Not so long ago a parent wrote in on this site talking about the topic of pica so I thought that I would address this issue. What is pica? Pica disorder is when the person has an appetite for things which are considered non-food substances or objects. Some of the most common things people with pica will try to ingest include: Sand, dirt, clay, chalk, paper, or ashes. There are some cases where the individual will even be attracted to eating metal as in coins, nuts, and bolts. Sometimes the pica will be an appetite for ingredients which are edible but non-nutritive in the form desired, such as eating flour, raw rice, ice cubes, and salt. In order for Pica disorder to be diagnosed the person has to have engaged in this behavior for at least a month and be old enough for this behavior to be considered developmentally inappropriate (generally over the age of two).
Who has pica? This behavior is typically seen in young children, pregnant women and people who have developmental disabilities including mental retardation and/or autism spectrum disorders. People with obsessive compulsive disorder may also be more prone to having this disorder.
Last summer my son Max developed pica for wanting to eat sand and dirt. I was very worried about this odd new behavior. I remember seeing an episode of the TV show House where the doctor has a case of an autistic boy who is very ill and they can’t figure out why. When they follow the routine of the child as he might go about his day they find that he spends time playing in a sandbox. It turns out that the child on the show was eating sand with some sort of animal feces in it. Needless to say, I was riveted to that show. But they never showed how to cure the child from wanting to eat sand in the first place.
I remember going to visit a friend and telling her about Max trying to eat sand and she told me about her elderly mother’s obsession for eating ice. She then told me that the doctor said that was a form of pica and that it can indicate a mineral or vitamin deficiency. I took this information and began to research and found that most theories validate what my friend was telling me. And it can also be an obsessive compulsive behavior.
For my son I suspect that his pica was caused by an iron deficiency and was also becoming an obsession. Every time we visited the beach, a lake, or a playground with sand we would have to watch him closely so that he didn’t try to ingest any sand.
When I reviewed my son’s diet, he had stopped eating any red meat for months. Add to this, he has celiac disease. I found research which shows that pica can be a presenting symptom of celiac disease and related iron deficiency. It all seemed to make sense.
When I finally figured out that Max’s pica was possibly due to an iron deficiency I quickly sought ways to improve his diet in this regard. It is hard with Max because in addition to his limited food preferences he also has multiple food allergies to peanuts, gluten, dairy, and soy.
Max is becoming more of a vegetarian or even a vegan every day, so I looked for dietary guides for vegans of how one can still get iron. I was amazed to find that aside from cooked soybeans (which he can’t eat), that two tablespoons of blackstrap molasses has 7.2 mg of iron So this was one ingredient we soon added to our larder. It can be added to pancakes or muffins or cookies easily. Foods like chickpeas which can be ground up and made into filafils also have iron. Veggies like broccoli and potatoes also contain iron. Veggie hotdogs and veggie burgers can also be a source of iron. Other iron enriched foods that Max enjoys are raisins and dried apricots.
The other way we addressed any vitamin or mineral deficiencies was to give Max a multi-vitamin with iron. You have to really look at the labels because many children’s vitamins do not contain iron. I found Flintstone’s vitamins did have a type which included iron. The vitamins paired with a new diet of iron enriched foods were critical to altering his behavior.
The end to this story is a happy one! Max is no longer eating sand. We could have approached this whole thing in a behavioral way but in the end I believe that he was craving nutrients which were lacking in his diet. Now it is your turn! Do you have a child who has engaged in pica behaviors? Did you find any remedy which worked? Tell us all about it. We want to hear from you!
I am a mother, a writer, and now an MS patient