  • Baking soda
  • Ashes
  • Mud
  • Ice cubes
  • Coffee grounds

Although these substances are most common, there are many other items that pregnant women with pica might eat. These can include things like pencil erasers, hair or paint chips. The risk or potential harm associated with substances consumed by people with pica can also differ, as some substances may be toxic or can get stuck in the digestive system

What Causes Pica During Pregnancy?

There are multiple theories on the causes of pica, from hormonal changes to it being a way to cope with stress. According to this theory, pica behaviors can be self-soothing, and help to reduce feelings of stress, worry or pain.

The most common theory of the cause of pica during pregnancy is linked to micronutrient deficiency. The demands of pregnancy on the body are high, and the nutrition status of a pregnant woman is important to the health of the fetus and for carrying out a healthy pregnancy. Nutrient deficiencies can be a result of a poor quality diet for an extended period and can impact the health and development of a baby.

To correct a deficiency or to protect against it, pregnant women may seek out nonfood substances that are rich in nutrients that are commonly deficient and important to pregnancy, like iron, zinc or calcium. Items like soil and dirt are rich in nutrients and can provide these to a pregnant woman who is deficient. Although it’s commonly thought that eating ice is a sign of iron deficiency, scientists aren’t exactly sure of the cause. Eating ice might help to increase feelings of alertness and counter the low-energy symptoms of nutrient deficiencies.

Risk of Pica During Pregnancy

Pica is not overly common in pregnancy and there is currently no reliable estimates of the rates of pica in pregnant women. It’s believed that pica is more common in certain places, such as India and Africa, where cultural norms might influence rates. Pica can also be impacted by other mental health conditions, such as obsessive-compulsive disorder or substance use disorders. Although it’s not an overly common condition, eating nonfood substances can be risky to the mother and baby.

The potential for harm can depend on the type of substance being consumed. The possible complications related to pica can include:

  • Blockages or damage to the gastrointestinal tract
  • Preterm labor
  • Mercury or lead poisoning
  • Ongoing malnutrition or nutrient deficiencies

Despite the theory that pica is a way that women are self-regulating a nutrient deficiency, many of the substances consumed have no nutritional value or benefit. Items like erasers or paint chips are much more likely to do damage and do not address the underlying issue of nutrient deficiency. If women are consuming non-food items, it’s likely that their nutrient deficiencies will persist, unless addressed by an improvement in the diet that addresses the possible root cause of pica.

Malnutrition during pregnancy can be stressful for a mother and baby and can have an impact on health well beyond birth. Addressing underlying nutritional deficiencies reduces risks and complications related to pica and can be essential to maintaining a healthy pregnancy.

Managing Pica While Pregnant

Pregnancy can be a stressful time for women, and many will change their behavior or routines to promote and protect the health of their baby. Pica is a diagnosable psychiatric condition, classified as an eating disorder, and is not a matter of not caring for health. Management of pica can be very important in ensuring that both mother and baby remain healthy and nourished.

Even though the exact cause of pica during pregnancy is unclear, there are several treatment strategies that can help to address the desire to eat nonfood substances. As a first step, it’s important to test for nutrient deficiencies or any possible poisoning and treat these as necessary.

In addition, several treatment strategies can address the behavioral aspects of pica. Pica treatment can include:

  • Education surrounding the risks of consuming nonfood items during pregnancy
  • Forming negative associations with specific items, as a deterrent to eating them
  • Goal-setting or rewards for eating regular food items

If you or someone you care about is experiencing pica and a related substance use disorder, contact The Recovery Village to discuss available treatment options.