Risk Factor: C
Class: Gastrointestinal agents/ Antidiarrheals
Fetal Risk Summary
Kaolin is a hydrated aluminum silicate clay used for its adsorbent properties in diarrhea, and pectin is a polysaccharide obtained from plant tissues that is used as a solidifying agent. Neither agent is absorbed into the systemic circulation.
No reports have related the use of the kaolin/pectin mixture in pregnancy with adverse fetal outcome. There have been reports of iron deficiency anemia and hypokalemia secondary to the eating of clays (i.e., geophagia) containing kaolin (1,2 and 3). The mechanism for this is thought to be either a reduction in the intake of foods containing absorbable iron or an interference with the absorption of iron. In humans, iron deficiency anemia may significantly enhance the chance for a low-birth-weight infant and preterm delivery (4,5).
Female rats fed a diet containing 20% kaolin became anemic and delivered pups with a significant decrease in birth weight (6). When an iron supplement was added to the kaolin-fortified diet, no anemia or reduced birth weight was observed.
Breast Feeding Summary
Other than producing anemia in the mother after prolonged, chronic use, the kaolin/pectin mixture should have no effect on lactation or the nursing infant.
- Mengel CE, Carter WA, Horton ES. Geophagia with iron deficiency and hypokalemia: cachexia africana. Arch Intern Med 1964;114:4704.
- Talington KM, Gant NF Jr, Scott DE, Pritchard JA. Effect of ingestion of starch and some clays on iron absorption. Am J Obstet Gynecol 1970;108:2627.
- Roselle HA. Association of laundry starch and clay ingestion with anemia in New York City. Arch Intern Med 1970;125:5761.
- Scholl TO, Hediger ML, Fischer RL, Shearer JW. Anemia vs iron deficiency: increased risk of preterm delivery in a prospective study. Am J Clin Nutr 1992;55:9858.
- Macgregor MW. Maternal anaemia as a factor in prematurity and perinatal mortality. Scott Med J 1963;8:13440.
- Patterson EC, Staszak DJ. Effects of geophagia (kaolin ingestion) on the maternal blood and embryonic development in the pregnant rat. J Nutr 1977;107:20205.