What is pica?
Pica is an eating disorder that causes people (often children) to eat things that aren’t food. This can include things found outside like dirt and plants; classroom supplies like paper and crayons; and other substances like clay, hair, paint chips, ice, or in some cases faeces.
Children with pica commonly develop other health problems as a result of eating things they can’t properly chew or digest. These can include constipation, diarrhoea or other gastrointestinal issues; lead or other metal poisoning; intestinal infections or obstruction; or injuries to their mouth and teeth.
It’s normal for young children to put things in their mouths or chew on things as part of learning to navigate the world, and most children will occasionally swallow something they shouldn’t.
However, a child aged 3 or older who has been deliberately eating things that aren’t food for at least one month should be seen by a doctor.
Supporting a child with pica:
Pica is often temporary, and goes away on its own after a few months. The most important part of supporting a child with pica for those few months is preventing more serious health problems by taking away their access to things that are dangerous to eat.
- Keep things the child consistently seeks out somewhere unreachable, like a high shelf or locked away.
- Supervise the child closely for as much of the day as possible, and immediately remove non-food items that they try to eat. (Or remove the child, if the non-food item is something that cannot be removed, like dirt or paint.)
- Clean the child’s environment as often as possible to reduce the likelihood of them finding things to eat on the floor.
- For some children, being distracted or redirected every time they are about to eat something that isn’t food (or every time they seem to be looking for something to eat) can help to break the habit of eating non-food items.
If the pica behaviour doesn’t go away by itself after 4-5 months, you may want to consider some of the following strategies:
- Consult a dietician to check if the child is missing any particular nutrient that they may be trying to get from non-food items. You can find a dietitian in your area here: https://dietitians.org.nz/find-a-dietitian/
- Pica in some children is a response to extreme stress, like poverty, abuse, or neglect. In this case, resolving the source of the stress will usually end the pica behaviour. If you think this may be the case for your child or a child you work with, there are organisations that can help – Parent Help (https://www.parenthelp.org.nz/), the Family Services directory (https://www.familyservices.govt.nz/directory/), or Mana Mokopuna (https://www.manamokopuna.org.nz/help-and-advice/) can be good places to start.
- Mental health or disability professionals can help when ongoing pica is associated with a disability or a mental health condition. Your child’s GP should be able to help with a referral if your child doesn’t have an existing relationship with a disability or mental health professional.
- In some children with developmental or learning disabilities, pica can be a result of not understanding what counts as food and what doesn’t. For these children, making a game out of identifying what is food and what isn’t can help. This could include visual reminders with pictures of things that are and aren’t good to eat; sorting items into ‘food’ and ‘not food’ categories; or any other games appropriate for the child’s ability.
Providing frequent snacks or having snacks constantly available can help to reduce or stop pica in children who enjoy the sensations of eating; being able to eat food whenever they want can mean that they stop looking for eating sensations with inappropriate items.
Chew toys with different textures; snacks with similar textures to the non-food items they commonly eat; or vibrating toothbrushes to simulate the feeling of vibrating their jaw by biting something hard can help provide the sensory input these children are looking for.
Some suggestions for snacks that can help provide sensory input:
- Blended biscuits (similar to sand or dirt)
- Edible paper or rice paper (similar to tissue)
- Meringue (similar to chalk)
- Boba (similar to various squishy textures)
- Powdered sugar or crushed ice (similar to baby powder and other powders)
