Pica, Child

Pica is an abnormal craving or a compulsive eating of substances or a nonnutritive food. It happens most often in children, especially those with developmental disabilities, and in pregnant women. Tasting and mouthing non-food items is normal in infants and toddlers. After age 2, this type of behavior is not normal and means that pica may be present. In children, pica generally goes away with age and/or proper treatment.

CAUSES

The exact cause of pica is not known. The most common thought reason for pica in children is iron deficiency. It is not clear if this is a cause or a result of pica. It may be both. Pica is also seen with other diet deficiencies. It can be seen in children with developmental delay. Children with behavior or family problems have a higher risk of pica.

SYMPTOMS

The main symptom of pica is the eating of non-food items. Dirt is a commonly eaten substance. Many other types of non-food items can be eaten. Other symptoms may happen depending on what is eaten. There can be problems in the nervous system or intestinal tract, for example. Children can also suffer from poisoning if what they eat is toxic. Lead chips are a common source of poisoning.

DIAGNOSIS

The diagnosis of pica is usually made based on the story given by the parents. Tests for problems that can cause or result from pica may be done. Blood and/or stool tests may be needed. If problems with the intestine are suspected, imaging studies (x-rays and others) may be done.

TREATMENT

The main treatment is to address the problems associated with the pica. Iron deficiency is the most common nutritional problem. Iron supplementation can decrease pica in cases where iron deficiency is found. Side effects of pica (such as lead poisoning from eating lead based paint) or intestinal issues need to be addressed.

Often treatment involves a team of caregivers working together to address the causes of pica. A psychologist, social worker and physician may work together to help form a treatment plan. Behavioral therapy may be used to help stop the pica.

In some cases, medications can be given to help stop pica. Pay careful attention to the eating habits of the patients.

HOME CARE INSTRUCTIONS

  • Watch your child closely for pica so that you can intervene fast if it happens.

  • Mild punishment for pica can be given along with rewards for eating food.

  • Keep the non-food substance that your child eats away from your child.

  • Use child-safety locks and high shelving to keep dangerous substances, household chemicals and medications out of reach.

SEEK MEDICAL CARE IF:

  • You child is constipated.

  • Your child has eaten paint chips.

  • Your child has an unexplained temperature at or above 102° F (38.9° C).

  • Your child has belly (abdominal) pain.

  • You child has a decreased appetite.

  • You child has diarrhea.

  • You child has behavioral or learning problems.

SEEK IMMEDIATE MEDICAL CARE IF:

  • Your child keeps vomiting, especially yellowish in color.

  • You child has a severe headache.

  • Your child has severe abdominal pain.

  • Your child become uncoordinated.

  • Your child is unusually drowsy.

  • Your child becomes confused.

  • You child has seizures (convulsions).

  • Your child has ingested a possible poison.