PICA: Causes, Symptoms, Prevention Tips, & Treatments

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If you suspect your child has ingested a dangerous substance, call poison control immediately at 1-800-222-1222.

It is extremely common to witness a young child putting non-food items into his mouth, such as sand from a sandbox. Children are naturally inquisitive about their surroundings and usually no harm is done.

However, with children that have the eating disorder called pica, this curiosity leads to a compulsion to ingest non-food items.

The term “pica” is Latin for the word “Magpie,” which is a bird known for its unusual and indiscriminate eating behaviors. It is estimated that 10% to 30% of kids ages one through six have this disorder; and it is especially common in pregnant women as well.

Most children who develop pica are in the two- to three-year-old range. To know whether or not your child may have pica, certain characteristics must be present.

The small boy bites colour toys

DSM-IV Characteristics of Pica

  • Eating must persist for longer than one month, and at an age considered developmentally inappropriate
  • Does not meet the criteria for either having autism, schizophrenia, or Kleine-Levin syndrome
  • Must not be part of a culturally sanctioned practice

Note: If the eating behavior occurs exclusively during the course of another mental disorder (e.g., intellectual disability, pervasive developmental disorder, schizophrenia), it is sufficiently severe to warrant independent clinical attention.

The most common substances those with pica will ingest are clay, paint chips, dirt, sand, paper, ash, soap, rocks, glass, chalk, hair, glue, powders, starches, and even feces. The key factor lies in the repetitive consumption of the substance, more than the actual substance itself.

There can be many causes for developing pica; and in some parts of the world, including parts of the United States, it may even be seen as a normal “culture-bound syndrome.” More often than not though, it is brought on by mineral deficiencies or mental disabilities.

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Common Causes of Pica

  • acquired taste for the item
  • mineral deficiency, such as iron or zinc (Celiac disease or hookworm can sometimes cause this as well.)
  • obsessive-compulsive disorder
  • chemical imbalance in the brain
  • brain injury
  • attention-seeking behavior
  • maternal deprivation, poverty, or neglect

Whatever the cause of pica may be, it is imperative that it is treated, before it leads to more serious physical and emotional problems. Depending on what was ingested, pica can cause complications, such as intoxication, resulting in physical or mental impairment, lead poisoning, surgical emergencies, dental injury, nutritional deficiencies, parasitosis, intestinal obstruction, perforation, and bowel problems. For these reasons, it is important to do all you can to prevent pica from being established.

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Pica Prevention Tips

  • Teach your children what is and is not safe to eat.
  • Explain the differences between food and non-food substances, as well as the consequences of eating non-food items.
  • Store any craved non-food items in a locked cabinet, or out of your child’s reach.
  • Offer your child plenty of well-balanced, nutritious meals and snacks.

If you have done all you can to prevent pica and it is still a problem for your child, then it is time to seek a professional’s help. Your child’s pediatrician will do several things to diagnose your child, including testing blood and lead levels, checking hemoglobin for anemia, checking for infection, taking x-rays to identify what was eaten (if needed), and collecting urine and stool samples.

Treatments for Pica

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  • Increase communication skills with your child, so that she can better relate what she wants or needs.
  • Develop a “pica” box full of edible items that your child can choose from, instead of his “go-to” substance.
  • Practice positive reinforcement when your child avoids pica and negative chore-based punishments when pica is present.
  • Briefly restrain your child after pica is attempted, or use self-protection devices, time outs, or overcorrection.

For some children, alleviating pica behaviors can be a relatively easy process, while for others it may take a professional working with your child through more advanced techniques. It is important to remember to have patience with the process and continue to be positive. Always encourage your child, no matter which treatment route is taken.

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PICA: Causes, Symptoms, Prevention Tips, & Treatments

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16 comments

  1. Vashah says:

    Hi I have baby girl her age is 3.3 she eat dust ,mud,wall paints,hair ,pencil wood ,colour pencil tip ,crayons I m worry about her she is only one baby after 8years with IVF tell me about her what can I do best for her plz

    • Megan Klay says:

      Hi Vashah – This could be perfectly normal toddler behavior, but it’s worth scheduling an appointment with your daughter’s pediatrician to discuss. You can print out this article to bring with you and discuss the symptoms you’re seeing. Best wishes!

