Abstract
In 2009, the Institute of Medicine reexamined the guidelines for weight gain during pregnancy. The committee noted that if a woman's gestational weight gain is not within the recommended guidelines, clinicians should consider modifiable factors that might be causing excessive or inadequate weight gain before suggesting that a woman modify her pattern of weight gain. We present 2 cases from our clinics where pregnant women's practice of pica affects their weight gain. A brief summary of the current literature describing the global practice of pica, including the United States, is presented. Although the Institute of Medicine guidelines discuss determinants of gestational weight gain such as culture, the practice of pica is not included in that report.