What Is Pica?
Pica is an eating disorder characterized by persistent consumption of non-food items (paper, dirt, hair, etc.) for at least one month at an age when eating such objects is developmentally inappropriate (typically beyond 18–24 months). It’s not a phase to ignore—pica can cause poisoning, blockages, infection, or choking.
Doctors diagnose pica when the behavior is not part of a culturally supported practice (like chewing betel nut) and is severe enough to need clinical attention.
Common Non-food Items Kids May Eat
Why Does Pica Happen?
Nutritional Deficiency
Iron, zinc, and calcium deficiencies can trigger cravings for soil, ice, or other substances.
Developmental Differences
Pica is seen more often in kids with autism, intellectual disability, or sensory processing disorders.
Mental Health Factors
Obsessive-compulsive disorder (OCD), anxiety, or trauma can drive compulsive ingestion.
Environmental Stress
Lack of supervision, neglect, or limited access to food may increase risk.
Health Risks to Watch
- Lead exposure — Eating paint chips or contaminated soil can cause irreversible brain injury
- Blockages & choking — Hair, coins, or stones can obstruct airways or intestines
- Infections & parasites — Soil, feces, or trash carry bacteria and worms
- Dental damage — Chewing ice, rocks, or metal harms enamel and gums
- Toxin ingestion — Laundry pods, batteries, and cleaning supplies poison quickly
Call your pediatrician or poison control immediately if ingestion could be toxic or obstructive.
When to Call the Doctor
- Persistent eating of non-food items past age 2
- Any ingestion of sharp, metallic, battery, or chemical objects
- Signs of anemia: fatigue, pale skin, headaches, brittle nails
- Abdominal pain, vomiting, constipation, or blood in stool
- Behavior interfering with normal meals or weight gain
- Co-occurring developmental delays or behavioral changes
Ask for referrals to gastroenterology, nutrition, behavioral therapy, or occupational therapy as needed.
Treatment Plan: Build a Team
Medical & Nutritional Workup
- Blood tests for iron, zinc, lead, celiac disease, and anemia
- Review medications, GI history, sensory needs, and feeding patterns
Address Deficiencies
- Supplement iron or other nutrients, then reassess cravings
- Increase dietary protein, fiber, and hydration to reduce chewing urges
Behavioral Therapy
- Applied behavior analysis (ABA) or CBT to replace pica behaviors with safe alternatives
- Visual reminders, token systems, and differential reinforcement
Environmental Controls
- Lock cabinets, repaint chipped surfaces, secure yard soil, monitor playgrounds
- Provide safe chew or fidget items to meet sensory needs
How Parents Can Help Day to Day
Supervise & Document
Track when and where pica occurs (boredom, stress, specific rooms). Share logs with healthcare providers.
Childproof & Provide Alternatives
Lock away dangerous items. Offer chew-safe necklaces, crunchy snacks, or sensory bins for tactile input.
Positive Reinforcement
Reward safe chewing, hand washing, or asking for help. Avoid shaming—focus on safety and learning.
Partner With School
Inform teachers, therapists, and aides. Request goals in IEP/504 plans for feeding and sensory strategies.
Frequently Asked Questions
My toddler still mouths everything—when should I worry?
Exploring with the mouth is normal until about age 2. Talk to your pediatrician if your child intentionally swallows nonfood items past that age or seeks them persistently.
Is pica linked to autism or sensory processing disorder?
Yes, pica is more common in children with developmental disabilities. Sensory-seeking behavior or difficulty distinguishing food from objects may play a role, so occupational therapy can help.
Should I punish my child for eating non-food items?
No—punishment can increase anxiety and secrecy. Focus on supervision, redirecting, praising safe choices, and providing professional treatment.
How long does pica last?
Duration varies. When underlying causes are treated and behavioral supports stay consistent, many children significantly reduce or stop pica over months to a few years.
Key Takeaways
Medical First
Always rule out deficiencies or poisoning when pica appears.
Prevention Saves
Childproofing, supervision, and safe alternatives reduce emergencies.
Team Effort
Combine pediatric, nutritional, and behavioral expertise for success.
⚠️ Important Note
This resource is informational and not a substitute for professional medical advice. If your child eats non-food items, contact your pediatrician or poison control (1-800-222-1222) immediately. Seek emergency care for sharp, metallic, chemical, or battery ingestion, or if your child has trouble breathing, swallowing, or develops severe abdominal pain.