What is pica?

Pica is a compulsive eating disorder that affects 10% to 30% of young children, ages 1 to 2. It is the act of eating nonfood items. Dirt, clay, and flaking paint are the most common. Less common items include glue, hair, cigarette ashes, and feces. It is most common in children and adults with intellectual and developmental disabilities, such as autism. On rare occasions, pregnant women crave strange, nonfood items. For these women, pica often involves eating dirt and may be related to an iron and zinc deficiency.

Symptoms of pica

Pica symptoms are related to the nonfood item he or she has eaten. They include:

  • Stomach upset
  • Stomach pain
  • Blood in the stool (which may be a sign of an ulcer that developed from eating nonfood items)
  • Bowel problems (such as constipation or diarrhea)

These symptoms are the result of the toxic, poisonous, and bacterial content of the nonfood items. Repeatedly eating nonfood items over a period of time can cause lead poisoning, an intestinal blockage or tear (from eating hard objects, such as rocks), injuries to teeth, and infections (from organisms and parasites that get inside the body and cause disease).

How is pica diagnosed?

Many typical children chew on things such as their nails and ice, or mouth their toys and hair. A person diagnosed with pica repeatedly eats nonfood items, even if they make him or her sick.

  • Your doctor will look at your child’s physical symptoms (stomach upset, bowel problems).
  • If your child is in a high-risk group for pica (intellectual and developmental disabilities), your doctor may ask if you have seen your child eating nonfood items and for how long.
  • If the behavior has occurred for a month or more, your doctor may diagnose it as pica.
  • Your doctor may order a blood test to check your child’s iron and zinc levels. Not having enough of these vitamins is considered a trigger for eating dirt and clay in some cases.

Pica treatment

Treatment will address several areas. Your doctor will address your child’s illness from having eaten nonfood items. For example, your doctor will treat your child’s constipation, diarrhea, ulcer, intestinal tear, infection, or any combination of illnesses. If your doctor finds your child doesn’t have enough iron or zinc, he or she will address that with a vitamin supplement and dietary recommendations.

Another focus of treatment will address the underlying cause of your child’s pica diagnosis. Your doctor will discuss your child’s home environment, educate you as a parent, and refer your child to a behavioral or mental health specialist.

Can pica be prevented or avoided?

Pica cannot be prevented. Proper nutrition may help some children. If your child has been diagnosed with pica, you can reduce his or her risk of eating nonfood items by keeping those items out of reach in your home. Monitor your child’s outside play.

Living with pica

Most children outgrow pica as they get older. However, high-risk populations, such as children and adults with intellectual or developmental disabilities, may need continued monitoring of their behavior and environment.

Questions to ask your doctor

  • Can behavior therapy retrain my child from eating nonfood items?
  • What signs should I look for in cases of lead poisoning, ulcers, infections, or intestinal tears?