Understanding Pica: A Guide for Parents

Written By HOLLY ROSS

Hey everyone! Today we are talking about Pica! First let’s define it and goes over some introductory stuff, then we’ll look at strategies. (Scroll towards the bottom for strategies if you don’t want the general information.)

What Is Pica?

Pica is an eating disorder characterized by the persistent consumption of non-nutritive, non-food substances for at least one month. The name comes from the Latin word for magpie, a bird known for eating a variety of unusual items.

While occasional curiosity-driven mouthing of objects is normal in infants and toddlers, pica becomes a concern when it continues beyond early childhood or occurs in individuals with certain medical or developmental conditions.

Common Substances Eaten in Pica

Children and individuals with pica may consume:

  • Dirt or soil

  • Chalk, crayons, or pencils

  • Paper, cardboard, or books

  • Hair or fabric or yarn

  • Soap, clay, or paint chips

  • Ice (often associated with iron deficiency)

  • Clothing

  • Chucks, Diapers, Foam

BASICALLY ANYTHING THAT ISN’T FOOD!

Who Is at Risk?

Pica can occur in people of all ages but is most commonly seen in:

  • Young children (especially those under 6 years old)

  • Individuals with developmental disabilities, including but not limited to autism spectrum disorder (ASD), ADHD, TBI, Down Syndrome, etc.

  • Pregnant women (due to nutritional deficiencies)

  • People with iron or zinc deficiencies

  • Individuals with obsessive-compulsive disorder (OCD) or sensory-seeking behaviors

Okay now the good stuff! What is the cause and how can I trial and error to figure out how to fix it with my loved one.

What Causes Pica?

There is no single cause of pica, but several factors may contribute to it:

  • Nutritional Deficiencies: A lack of iron, zinc, or other essential nutrients can trigger cravings for non-food substances.

  • Developmental Disorders: Children with autism, intellectual disabilities, or sensory processing disorders may engage in pica as a form of sensory stimulation.

  • Cultural or Environmental Influences: In some cultures, eating substances like clay or starch is a traditional practice.

  • Psychological Factors: Stress, anxiety, or obsessive-compulsive tendencies can contribute to compulsive non-food consumption.

  • Medical Conditions: Certain gastrointestinal disorders or lead poisoning can be linked to pica behaviors.

  • Compulsions: Needing to act on an impulsive thought to eat something. Compulsions exist in multiple different diagnoses not just OCD.

Potential Risks and Dangers

Eating non-food items can pose serious health risks, including:

  • Choking or Intestinal Blockages: Objects like fabric, plastic, or hair can cause digestive issues.

  • Poisoning: Paint chips may contain lead, and other substances may have harmful chemicals.

  • Parasitic Infections: Eating soil or raw starch can expose a child to parasites.

  • Nutritional Deficiencies: Pica can interfere with proper nutrition if it replaces normal food intake.

How Can Parents Manage Pica?

If you suspect your child or loved one has pica, here are some strategies to trial and error with. Remember you are the expert on your child or loved one when you are the primary caregiver. You have the best chance of figuring out the reason why they engage in these behaviors. Once you have the reason why, it’s easier to come up with treatment strategies:

1. Identify and Address Nutritional Deficiencies (sometimes this one is sneaky to figure out)

  • Have your child evaluated by a pediatrician for iron, zinc, or other deficiencies.

  • People who show signs of pica often have mineral or other deficiencies in their diet. Iron (anemia), calcium and zinc deficiencies are some of the most common reasons people show these signs. – Cleveland Clinic

2. Provide Safe Alternatives

  • If your child craves oral stimulation, offer safe options like chewable jewelry, crunchy snacks, or gum if they will take them from you.

  • Chewing on cloth or string? – Sometimes find a non-dyed fabric or cutting into small pieces are effective strategies to prevent illness without necessarily stopping the Pica.

  • Tie up electrical cords or hide them under mats, rugs, duct tape, etc. to prevent these dangers while on the floor.

  • Discourage eating non-food items and redirect your child’s attention to appropriate activities if that is possible.

  • Use positive reinforcement when they choose appropriate items instead of non-food objects. You could say “Look at that chewy that’s nice!”

  • Figure out maybe what nutrients that item does provide and see if there is a food your child or loved on is willing to eat that contains those materials. (But why would they need this now and they haven’t before? Growth spurt, puberty, neuronal changes all could be reasons).

  • Freeze the preferred eaten item in a Tupperware in the freezer. Explain to the loved one that they cannot eat it and by the time the ice melts they may have convinced themselves to avoid eating the item.

  • Find a food item that almost matches the non-edible item and try redirection to that item.

3. Modify the Environment

  • Keep non-food items out of reach to the best of your ability.

  • Use locks on cabinets containing harmful substances.

  • Stop buying the eaten non-edible items (if you can do so without causing significant stress to your loved one).

Work with your healthcare team and OTs like me to pinpoint the reason and come up with customized solutions for your loved one. This is a really tough topic. Just remember you are doing a great job as a parent and doing the best you can to manage Pica. They still may eat things but if you prevent poisoning, a hospitalization, or other emergency that is is related to Pica they you are doing good!

Here are some more links with more information about Pica. Some of the above information comes from these links but you may find more helpful nuggets as you continue to read.

  • "Pica: A Guide for Professionals" by Autism Speaks: is guide provides comprehensive information on pica, particularly in children with autism, and discusses intervention strategies, including the role of occupational therapy. autismspeaks.org](hps://www.autismspeaks.org/sites/default/files/2018-08/Pica%20Professionals.f?utm_source=chatgpt.com))

  • "Understanding and Managing Pica" by the National Autistic Society: This article offers insights into pica behavior and highlights the importance of a multi-disciplinary approach, including occupational therapy, in managing the condition. (utism.org.uk](https://www.autism.org.uk/advice-and-guidance/professional-practice/managing-pica?utm_source=chatgpt.com))

  • "Pica Therapy: Effective Treatments for Non-Food Cravings" This piece discusses various therapeutic approaches to pica, emphasizing the significance of occupational therapy in addressing senry needs and providing safe alternatives. (neurolaunch.com)

  • "Pica: Critical Information and Practical Strategies for Parents and Professionals" by the University of Rochester Medical Center: This resource offers detailed information on pica, including definitions, diagnostic criteria, and practical strategies for management, wit focus on the role of occupational therapy. (urmc.rochester.edu)

  • https://my.clevelandclinic.org/health/diseases/22944-pica - Overview

Until next time! Please email me for future topics and or questions you may have about Pica. Have something you know about Pica from your perspective that you want me to add? Email me! holly@canoecommunity.org – Holly Ross OTR/L, WSI/T, LTP, ATRIC

HOLLY ROSS
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