How to cope with unusual cravings in pregnancy

It is unclear why some women will develop pica, and why others will not.

Dear Dr Murage,

I am pregnant and have been craving strange things lately. Is it true that I could be lacking some nutrients?

Ednah

Dear Ednah,

Cravings are common in pregnancy, occurring in the majority of pregnant women. However, most women crave for safe, and healthy stuff. But some will crave for substances which have no nutritional value, sometimes endangering their own health and that of the unborn baby.

Ever heard of the bird called Magpie? Magpies are of the Crow family of birds, and they are famed for their unusual eating habits. They can eat almost anything. The Latin word for Magpies is Pica, which has been borrowed by the medical world to describe non-nutritional cravings. You will therefore be described as suffering from Pica if you find yourself irresistibly suffering from cravings during pregnancy.

It is unclear why some women will develop pica, and why others will not. There is speculation about the connection with some mineral and vitamin deficiencies, such as iron for example. Pica then becomes an attempt by the body to obtain micro-nutrients. However, pica may also be related to physical and mental illnesses, or even to cultural practices not necessarily associated with a deficiency or disorder.

Common cravings include stones, soil, charcoal, toothpaste, baking soda, cigarette ashes etc. Real harm can occur depending on what you are ingesting. There may be interference with absorption of healthy foods, leading to specific deficiencies. You might ingest toxins, like lead, which might cause damage to your organs. Some cravings will harbour disease causing parasites and bacteria, predisposing you to avoidable infections.

So what can you do to cope with pica? Once you catch yourself craving and ingesting non-nutritious substances, inform your obstetrician or midwife at the earliest opportunity. Detail what you are craving for. Your healthcare provider will advise you on any potential risks and may require some tests to check levels of essential vitamins and minerals in your body. But in the majority of cases, no specific deficiency will be identified.

Several approaches will help in the management of pica. You could try potential substitutes to your cravings. Try chewing some sugar-free gum once the craving comes, or some other harmless substance like popcorn. You could actually make up a Pica Box and fill it up with healthier substances that you can take whenever cravings appear. Some women benefit from concentrating on other chores that distract them from cravings. In extremes of cravings, some specific medications may be advised.

Don’t panic if you find yourself suffering from pica in pregnancy. But watch what you eat, even if only occasionally. Some substances can cause serious harm. You can easily get helped, ending up craving for just healthy stuff.

- Dr Alfred Murage is a consultant obstetritian and gynaecologist