Pica

Question of the Week

A child with a mud pie?
What do you do when your child actually wants to eat the mud pie she made?. Photo by Ambre Haller/Getty Images

Question. I have a nephew who is about 1 1/2 yrs. old and he is always picking up screws, bolts, anything metal, etc..., and rocks to eat. Out of everything else on the ground outside, all he wants to put in his mouth is either metal or rocks. Does this mean that something is wrong or is it just a bad habit? Could he be lacking something? Hilo, HI

Answer. It sounds like he may have pica (PI-kuh), which is a disorder in which children crave or eat non-food substances, like rocks, clay, hair, etc.

Other children with pica eat paper, cardboard, or even the stuffing from furniture.

Pica

While it isn't known what causes pica, these children may have some kind of nutritional deficiency, especially a deficiency of iron or zinc.

Does he drink a lot of extra milk? If he drinks too much milk and doesn't have a 'healthy diet,' he may very well also be suffering from iron deficiency anemia.

In addition to providing him with a safe environment, so that there aren't any screws or bolts for him to pick up and swallow or choke on, he should see his pediatrician for an evaluation. Along with a physical exam, this evaluation will likely include a complete blood count to see if he is indeed anemic.

If you think that he may have swallowed some of the things that he puts in his mouth, a chest and abdominal x-ray may also be a good idea.

Treatments for Pica

Pica typically resolves fairly quickly once the underlying nutritional deficiency is fixed.

For example, if a child is eating dirt and rocks because he is low in iron, giving him a vitamin with iron and extra iron rich foods should treat his underlying anemia. His pica should soon resolve too.

Pica vs Bad Toddler Habits

Since toddlers do tend to normally put things in their mouth, if everything is normal in his evaluation with his pediatrician and he doesn't do it all of the time, then it may just be a habit that he will outgrow.

In an older child, like over 3 or 4 years, this behavior would clearly be identified as pica, but it is harder to make a diagnosis in a toddler.

It is also more likely to be a problem if he is very aggressive and continues to want to eat these things as you try to distract him away from them or offer him real food to eat instead.

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