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Pica in children: How to help your child eating mud
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Pica in children: How to help your child eating mud

An eating disorder in children under the age of three, Pica is characterised by eating non-food substances. It can be treated but requires careful monitoring
Pica in children causes them to eat non-food items such as mud and chalk
Photo by Anantha Subramanyam K/Happiest Health

Priyansh Jagdale from Pune was two years old when his parents noticed that the boy was eating mud. The parents got worried, as the boy’s habit only continued. Speaking to Happiest Health, Priyansh’s mother Sangita Ashok Jagdale said that they could see something amiss and didn’t ignore it any further. Instead, they reached out to a pediatrician in January 2023. At the consultation, they learnt that Priyansh was suffering from iron deficiency, and was diagnosed with Pica, a rare eating disorder seen in children. Pica in children is a compulsive eating disorder, but it’s a treatable condition.

What is Pica in children?

Dr Shivaprakash Sosale, assistant professor, department of pediatrics, Bangalore Medical College and Research Institute, Bengaluru, says that Pica is a craving for non-food items or non-nutritive substances. “This eating disorder is seen in toddlers of one to three years. With early diagnosis and the right treatment, Pica can be resolved in a mere two to three months. However, it requires close follow-up,” says Dr Sosale.

Why does a child eat soil, paint, mud or chalk?

According to Dr Sosale, there is no particular reason for eating non-food items. “Those with Pica will eat a piece of chalk, mud, sometimes even granules of stones, and lick paint on the wall. They are also vulnerable to lead poisoning, which occurs when there is a buildup of lead in the body. However, Pica leading to lead poisoning is rare,” said Dr Sosale. But when a similar symptom is seen in older children or youngsters, they need to be counselled and psychiatric evaluation is needed, say doctors.

“The concern was not just about eating mud, but also about digestion. He was not gaining weight. After the Pica diagnosis, within three months, he stopped eating mud and his health improved. In the last six months, he also started gaining weight gradually,” said Sangita.

Dr Sosale adds that many parents who come to the outpatient department (OPD) report the worrying problem of their children eating non-edible substances. “Over six months’ time, we get about 20 such cases in the government medical college OPD unit, where parents complain about their children’s mud-eating habit. In some cases, parents also mention their kids tried to eat the muddy substance by scraping the wall.”

No diagnostic test for Pica:

While there is no diagnostic test to detect Pica in children, doctors must check the history of the child’s activities. “In some cases, Pica also comes with behavioural issues, which require tackling. We ask parents to tell us about the child’s routine and physical activities and understand the pattern,” said Dr Jagadish Kathwate, consultant neonatologist and pediatrician, Motherhood Hospital, Pune, Maharashtra, who comes across at least two cases of Pica in a span of six months at his practice.

Who is more vulnerable to Pica?

According to the Indian Academy of Pediatrics (IAP), children with malnutrition, specific nutritional deficiencies such as calcium deficiency, zinc deficiency, and iron deficiency, and those facing neglect or are in poor family environments are more likely to be affected.

Link between Pica and anemia

Iron deficiency can lead to Pica, but so can worm infestations. According to Dr Kathwate, it is a vicious cycle. “While iron deficiency can lead to Pica it is equally possible that after a child eats mud, they have a worm infestation that causes anemia, further leading to Pica,” he said. “If a child is persistently eating soil or licking walls, chalk or any such non-nutritive substances for over a month, parents must suspect a problem and consult a pediatrician,” stresses Dr Kathwate.

Link between Pica and autism

While the cause-effect between autism and Pica has been established, there are cases of some children with autism who have been diagnosed with Pica. Speaking to Happiest Health, Dr Kathwate said he had recently come across a case of a 2.5-year-old boy with autism with a history of scraping off wall paint and mouthing mud. “The boy also had issues of speech delay and fleeting attention. While I treated him, he was further referred to a child psychologist,” Dr Kathwate said.

According to IAP, it is likely to be more common in children with intellectual disability, autism and schizophrenia. Therefore, a proper assessment of the child is important.

What do children with Pica choose to eat?

Treatment for Pica:

Treatment for Pica in children includes iron and zinc supplementation. The first line of treatment for the compulsive eating disorder also includes administering deworming medicine to clear out the digestive system. Some children might  be suffering from anemia, too. Following treatment for about three months, kids with Pica will improve. “Moreover, they will also put on weight once the deficiency is treated with medicines and nutritious food. Besides, the supplements will help in improving their overall health,” said Dr Sosale.

Takeaways

  • Pica is an eating disorder seen in some children between one and three years of age. Here, they tend to eat non-nutritive, non-edible substances like mud, chalk and paper.
  • According to IAP, children with calcium, iron or zinc deficiency are more vulnerable to Pica. Moreover, children neglected by parents and those with intellectual disabilities, autism and schizophrenia are more vulnerable.
  • While there is no diagnostic test for Pica, it is assessed based on a child’s behavioural pattern.

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