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Young children often put non-food items in their mouths, such as grass or toys, because they’re curious about the world around them. However, children with Pica take this a step further and actually eat them.

What is Pica?

Pica is an eating disorder characterised by the compulsive eating of non-food items. A person with Pica may eat relatively harmless substances, such as ice, but many crave potentially dangerous ones, including hair, dirt or faeces. This can lead to serious complications and occasionally death. The name is derived from the word ‘pica’, meaning magpie, based on the idea that magpies will eat almost anything.

Pica is diagnosed when:

  • A patient persistently eats non-food items for greater than a month
  • This consumption is developmentally and culturally inappropriate.

If the behaviour occurs in a patient with another disorder, such as autism, it must be persistent enough to warrant a separate diagnosis.

Who develops Pica?

Anyone can develop Pica, however it is most common in young children, pregnant women and people with developmental disabilities. It is unclear how many people are affected, but it is believed to be more prevalent in developing countries due to higher levels of malnutrition and food insecurity.

Pica can also be found in other animals, such as dogs or cats.

Causes

There is no clear cause of Pica, but doctors have found that it is more common in individuals who experience:

  • Malnutrition
  • Iron deficiency
  • Autism
  • Intellectual disabilities
  • OCD
  • Schizophrenia
  • Trichotillomania
  • Excoriation disorder (also known as dermatillomania)
  • Emotional trauma
  • Parental neglect
  • Maternal deprivation
  • Family issues
  • Pregnancy

Pica and pregnancy

Pica in pregnant women is thought to be caused by iron deficiency anaemia. It’s not uncommon for pregnant women to crave strange combinations of food, however, to be diagnosed with Pica the woman must be craving and ingesting non-food items such as soil, ice, or laundry detergent.

Worldwide, Pica is thought to occur in 25% of pregnant women. The reasons for this are often attributed to the geographic region and the associated risk of malnutrition and anaemia.

Pica in children

Young children often put non-food items in their mouths, such as grass or toys, because they’re curious about the world around them. However, children with Pica take this a step further, and actually consume them.

Small children make up 25 to 33 percent of all Pica cases. The minimum age for diagnosis is two years, as children under two often eat non-food items due to lack of understanding.

Pica in adults

In adults, Pica is usually a symptom of an underlying medical condition, such as iron deficiency anaemia. If not, it is often caused by psychiatric conditions or developmental disabilities.

It is difficult to determine the prevalence of Pica in adults, as many may not want to admit to craving and eating non-food items. In institutionalised adults, the prevalence is 21 to 26 percent.

In order for an adult to be diagnosed with Pica, the eating behaviour must be culturally inappropriate. In certain cultures, a non-food item may be considered appropriate for consumption. For example, eating dirt and clay is considered a custom in some parts of rural Mississippi.

Pica in animals

Many animals, such as cats and dogs, chew on non-food objects, but a much smaller percentage actually consume them. Pica behaviours are often caused by behavioural problems, such as anxiety, boredom, or compulsive behaviour. It is also seen in dogs who are teething.

Dangers

Eating non-food, non-digestible and potentially toxic materials can have numerous consequences, including:

  • Malnutrition
  • Gastrointestinal issues
  • Dental issues
  • Choking
  • Intestinal obstruction
  • Intestinal parasites
  • Internal bleeding
  • Damage to internal organs
  • Lead poisoning
  • Brain damage

Treatment

Treatments for Pica vary depending on the underlying cause. For example, if symptoms are due to iron deficiency, supplements and dietary changes may alleviate symptoms without other treatment methods.

Behavioural modification techniques are often used, assisting sufferers to unlearn Pica behaviours. These techniques include:

  • Aversion therapy, where the individual faces a negative consequence for eating non-food items. For example, a child may have his or her toys confiscated, and a dog may be sprayed with water.
  • Positive reinforcement, where the individual is rewarded for eating nutritious food, or for not engaging in Pica behaviours.
  • Overcorrection, where Pica behaviours result in the individual, usually a child, being required to dispose of non-edible objects, wash themselves, and participate in chore-based punishment when they engage in Pica behaviours.

Treatment may also include dealing with complications, such as surgery for intestinal obstruction.

Does Pica go away?

In young children and pregnant women, Pica often resolves on its own within a few months, or after childbirth. Similarly, if Pica behaviours are due to a nutritional deficiency, treatment and supplements should alleviate symptoms.

However, Pica doesn’t always go away. In those with mental illness or developmental disabilities, Pica may continue into adulthood. In these cases, ongoing treatment and support may be required, including counselling and behavioural modification techniques.

This Christmas marks the fourth anniversary since 7 year old Jarvis was diagnosed with cancer. Make a Wish foundation has been valuable in offering joy, hope and the chance to feel like a regular kid, for many children like Jarvis.

