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Feeding and eating disorders of infancy or early childhood: pica

Feeding and eating disorders of infancy or early childhood: pica. Provided by Your Local Public Health Agency and the Child Care Health Consultation Program. Overview: definition prevalence common items ingested. What is PICA?.

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Feeding and eating disorders of infancy or early childhood: pica

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  1. Feeding and eating disorders of infancy or early childhood: pica Provided by Your Local Public Health Agency and the Child Care Health Consultation Program

  2. Overview:definitionprevalencecommon items ingested

  3. What is PICA? • Children persistently eat one of more non-food substances over the course of at least one month • Considered a behavioral problem—self-injurious • Theoretical causes include anemia, zinc deficiency, mental retardation, developmental delays, or family history • Other theories are oral fixation, lack of appropriate stimulation, lack of attention • Causes are not definitively known

  4. What is pica? • More common among children and adolescents with other developmental disabilities (Autism, Mental Retardation), or children who have suffered a brain injury affecting their development • Also more common among children between age 2 and 3 • As many as 15% of adults with severe Mental Retardation also have PICA • Information on overall prevalence rates is limited

  5. What is pica? Specific causes are unknown, but certain situations increase risk: • Nutritional deficiencies • Extreme dieting • Malnutrition • Cultural factors – certain religious rituals, folk medicine, or magical beliefs • Neglect/food depravation • Mental health conditions

  6. Commonly ingested non-food items • Burnt match heads • Cigarette butts • Feces • Ice • Glue • Hair • Buttons • Paper • Sand • Toothpaste • Soap • Dirt • Clay • Paint chips • Plaster • Chalk • Cornstarch • Laundry starch • Baking soda • Coffee grounds • Cigarette ashes

  7. Common non-food items ingested • Older children • Animal droppings • Sand • Insects • Leaves • pebbles • Younger children: • Paint • Plaster • String • Hair • cloth

  8. Commonly ingested non-food items Because of the potential serious health effects of ingesting these items, be aware if any are in your environment!!

  9. Effects:health problemsmedical emergencies

  10. Effects of pica The potential for illness and even death is great because of toxicity of some of these items, or risk of intestinal blockage, poisoning, or parasitic infections. Malnutrition is also a potential risk.

  11. Effects of pica Two very common conditions associated with PICA are lead poisoning (often a result of eating earth substances that contain lead) and iron deficiency anemia which may actually be an underlying trigger to PICA.

  12. Effects of pica • Constipation, diarrhea, or intestinal blockage or perforation can all result from items ingested • Parasites or other infections can occur • Tooth or mouth injuries can occur

  13. Medical emergencies • If a non food item ingested was toxic, you should follow your emergency medical procedures • Even small amounts of toxic substances can cause death in young children (nicotine in tobacco products, soaps, laundry items)

  14. diagnosis:warning signseducation

  15. Warning signs • Eating of nonfood items for a period of at least 1 month or longer (in spite of efforts to restrict) • Behavior inappropriate for child’s age or developmental stage • Behavior is not part of cultural, ethnic, or religious practice

  16. diagnosis • No single theory explains what causes PICA • Each case must be individually evaluated by a Doctor • Thorough physical exam in needed • Thorough medical, psychological, and developmental histories must be gathered

  17. diagnosis • Food-related behaviors evaluated • Dietary assessment • Environmental factors (presence of the non-food items) • Developmental assessment

  18. treatmentrestrictionsbehavioralmedical evaluation

  19. treatment • Provide alternative ways for oral stimulation (they like the taste/texture) • Education on acceptable and unacceptable food items • Replace non-food items with healthy nutritious food items • Restriction of non food items to prevent access/remove items from home (safety locks, high shelving, keep chemicals out of reach)

  20. treatment • Medical evaluation for nutritional deficiencies • Lead screening • Parasitic screening • Imaging for bowel problems/obstructions • Behavioral intervention if needed

  21. Sources • Nemours Foundation, www.kidshealth.org • Feeding and Eating Disorders of Infancy or Early Childhood: Pica, http://www.pvmhmr.org/37-childhood-mental-disorders-and-illnesses/article/572-feeding-and-eating-disorders-of-infancy-or-early-childhood-picaAndrea Barkoukis, M.A., Natalie Staats Reiss, Ph.D., and Mark Dombeck, Ph.D.

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