  2. ManyKids says:

    One of our sons is almost 4 years old. He has a habit of eating feces, stuffed animal stuffing, string, book pages, and carpet foam. He primarily does it in the very early morning part of the day, about 3-5 am. We have removed many things from his room and now lock up his toys during the night, but he has now taken to pulling up the carpet and eating the foam padding. We moved his dresser over the first spot, but then he t pulled up a new spot. We have talked to pediatricians, psychologists, and psychiatrists. We have done blood and urine tests, but the only advice anyone can give us is to remove dangerous items from his room and educate him. We can’t remove his carpet from our rental home. He sleeps in a toddler bed so I put a sheet of plywood on the open side to keep him in his bed, but he has figured out how to climb out now. I am afraid he is going to swallow a large enough piece of foam and choke to death while we sleep. A friend told us to flip his bed over, but I am not sure about that. Does anyone have any suggestions?

    • Megan Klay says:

      Hi there – It sounds like you’re doing all the right things! Has he said why he does this? I know he’s young, but maybe having a conversation with him would help to determine his motivation and help you to work together to solve the problem?

  3. tiersa says:

    My son is 4 and eats cardboard, backings on books, paper, napkins or what ever be can get his hands on. I’ve tried getting him to stop. Even talked to a pediatrician but they didn’t give me any clues on what to do. I’m at my wits end trying to get him to stop.

    • Amanda says:

      I’m a producer working on a new pilot about pica and I would love to talk to you! Is there anyway you can message me at…. tvtalk2010 at gmail dot com

      Thanks,
      Amanda

  4. Anjelica says:

    I am freaking out my daughter who is about to be two in July wont stop eating paper. it doesn’t matter what type of paper it is she still eats it even toilet paper. she actually cries when I take it away form her. what do I do I need help?

  5. LIZ says:

    im so scare of this happen to my baby, very important information to know

  6. Timothy says:

    I liked this lesson

  7. nichole says:

    Thank you for the comment Honeybunches_Mom!

  8. nichole says:

    gfeld,
    I am the author of this article and to answer your question, I don’t think that your friend’s child would qualify for having pica at this point. Although it may seem too old, it’s very common for a child that age to still mouth items. I would wait until the child became a bit older (2-3) before I worried. Also, pica is characterized by a compulsion to eat non-food items, so I doubt at 16 months, a child has the actual intent to do so.

    • Amanda says:

      I’m a producer working on a new pilot about pica and I would love to talk to you! Is there anyway you can message me at…. tvtalk2010 at gmail dot com

      Thanks,
      Amanda

    • Josselyn says:

      If a child can’t have this at 16 months because its considered common or “normal” for them to put things in their mouth, what would you say about my daughter??
      She’s 17 months and eats paper like its candy. She eats paper, cardboard, toilet paper, cigarette butts when she finds them on the ground, and even dried leaves and stuff when she can’t find paper outside…. She’s been doing it for 4 months now. At first I figured it was just her way of figuring out what paper was, just learning and experimenting. But now its so bad she goes on a search for it throughout the day. She eats hard covered books (at home AND at daycare). I offer food instead, trading a snack for the paper, but she gets angry and throws the food. She actually ate my little sisters homework a couple weeks ago.
      Do you really think this is “normal” just because she’s not 2?
      I mean, she knows better not to eat the paper. I’ve been teaching her for the last 4 months that its not good but she still insists on eating it. And she doesn’t just chew and spit. She actually swallows it.
      Now you can’t tell me that’s not a problem.

  9. gfeld says:

    It’s interesting. My friends son loves to take anything into his mouth at 16 months old, as long as it’s not food. I found him with paper, playdough, pebbles, and what-not. I told her that I think he is a bit too old to be doing that. I don’t know if he swallows it though or just chews on them and then’ll spit them out. Is that still part of this pica diagnoses?

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