Pica Eating Disorders

Kids are naturally curious about their surroundings and may try to eat dirt, sand or other nonfood items. For most children, these behaviors are an innocent exploration of their environment; but for kids with pica (an eating disorder characterized by persistent and compulsive cravings to eat nonfood items), this could signal a bigger problem.

As many as 25 to 30 percent of kids (and 20 percent of those seen in mental health clinics) have pica. The word "pica" comes from the Latin word for magpie, a bird that is known for eating anything and everything. Although common in infants and toddlers, most children outgrow pica by the time they are about 3 years old.

If your child is growing and developing normally, then pica is more likely a habit than an obsessive-compulsive disorder. Pica also is more common with other disorders, such as mental retardation, autism and other developmental disabilities. Pica may surface in children who've had a brain injury affecting their development. It also can be a problem for some pregnant women, as well as people with epilepsy.

Look for these warning signs that your child may have pica:

People with pica frequently crave and consume nonfood items including:

Although consumption of some items may be harmless, pica is considered to be a serious eating disorder that can sometimes result in serious health problems, such as lead poisoning and iron-deficiency anemia.

The specific causes of pica are unknown. Some children with pica may be imitating a pet dog or cat that routinely chews on grass and other nonfood items. Others may have an oral obsession and are comforted by having things in their mouth.

Children in underdeveloped countries may eat soil or clay as a result of lack of food. Pica also may be a ritual associated with certain religions, folk medicine and magical beliefs.

There is evidence that at least some pica is a response to a dietary need. Pregnant women, for example, have given up pica after they were treated for iron deficiency anemia. However, pica can cause dietary deficiencies by blocking the absorption of essential nutrients in the intestines.

Despite the wide variety of causes, not one of them explains all forms of pica. A doctor must treat every case individually to try to understand what may be causing the condition. 

If your child has pica, then it's probably best to start off with a visit to your pediatrician to rule out a physical cause. After that, counseling with a child psychologist and/or child psychiatrist might be helpful. 

If your child is able to talk, ask her why she's doing it. If it's because she's nervous or it makes her feel good, then you can try to substitute a different behavior. Offer lots of praise and attention when you notice that she isn't eating things she shouldn't.

You'll want to evaluate if your child has any risk factors for lead poisoning, such as living in or often visiting a house (or daycare) that was built before 1950, or living in or often visiting a house (or daycare) that was built before 1978 and is being remodeled. These types of houses may contain lead paint, which can cause lead poisoning if your son is eating the paint or chewing on the windowsill.

If you think he has swallowed something poisonous, call the Drug and Poison Information Center at 800-222-1222.

In addition to lead poisoning, pica can put your child at risk for bowel problems, blockage or tearing of the intestines, tooth damage and infections. Medical emergencies and death can occur if the craved substance is toxic or contaminated with lead or mercury, or if the item blocks the intestines.

Depending on your child's age and developmental stage, your pediatrician will work with your daughter to teach her ways to eat more appropriately. Medication may be prescribed to help the behavior associated with pica. Your doctor should be able to advise you on how to keep your child from obtaining the nonfood items she craves (i.e., using child-safety locks and high shelving, and keeping household chemicals and medications out of reach of your child).

If your child has eaten a potentially harmful substance, such as lead, your pediatrician will screen him for lead poisoning, anemia, or other abnormalities, and may order stool testing for parasites or X-rays for bowel blockages.

Fortunately, pica is usually a temporary condition that improves as children get older. But for individuals with developmental or mental health issues, pica can be a long-term concern.

Following treatment, if your child's pica behavior continues beyond several weeks, contact his doctor again for additional treatment options. 

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