• Determine the extent of the practice and its potential for harmful effects.

  • If indicated, explore ways to curb or completely eliminate the practice. Guidelines appear in the box.

Bed Rest
  • If bed rest is advised, emphasize the importance of achieving adequate energy and nutrient intake for the growth of the fetus, even though the mother's activity level is low Provide anticipatory guidance. (See box on the next page.) Expect weight fluctuations.

  • Arrange for a referral for home health care or homemaker services if indicated.

For the Health Professional:


Identify pica practices that may be harmful because they interfere with the ingestion of adequate amounts of food, they may lead to intestinal obstruction or impaction, or they may involve toxic substances. Explore possible substitutions for pica substances and behaviors with the woman.

  • When you feel the urge to eat X, what else could you do instead? Take a short walk? Read to your child?

  • Would you try chewing sugarless gum when you get the urge to eat X?

  • Instead of chewing ice, try freezing fruit juice cubes to chew.

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