How Pica Is Treated

Pica is the persistent ingestion of non-nutritive substances such as paint chips, dirt, paper, or hair for more than one month, which often occurs in childhood and during pregnancy.

Treatment for pica will address several areas. Your doctor will look for illness or injury from eating nonfood items and address the underlying cause of a pica diagnosis.

There are currently few evidence-based treatments for pica, and research into this area is limited. Historically, interventions have focused on a variety of methods to reduce or eliminate pica.

Prescription Medications

The first-line treatment for pica involves testing for mineral or nutrient deficiencies and correcting those.

Pica is commonly seen in individuals with iron deficiency. In many cases, concerning eating behaviors disappear as deficiencies are corrected.

Medications may also be used to treat the effects of eating nonfood items. Some medications a doctor may prescribe include:

• Nutritional supplements for vitamin and mineral deficiencies
• Medications for constipation or diarrhea caused by ingestion of nonfood items
• Antibiotic or antiparasitic treatment for infections caused by eating contaminated soil or feces

If pica occurs in an individual with a developmental disability, treatment for this condition may help with the symptoms of pica. The use of selective serotonin reuptake inhibitors (SSRIs) has been reported to be helpful in some cases. A further case report describes the resolution of pica following the use of methylphenidate to treat people who also had attention deficit hyperactivity disorder.

If the behaviors aren’t caused by malnutrition or don’t stop after nutritional treatment, a variety of behavioral interventions are available. 

Behavioral Therapy

A complete behavioral assessment of the cause of pica may be critical to its successful treatment. Behavioral researchers have demonstrated that interventions based on a comprehensive assessment are more likely to produce a clinically significant reduction in pica, particularly in individuals with an autism spectrum disorder. Primary care physicians should refer a child with autism and pica to either a board-certified behavior analyst or a psychologist with training in behavior analysis.

A variety of behavioral interventions to help a child with pica include:

• Positive reinforcement if pica is not attempted, such as giving rewards for selecting food items instead of nonfood items
• Training your child to differentiate between edible and inedible substances
• Aversive presentation if pica is attempted—for example, giving a child something with a bitter taste, such as lemon juice
• Time-out if pica is attempted

Although studies in the existing literature are limited to small sample sizes, it is commonly believed that these methods can be highly effective treatments for pica.

Your child may also receive applied behavior analysis (ABA) if pica is part of an autism spectrum diagnosis. It is one of the oldest and most fully researched treatments specifically developed for autism.

ABA is a very intensive system of reward-based training. It is based on behaviorist theories that, simply put, state that desired behaviors can be taught through a system of rewards and consequences.

Lifestyle

Parents and patients should educate themselves about the condition, as there are many strategies that can be put into place to help empower parents to better manage the situation.

Coping with a child who has pica can be challenging, but learning about the specific underlying factors pertaining to your child’s individual situation may be an effective way to help alleviate stress. There are some proven strategies that can help you take control of the situation.

Some examples include:

• Ensure your child has a balanced diet: Iron-deficiency anemia and malnutrition are two of the most common causes of pica, followed by pregnancy. In these individuals, pica is a sign that the body is trying to correct a nutrient deficiency. Encouraging a balanced, healthy diet can help ease pica symptoms.
• Pica-proof your home: Consider your home environment and other places where your child spends time. Put items they commonly eat out of sight or lock them away. Vacuum and sweep frequently. 
• Provide frequent snacks at regular intervals: This may help because more frequent snacks can provide options to the child other than eating nonfood items.
• Enrich your child’s environment in other ways: This is particularly important if your child’s pica is related to sensory stimulation, but it can help anyone with pica. Provide access to a variety of activities that your child enjoys and that don’t include their pica attractions.

A Word From Verywell

The success rate for the treatment of pica varies, depending on the underlying causes/related factors. In kids, pica usually improves as they grow up. But for those with a mental illness or developmental disorder, it commonly continues into the teenage years or even into adulthood.

A thorough medical evaluation can result in the effective treatment of underlying problems (such as nutritional deficiencies), which may end up resolving pica.  

Some children have pica that cannot be helped by the treatments described above. Sometimes this is because the child has a challenging underlying neurodevelopmental or psychiatric disorder. You likely need a professional who has high-level skills in working with children with pica as well as other behavioral problems.