Pica And Your Toddler-Signs, Causes And Symptoms

Bache to kuch bhi khaa lete hain! Most of us have heard such generic statements often; assuming toddlers have natural appetite to explore things and taste them, even though if it is away from the norms of being edible. Such things were easily acceptable in previous generations where an infant can pick up a paper or pebble from the floor and munch it for fun. But the evident indigestion issues prevailing amongst young children these days, have classified this common habit into a disorder called pica.

What Is Pica?

Pica is appetite for non-nutritive substances like chalk, pebbles, ice, dust, soil, paper, hair, metal, paint or even glass. This is defined as persistent indigestion of non-edible items for minimum one month at a certain age of year, for which this behaviour is developmentally inappropriate. This could be seen in pregnant women and most commonly in children. Researches shows 4-26 percent children are affected from pica all over the world.

Is Pica A Disability?

In many cultures eating non-nutritive substances is culturally well accepted. Like in Africans, children have natural liking for clay, and they seem to be a feeding norm for them. So in Africa, clay is not categorised under pica. Thus pica may not be a culturally accepted practice, it has to be a prolonged abnormal eating behaviour to fit in. Pica as a disorder is associated with mineral deficiencies or behavioural abnormalities by Diagnostic and Statistical Manual of Mental Disorders, 4th. Edition commonly known as DSM IV.

What Are Signs And Symptoms Of Pica?

Sensory, physiological, cultural and psychological perspectives have been associated with pica. So the multidimensional affiliations lead to variable signs as symptoms in children with this disorder. It is clinically difficult to diagnose the disability but in cases of being exposed to poisonous substances, the victim child shows relative hard symptoms. Most accepted signs to relate patient with pica are

1. Dental manifestations: Loss of tooth in children, severe tooth abrasions and dental abnormalities could be seen as a sign in pica.
2. Gastro manifestations: The signs related to digestive tract are the most crucial ones. The digestion of absurd substances like dust or soil leads to many digestive problems like constipation, irregular bowel movements, stomach ache and in critical cases it leads to haemorrhage. The sharp edged substances like glass or stones are abrasive and tear apart the inner lining. Also the undigested items are difficult to absorb by the intestinal tissues, so they bring hard stool or constipation in young children.
3. Infections: Serious infections could be seen in pica due to engulfing substances like soil or sand which have high level of parasites and bacteria to induce infections.
4. Mental disorders: If the child is prone to eat poisonous substances containing lead, it hampers the mental growth and sensory responses of the child. Learning disability could be another major symptom in children.
5. Mineral deficiencies: As per few practitioners, appetite for non-nutritive items can lead to mineral deficiencies which could be seen in predictive patient. Doctors check for anaemia or iron deficiencies to associate symptoms to pica.

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How To Diagnose Pica?

If your child is anywhere between 1 and 2 years, you may need to be extra careful around him or her. Generally, children from the age of 1- 2years are at high risk of pica. Diagnosing a child with pica is a task with multi-level filtering. A doctor first checks for any mineral deficiency, like an anemic child. Though it is not the ideal directive as researchers are still confirming about pica inducing mineral deficiency or it is the deficiency that prompts the child to have appetite for mineral rich substances.

Then the practitioner looks for the potential toxicity to check possibility of ingestion of poisonous substances like metals or lead.

If symptoms are prevailing and they are guiding to the syndrome, then the next step is detailing the complete medical history of the child. It is believed that pica is more common among the children with mental disorders. They lack the discrimination between food items and non-food items, that tend to make them eat everything.

The final stage is to perform medical tests like blood test, radiography of gastro intestinal tract, and may be X Ray for target organs.

What Are The Causes Of Pica?

There are many reasons associated with pica, which leads to the eating disorder among toddlers or infants.

• Nutritional deficiency: This may be a reason which causes a child to attain pica. The medical generals explain that sometimes a deficiency of mineral promotes eating misbehaviour in child. A child with craving for metals can be mineral deficient. It may be vice versa in some cases
• Family factors: The circumstances in family and society do impact the living behaviour of a child. If parents are separated or misbehaving with child, it all affects the confidence of child and directs him to deteriorating habits, one such thing could be pica
• Stress: Children these days are surrounded by different level of stresses. Peer pressure with stress to perform well or it could be to fulfill expectation everywhere. Ultimately when they fail to accomplish, they feel stressed and behaviour modifies
• Low socio-economic status: Sometimes children living in unstructured or poorly maintained places get prone to addiction of eating inedible stuff. Obviously if a toddler is exposed to stones or street sand in initial years, it tends to become a regular habit. And these habits become pica, if prolonged
• Inability to discriminate: Few children are not completely developed as per the age requirements. Due to retarded mental or physical growths, it become difficult for them to differentiate between food times and non-food items
• Social factor: Often a child fell prey to social exploitation that cause behavioural changes. These changes are sometimes towards the eating patterns that forces child to be non-discriminative towards the food to consume. Child abuse and child based crimes may be the reason for pica in few children

How To Treat Pica?

As we have discussed that pica is based on so many factors that impel the child to pica, so treating this disorder asks for multidisciplinary approach. A lot of contribution is seemed from family to physician to psychologist for helping pica affected child. Since there is no specific medication or drug to treat it, many doctors use nerve stimulators to treat the same. Basically behavioural strategies are more emphasised to treat the child. Commonly known techniques are

• Training the child to discriminate: Yes with the help of psychologist or family member, a child can be trained to learn what to eat and what not to.
• Using protective devices: Self-protecting child from taking non-nutritive food into mouth can be opted. Cover the mouth with mask or cloth can be a good idea.
• Sensory reinforcement: An individual might feel sensory stimulation at the sight or smell of certain substances. Even in pica children, such stimulations happen and controlling such stimuli can prevent child from eating harmful items. The object that induce stimuli can be removed or substituted with a healthy item.
• Correcting child: If a child is under pica, the family members shall keep correcting on good things to eat and right things to eat. With repetitive corrective actions, child may develop the right decision power.
• Dental intervention: Dentist help can also be sought to prevent dental manifestation in pica child.
• Social working groups for help: Psychologist and social working groups shall be approached for multidimensional help on curative measures.
• Other edible stuff as an option: Popcorns or chewing gums are also suggestive options to remove the desire for non nutritive food items.
• Social attention: Love and care are the best remedies to treat any ailment. So forget about pica and pay attention to your child. All love and personalised care can help bring behavioural improvements.

  Young children are naturally curious to taste the things coming their way but when this innocent urge go beyond the limitations, it has to be diagnosed and worked upon. Sometimes the poor mental condition, brain injuries, or any problem can create this syndrome in your child's life. Be aware and well read, before you tag it as pica.

  Having said all about pica – if you found your toddler eating a handful of mud from your plant pot don’t immediately label it as pica, as your toddler in all his or her innocence just tasting it. Instead gently remove him or her from there and give something edible to munch on.

  Did you like the blog on pica and your toddler? Share your thoughts, views and feedback in the comments section below as I would love to hear them. I learned a lot about pica while doing this blog, I hope I am able to pass on my learnings to fellow parents as well.