Pica is an eating disorder where a child has a tendency of eating non-nutritive or non-edible substances such as wood, paper, dirt, chalk, metal, or paint.

You must have often noticed infants and toddlers (children aged between 0-3 years) biting or chewing on a lot of things. This is their way of exploring the world around them through their mouth and this is quite normal. However, when a child, who has passed this developmental milestone (usually after 3 years of age), suddenly begins to eat non-food items once again, it can indicate a problem. 

Pica is more common in children and mostly affects the age group of 1-6 years. This condition is also seen in children with developmental disabilities (a group of conditions due to an impairment in physical, mental, language, learning, or behavioral areas) and in pregnant women. 

It is often more severe and long-lasting in children with developmental disabilities. Usually, pica is not a serious condition and can resolve with appropriate treatment.  

Let’s understand all about pica in children.

How to Identify Pica?

Children who suffer from pica will have a regular tendency to consume non-food items. This behavior should continue for at least a period of one month to qualify as pica. Children with pica are tempted to eat one or more of  the following:

  • Clay 

  • Dirt

  • Animal feces

  • Hairballs

  • Ice 

  • Paint 

  • Sand 

  • Wood 

  • Paper

  • Soap

  • Chalk

What Are The Common Causes of Pica?

Pica can have multiple causes and it includes the following:

  • Nutritional deficiencies such as lack of iron, zinc, and other vitamins can be a major cause of pica. Unusual cravings can be a sign that your child’s body is trying to replenish the low nutrient levels. This is a common cause of pica in children who are living in poverty and are malnourished (deficient of the essential nutrients).

  • If your child is suffering from certain developmental disorders such as autism, pica can develop as a coping mechanism. Autism is a developmental disorder that causes problems in social interactions and communication.

  • Mental health problems like obsessive-compulsive disorder (OCD), stress, etc., can also lead to eating disorders such as pica. OCD is a mental health condition that is characterized by excessive unwanted thoughts that leads to compulsive behavior.

If you think your child is suffering from pica, then you must consult your pediatrician to confirm the diagnosis.

How is Pica Diagnosed?

There is no specific test that can help diagnose pica. You should discuss your child’s symptoms and other medical conditions (if any) with your doctor. Your pediatrician will: 

  • Perform a physical examination and suggest certain blood tests that can help identify nutritional deficiencies such as lack of iron or zinc.  

  • Advise checking the lead levels in the blood. Lead levels should always be checked in a child who may have eaten objects covered in lead-based paint or lead dust, to check for lead poisoning.

  • X-ray or other imaging tests to check for any signs of bowel problems.

  • Stool tests to identify any parasites (if present).

Ensure you explain in detail about your child’s cravings to the doctor. This will make it easier for the doctor to diagnose exactly and plan the treatment.

How is Pica Treated?

Treatment for pica may vary for each child depending on the underlying cause. Your pediatrician will advise you to keep non-food items in childproof locks and out of reach to prevent your child from consuming them.

  • If the underlying cause is nutritional deficiency, then your doctor would recommend supplements that will help replenish your child’s nutrient levels.

  • Your doctor might also suggest a psychological examination, to determine if the child has any disorders such as OCD or other conditions affecting the child’s mental health.
    In such cases, managing behavioral problems would help treat pica. Being positive about the good things that they do, offering rewards, and not overreacting to their actions will be able to alter minor behavioral issues in children.

  • Children who are diagnosed with lead poisoning will need to undergo chelation therapy. During this treatment, the child will be given medications that can bind with lead, which can then be excreted through the urine.

You can encourage your child to eat normal food and avoid non-nutritive substances through positive reinforcement. It is the process of reinforcing or encouraging good behavior or good habits. You can motivate your child to choose food items over non-edible substances and appreciate them for their effort.

What Are The Complications Associated With Pica?

In some cases, pica can lead to serious complications depending on the items that your child consumes.

  • Certain items such as paint chips can cause lead poisoning. It is a dangerous condition and can even cause brain damage.

  • Consuming dirt or animal feces can lead to parasitic infections in your child’s intestine.

  • Objects such as wood cannot be digested and it can cause constipation or diarrhea, which can lead to intestinal blockage.

  • Swallowing hard objects can choke your child and interrupt breathing.

  • Mouth injuries or tooth chipping can occur if your child bites on to a hard object.

By paying careful attention to your child’s eating habits and closely supervising his/her activities, you will be able to detect the condition at an early stage and prevent any complications. Your pediatrician will be able to identify the exact cause of pica in your child and suggest the right treatment. 


References:

1.Encyclopedia, M., 2021. Pica: MedlinePlus Medical Encyclopedia. [online] Medlineplus.gov. Available at: <https://medlineplus.gov/ency/article/001538.htm> [Accessed 11 April 2021].

2. Kidshealth.org. 2021. Pica (for Parents) - Nemours KidsHealth. [online] Available at: <https://kidshealth.org/en/parents/pica.html?WT.ac=pairedLink> [Accessed 11 April 2021].

3. staff, f., 2021. What Is Pica? - Pica Eating Disorder | familydoctor.org. [online] familydoctor.org. Available at: <https://familydoctor.org/condition/pica/> [Accessed 11 April 2021].


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