PICA is the eating of non-edible, non-nutritious items such as stones, plastic, wood etc.
It is more common in children on the Autism Spectrum, children with a learning disability and children who have had a brain injury which has affected their development. It is possible that children with developmental trauma and those who have suffered neglect may develop PICA as a means to get their nutritional needs met. For example, feeling compelled to eat non-food items because they are hungry. It is also possible that for children with developmental trauma, PICA is a strategy they have learnt to self-sooth when they are anxious or frightened.
There are a number of possible causes for PICA.
Neurological
This can include a brain injury which effects development, Autism , or developmental disabilities.
There are a number of reasons why these neurological difficulties can cause PICA. It could be that the child struggles to differentiate between edible and non-edible items or it could be a continuation of infant mouthing behaviour. PICA in children with neurological difficulties may also be a means of seeking out sensory input or trying to relieve pain or discomfort.
Biological
For example, iron or zinc deficiencies. Deficiencies in iron or zinc can trigger specific cravings however, the non-food items craved usually don’t supply the minerals lacking in the person’s body.
Sensory
If a child is hypo sensitive to taste or texture, non-food items can fill a sensory need for them. For example, the strong tastes that certain non-food items have (like soaps) or the rough textures of a non-food item.
Cultural/Social
In some African cultures, eating non-food items is learned as part of the culture or religious practice. For example, in some cultures it is believed that eating dirt will help incorporate magical spirits into the body.
For some families suffering extreme poverty, food may not be regularly available and children may attempt to ease their hunger by eating non-food substances to get a feeling of fullness.
Emotional regulation
Children may be driven to eat non-food items in an attempt to manage anxiety or self-soothe. Chewing or sucking on clothes for example can create a sense of comfort for the child, helping them to regulate high emotions.
Strategies to support your child
At times, it can be easy to believe that the child has control over their PICA. However, PICA is similar to a compulsion and will be something that your child cannot control. There are ways that you can support your child so that they are safe and are not eating items which can cause them harm.
It can be helpful to explore with your child what are edible and non-edible items as it may be that they struggle to understand this.
The non-edible items that your child eats may serve a sensory purpose. For example, the texture of certain items like tree bark. In these cases, it can be helpful to find edible alternatives that your child can have which fulfil the sensory need. For example, giving your child cinnamon sticks as an alternative to wood or bark. Finding edible alternatives to the items your child eats can also help to reduce the risk of harm from the non-edible items that they eat.
It can also be helpful to think of self-soothing strategies to support your child with their anxiety. For example, breathing exercises or finding items which your child finds comforting such as a soft, cosy blanket. If you can identify the times that your child is feeling anxious and is more likely to eat non-food items you can connect with their anxiety, offer them comfort, and support them to use self-soothing strategies.
If your child is eating items that may be poisonous or risk harming them (e.g. sharp objects such as stones) it is important to take them to the GP for a health check. The GP can offer further advice and support or refer you to services who can offer your child and family further support.