Pica

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KEY POINTS

• Children who have pica eat items that are not food such as dirt, ice, soap, wall plaster, paint chips, hair, and other items. Children with pica disorder keep eating nonfood items for at least one month.
• Treatment depends on the cause of the pica, if known. For example, mineral supplements may be given to treat iron or zinc deficiency. Counseling or behavior therapy may be helpful.
• Pay close attention to what your child eats, both at home and in child care settings. You may be able to change the child's behavior by rewarding or praising good behavior and punishing bad behavior.

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What is pica?

Pica is an eating disorder. Besides eating regular food, children who have pica eat things that are not food such as dirt, ice, soap, wall plaster, paint chips, hair, and other items. Many young children try nonfood items such as eating some dirt out of their sandbox. However, children with pica disorder keep eating nonfood items for at least one month.

What is the cause?

The exact cause of this disorder is not known. This disorder is rare and occurs most often in infants and young children. Pica most often starts when a child is 18 to 24 months old.

Pica is sometimes related to a mineral or vitamin deficiency, such as being deficient in iron, zinc, or calcium. Pica is more likely if a child has autistic spectrum disorder, developmental delays, or has been neglected.

Pica typically lasts for just a few months. It may last longer in a child who has developmental problems.

What are the symptoms?

Children who eat non-food items may have a variety of physical symptoms. For example:

• Stomach pain and constipation caused by a blocked intestine
• Fever and infections caused by germs in feces or dirt
• Tiredness, weak muscles, and learning problems caused by eating lead paint

Pica can cause malnutrition, a thin body, and mineral or vitamin deficiencies.

How is it diagnosed?

There is no test for pica. It is often diagnosed when a parent or childcare provider sees the child eating nonfood items. It might also be diagnosed when a child is treated for poisoning or a blockage in the digestive system. The healthcare provider will do a complete physical exam and ask about the child's symptoms and behavior. Your child may need X-rays or blood tests.

How is it treated?

The treatment depends on the cause of the pica and if your child has health problems caused by something your child has been eating. For example:

• Mineral supplements may be given to treat iron or zinc deficiency.
• Your child may need treatment for lead poisoning or a blockage in the bowel.
• Counseling or behavior therapy may help with mental health or developmental problems.

How can I help my child?

Pay close attention to what your child eats, both at home and in child care settings. Change the child's behavior by rewarding or praising good behavior and punishing bad behavior. For example, by looking stern, and giving a brief, direct instruction, such as "No" or "Stop that." If pica continues, consider behavioral therapy.

If your child has stomach pain or bloating, lack of bowel movements, or symptoms of infection, call your healthcare provider right away.