PICA

General Information

DEFINITION--Craving or eating bizarre substances that have no food value.

BODY PARTS INVOLVED--Brain; gastrointestinal tract.

SEX OR AGE MOST AFFECTED--Children between ages 1 and 6 and pregnant women. Pica does not apply to infants and children up to about 18 months old who "put everything" in the mouth. That is normal.

SIGNS & SYMPTOMS

• Eating non-food substances, such as starch, clay, ice, plaster, paint, hair or gravel.
• Abdominal pain (sometimes).

CAUSES

• Instinctive need to replace minerals absent in the diet. This is especially true of eating clay for iron content.
• Psychological factors that are not well-understood, related to substandard housing, low income or emotional deprivation.

RISK INCREASES WITH

• Family history of pica.
• Poor nutrition.
• Poverty.
• Mental retardation.
• Anemia.

HOW TO PREVENT

• Remove substances from the reach of children.
• Repaint homes in which lead-base paints have been used. Don't use older baby cribs painted with lead-base paint.
• Provide a well-balanced diet for yourself and your children.
• Provide a loving, supportive home environment for your children.

What To Expect

DIAGNOSTIC MEASURES--

• Your own observation of symptoms.
• Medical history and physical exam by a doctor.
• Laboratory blood studies to detect anemia and measure fluids and electrolytes.
• X-rays of the abdomen.

APPROPRIATE HEALTH CARE

• Self-care after diagnosis.
• Doctor's treatment.
• Psychotherapy or counseling.

POSSIBLE COMPLICATIONS

• Lead poisoning from paint or plaster.
• Intestinal infections or parasites from soil.
• Anemia.
• Malnutrition.
• Intestinal obstruction.

PROBABLE OUTCOME--Pica during pregnancy usually ends with childbirth. Other forms can be controlled with treatment.

How To Treat

GENERAL MEASURES--

• If the craving is due to a deficiency of an element, such as iron, treatment involves iron replacement.
• Other treatment steps: Proper supervision of young children. Examine your home environment and family interactions. If you feel they are not what they should be, seek ways to create a healthier atmosphere. Consult a counselor, if necessary. Behavior modification therapy whereby parents learn to encourage the child's acceptable behaviors through positive reinforcement and unacceptable behavior by providing the child with distractions.

MEDICATION--Your doctor may prescribe iron or other supplements supplements if needed.

ACTIVITY--No restrictions.

DIET--Provide a well-balanced diet. Vitamin and mineral supplements may be necessary. If you need help planning meals, consult the home-extension service, a dietitian or a visiting nurse.

Call Your Doctor If

• Your child has symptoms of pica.
• You are pregnant and have symptoms of pica.
• Pica does not improve in 2 weeks, despite treatment.