All About Pica in Pregnancy

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Pregnancy is characterized by weird symptoms and cravings, and one of the weirdest of all is pica, where you crave or eat things that aren’t food, such as ice, soap, and chalk. Pica is medically classified as an eating disorder and is thought to be due to nutritional deficiencies. Read on to understand more about possible nutritional deficiencies in pregnancy, more about pica symptoms, and what to do to cope with pica during pregnancy.

Nutritional needs during pregnancy

Pregnancy is an intense time for your body. At birth, your blood volume will likely have increased by about 50 percent, you may have gained a significant amount of weight, and your hair, skin, ligaments, and muscles have likely all undergone changes. In order to support these changes as well as grow an entire new person, your nutritional needs are different than when you’re not pregnant.

First, you will likely need an increase in calories that goes up as your baby gets bigger. It’s recommended at the start of pregnancy to maintain an 1,800 to 2,000 calorie per day diet that adds 200-400 calories per trimester. In reality this might look different for you, but the idea is to eat a variety of nutrient dense foods. It can be tough to get a variety of nutrients if you have aversions to some foods or are experiencing nausea and vomiting during pregnancy. For this reason, in addition to the food recommendations in the next paragraph, it’s a good idea to take a prenatal vitamin, which can be prescribed by your doctor or purchased over the counter from your pharmacy, big box store, or online retailer.

The US government recommends that each day you eat:

  • 9 to 11 servings of bread, rice, cereal, and pasta, preferably whole grain options
  • 4 to 5 servings of vegetables, two of which should be from green leafy vegetables
  • 3 to 4 servings of fruit
  • 3 servings of dairy products, including yogurt, cheese, and milk
  • 3 servings of meat, poultry, fish, beans, eggs, and nuts
  • A moderate amount of fats and oils, preferably not trans fats

Pica symptoms and issues

The main symptom of pica is eating or craving nonfood items. If you find yourself looking longingly at your bar of soap in the shower or the clay mask you use for skin care, or grabbing and crunching ice throughout the day, it’s a good idea to speak with your care provider as soon as possible.

Overall, crunching ice isn’t usually a problem (unless you hurt your teeth), but the desire to crunch might be a sign of a bigger problem, such as not enough iron in your diet, which can lead to anemia. Anemia can be a problem during labor and birth, as it’s normal to lose a little blood, but having low iron can mean blood loss becomes more serious. Eating nonfood items like clay and chalk is also not a great idea because it could make you sick or make you too full to get the food that you need to nourish yourself or your baby.

How to cope

If you’re eating according to dietary guidelines and still experiencing nonfood cravings and you’ve already talked to your doctor or midwife, the following are some ideas that may help. Taking an iron supplement (your care provider will likely have a recommendation) is a good idea, as well as trying to increase the amount of iron you get in your diet. Foods that are high in iron include spinach, legumes, quinoa, red meat, and broccoli. It also might work to trick your brain by eating chalky things, such as antacids, that are safe in pregnancy—just make sure you stick to the recommended doses.

If your pica is severe, consultation with and treatment by a mental health professional who specializes in eating disorders may be helpful. Your midwife or doctor may have ideas of professionals you could contact, or you can ask in a local parenting group or do an internet search.

It also may help to know that pica that’s associated with pregnancy usually goes away after nutrient deficiencies are addressed or when the baby is born. It’s likely that it won’t be a problem for you long term, which might be a relief.


Abby Olena
Dr. Abby Olena has a PhD in Biological Sciences from Vanderbilt University. She lives with her husband and children in North Carolina, where she writes about science and parenting, produces a conversational podcast, and teaches prenatal yoga.

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