Pica is one type of eating and feeding disorder. The word Pica came from the Latin name of magpie bird, which is notorious for eating almost anything. Craving of non-edible substances with little or no nutritional value like chalk, dirt, plaster, toothpaste, sand, cigarette ashes,  glue, soap, burnt matches etc is known as pica. This condition can happen to anyone, pregnant or not, but it’s more common during pregnancy. 

Diagnosis of pica: According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) there are 4 major criteria of diagnosing pica. 

i.    Repeated consumption of non edible substances for a period of at least one month.

ii.    The eating habit is inappropriate to the age level of the individual. 

iii.    The food habit  is not part of a culturally supported practice.

iv.    If the eating disorder occurs in the context of another mental illness (e.g., intellectual disability, autism spectrum disorder, schizophrenia) or medical condition (including pregnancy), then this issue needs clinical support. 

 Causes of Pica during pregnancy

•    The exact cause of developing pica cravings during pregnancy is not known yet.

•    Vitamin and mineral deficiencies, in particular iron deficiency has been found associated with developing  Pica and also Pica is the behavioral response to the deficit.

•    Sometimes these cravings may be related to an underlying physical or mental illness.

Medical risks:

Major medical risks can occur due to the substances ingested and how severe the behavior is. For example: 

1. Taking toxic non-food items are potentially harmful to the body and may lead to health complications like internal parasites, stomach infection, poisoning, choking, respiratory problems, even death.

2. Inedible substances may interfere with the nutrient absorption of healthy food and cause a deficiency.

3. Iron deficiency anemia is responsible for pica craving, not correcting these underlying causes poses a threat to the health of the baby and mother.  

Management of Pica: 

If anyone is suffering from pica cravings the person shouldn’t hide it from her doctor. Respective clinician would identify proper causes from medical history and give appropriate treatment plan. 

1. Maintaining a balanced diet

 2. Regular monitoring of iron status along with other vitamin and mineral intake.

3. Considering potential substitutes for the cravings like sugarless chewing gum, candy etc.

4. Taking help from friends or family to avoid consuming non-edible items.