Pica: Kids Eating Non-Food Items

Pica is the act of eating non-food items. Although young children are curious about their environment and predictably put everything in their mouths, children with pica go beyond this simple exploration of their surroundings.

The eating disorder of pica is typically defi ned as the compulsive eating of non-food items for a period of at least one month at an age for which this behavior is developmentally inappropriate (after age 18 to 24 months). It is different from geophagy, the intentional eating of soil associated with cultural practices.

Which non-food items are consumed?

What people consider unfit for food varies by region and ethnicity. People with pica frequently crave and consume items such as clay, dirt, sand, stones, hair, feces, lead, laundry starch, vinyl gloves, plastic, pencil erasers, ice, fingernails, paper, paint chips, coal, chalk, wood, plaster, light bulbs, toothpaste, needles, string and burnt matches.

What causes pica?

Although the specific causes of pica are unknown, numerous theories have been proposed ranging from nutrition defi ciency (e.g., iron, calcium or zinc defi ciency) to emotional distress and developmental disorders.

How dangerous is eating dirt?

Continuous eating of non-food items can be harmful to your child’s health. Depending on the nature and amount of ingested objects, it may cause the following health problems:

• Lead poisoning. Eating soils contaminated with lead is a recognized cause of lead poisoning.
• Malnutrition. Consuming non-food items leaves less opportunity to eat nutritious foods.
• Bowel problems. Eating objects that could get lodged in the intestines may lead to intestinal obstruction or damage.
• Dental injury. Consuming hard substances may harm the teeth.
• Parasitic infections. Eating soil has been shown to be a signifi cant risk factor for exposure to soil-transmitted parasites and infections.

What are other ways in which children ingest considerable amounts of soil?

Contaminated food, soiled hands, and inhaled dust add soil to our diets. Observations show that normal behaviors in young children (e.g., putting objects in their mouths, playing with pets, handling food, eating after playing outdoors, sucking thumbs, biting fi ngernails, playing in sandboxes, and engaging in other hand-tomouth activities) may also contribute to soil and dust exposures. However, the extent of exposure depends on factors such as where children play, what they wear, and how often they wash their hands.

When should you call your health care provider?

Professional help may be needed if:

• Your child is constantly eating non-food objects.
• You have concerns about your child’s growth.
• Your child is unwell, tired and not eating.
• Mealtimes are causing lots of stress and anxiety. If your child has consumed a harmful object, seek medical care immediately. If you think your child has ingested something poisonous, call Poison Control at (800) 222-1222.

References and Resources

Pediatrics, Apr 2004. Children’s Behavior and Physiology and How It Affects Exposure to Environmental Contaminants. Online at http://pediatrics.aappublications.org/cgi/search?qbe=pediatrics;29/ 6/1012&journalcode=pediatrics&minscore=5000