girl covered in dirt

How to Tell If Your Child Has Pica

Most kids have playfully made mud pies with their friends. But what happens if your child isn’t just engaging in an imaginary game? For some children, eating dirt, paper, and other non-food materials can be a real behavioral concern. Although this disorder can also occur in adults, it’s most common in kids. Known as pica, it affects an estimated 10 to 30 percent of children ages one to six. Here’s what you need to know to determine if it is a problem for your child.

An Appetite for Destruction?

By definition, pica involves the regular consumption of anything that isn’t a food or beverage. (The word is derived from the Latin for “magpie”—a bird with a large and indiscriminate appetite.) A child may eat dirt (a subset of pica known as geophagy), as well as substances such as:

  • Clay
  • Sand
  • Paint
  • Chalk
  • Glue
  • Soap
  • Ice
  • Hair
  • Coffee grounds
  • Cigarette ashes
  • Paper
  • Metal
  • Animal feces

Simply sampling paste once during a kindergarten art class doesn’t mean your child has pica. The behavior must persist for at least one month to be categorized as the disorder.

Some, but not all, kids with it also have another condition, such as:

  • Intellectual disability
  • Obsessive-compulsive disorder (OCD)
  • Developmental disability

The cause isn’t entirely clear. It appears to have a behavioral basis, although some children may eat dirt or other substances because they are deficient in certain nutrients, such as iron or zinc.

Warning Signs of Pica

Pica can have dangerous complications, including:

  • Malnutrition
  • Intestinal blockage or internal injury
  • Infection from bacteria, parasites, or other microbes in dirt

If your child consumes items such as paint chips that contain lead or other toxic chemicals, he or she may be at higher risk for poisoning and brain damage. For these reasons, it’s important to contact your child’s physician if you think he or she has pica. The following signs can help you determine if a doctor’s appointment is warranted:

  • Your child regularly consumes non-food materials, even when you try to restrict access to them.
  • The behavior is persistent and lasts longer than one month.
  • The behavior is inappropriate for your child’s age or developmental stage (he or she is older than 18 to 24 months).

Pica Diagnosis

During an evaluation, the doctor will likely conduct a physical examination, run blood tests to check for anemia and other nutritional deficiencies, and screen for lead and other toxic substances. Your child’s doctor may also refer you to a mental health specialist and will work with you to help prevent and manage pica. For instance, you should discuss appropriate and inappropriate food substances and may need to restrict access to cabinets with childproof locks. The good news: Most cases of pica eventually resolve over time as a child ages. Taking care of the problem now can help prevent future complications.

Do you think your child may have pica? Have you known children with the disorder? How did it affect them? If you think your child may have pica, consult an expert at the Children’s Hopsital of Pittsburgh of UPMC.