Does my Daughter have Pica?

Patient

Q: My 2 year old is always eating hand soap, disinfectant, hand sanitizer, sun screen, shampoo, shaving cream, lotion, nappy cream, nappy wipes anything she can get her hands on she will seek out these things at home and at daycare this has been going on for at least 2 months now what should i do??

Doctor

A:   Pica is a disorder that occurs when children persistently eat one or more non-food substances over the course of at least one month. Pica may not sound like a dangerous problem, but when you consider that the non-food substances that are ingested are frequently toxic or otherwise harmful to the human body, there is increased potential for illness. The typical non-food substances that children with pica ingest tend to vary with age. Younger children with Pica frequently eat paint, plaster, string, hair, or cloth. In contrast, older children with Pica tend to eat animal droppings, sand, insects, leaves, or pebbles. Theorized causes of Pica include iron-deficiency (anemia), zinc deficiency, mental retardation, developmental delays, and a family history of Pica. Other theories suggest that Pica is caused by oral fixations, a lack of appropriate stimulation, or a lack of parental attention. In other words, the reasons why Pica occurs are not definitively known at this time.
I would advise that you take your daughter to her doctor. The assessing clinician will need to gather as much information about the child as possible, so parents will generally be asked to describe the child's medical, psychological, and developmental histories, as well as food-related behavior, environmental factors that seem to trigger the pica symptoms, and the consequences of food related behavior.
Pica can be difficult to treat. One of the first steps is to encourage children to eat a healthy, balanced diet. Replacing non-food items that children ingest with more suitable, nutritious food items is an important goal. Children with Pica enjoy not only the taste or texture of whatever substances they chose to eat, but also the oral stimulation involved. Therefore, a plan to decrease Pica should include alternative ways of obtaining stimulation (oral and otherwise) that are both positive and reinforcing (e.g., enjoying safe food items, and engaging in other highly desirable activities). To this end, therapists help parents and caregivers come up with developmentally-appropriate stimulation plans. Toddlers, for example, may be stimulated simply by playing a game searching for toys.

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