#WorstChristmasEver

It was only a couple of days before Christmas 2014 when Jarvis’ parents took him to the doctor for blood tests. He’d been feeling out of sorts, lethargic and falling asleep all the time, and they’d noticed bruises on his legs that weren’t healing.

Just two hours later, their GP rang and told them to go straight to the hospital where the team from Ward 3B were waiting. While their instincts told them something was wrong, the truth came crashing down as they arrived and saw the sign – Ward 3B was the children’s cancer ward.

At just four years old, Jarvis was diagnosed with Acute Lymphoblastic Leukaemia, a type of cancer that affects the blood and bone marrow.

The diagnosis came on Christmas Eve, and Jarvis started chemotherapy the same day.

For the whole family – Jo, Ben, Jarvis and his two little brothers – it quickly became the most desperate Christmas ever.

Every parent’s worst nightmare

Jo and Ben did their best to stay strong for their three boys – with their youngest just 16 weeks old at the time. However, Ben remembers feeling completely overwhelmed: “I was just walking through the ward, pushing the pram with the other kids, and it was all just a bit of a blur.”

In the months that followed, Jarvis began an intense course of medical treatment including daily chemotherapy and high dose steroids. However, the life-saving regime took a huge toll on his health, leaving him listless and often withdrawn. He gained around 40 percent of his body weight due to the steroids and was almost unrecognisable. His muscles also weakened to the point that his parents had to carry Jarvis between his bed at home and the hospital.

As Jo remembers, Jarvis hated going in for treatment. “He’d be crying and saying ‘please, don’t take me….’ He was old enough to know what was coming.”

Over the next three and a half years of treatment, Jarvis missed out on many of the things other kids might take for granted – from school and swimming lessons to birthday parties and playgrounds.

During this incredibly tough time, Jo and Ben felt they had to ‘bubble wrap’ their son.

His incredible wish

Through cancer support groups, Jo and Ben heard about Make-A-Wish® Australia and applied for a wish mid-2017. As a keen reader, Jarvis wished for a very special treehouse, much like the one in his favourite book, The 13-Story Treehouse.

As the #WishForce team quickly discovered, Jarvis’ treehouse had to be somewhere a young boy could escape his day-to-day cares, enjoy some quiet time, and let his imagination roam free. Of course, it also needed a veranda, a rock-climbing wall and its very own flying fox!

Construction began earlier this year, with Jarvis watching on excitedly as his vision came to life.

Today, visitors to the family’s home will find a two-storey treehouse taking pride of place in the backyard – with a good-natured seven-year-old playing with his brothers and friends inside.

Jarvis is now doing his best to put the years of cancer treatment behind him – and while it will be five more years of regular blood tests before he’s completely in the clear – thankfully, his chances of a full recovery are strong.

For Jo and Ben, the impact of their son’s wish journey is clear – it has allowed him to become ‘a regular kid’ again.

“Experiences like this give everyone hope and give kids who’ve missed out and faced a lot of adversity a bit of happiness. That’s very special – and so important,” says Ben.
Bake-A-Wish for kids like Jarvis

Each year, thousands of Australian children are diagnosed with a life-threatening illness. For their families and the kids themselves, life is put on hold while they learn to cope with and in the best cases, beat their illness.

Which is why a wish is so important – with the power to calm, distract and inspire sick kids at the time they need it most.

You can help bring more incredible wishes to life in 2019 by joining Make-A-Wish Australia’s largest ongoing fundraising campaign, ‘Bake A Wish’.

It’s a piece of cake, and whether you choose to arrange a dinner party with family and friends or an afternoon tea – every dollar raised means more unique and life-changing wishes coming true for sick kids like Jarvis.

Visit www.bakeawish.org.au or call 1800 032 260 to find out more, pledge your support and access your free fundraising toolkit.

 

Only 50 per cent of Australians eat the right amount of fruit and vegetables. Here are some tried and true tips, tricks and strategies to include more fruits and vegetables in your family diet.   

We all know that fruits and vegetables are good for us, and there is very good research confirming this. Not only do fruit and vegetables have protective effects for reducing our chance of getting cancer and heart disease, but anyone who eats the recommended amounts of two fruits and five vegetables are more likely to be a healthy weight.  

Adults are recommended to eat two serves of fruit and five serves of vegetables, legumes or beans. The recommendations for children can be seen in the table. 

      Serves per day* 
    13-23 months  2-3 years  4-8 years  9-11 years  12-13 years  14-18 years 
Vegetables and legumes/beans  Boy  2-3  2 ½   4 ½   5  5 ½   5 ½  
Girl  2-3  2 ½   4 ½   5  5  5 
               
Fruit  Boy  ½   1  1 ½   2  2  2 
Girl  ½   1  1 ½   2  2  2 

 

*Additional amounts may be needed by children who are taller or more active 

What is a serve? 

A standard serve of vegetables is about 75g or: 

  • ½ cup cooked vegetables 
  • ½ cup cooked or canned beans, peas or lentils 
  • 1 cup salad vegetables 
  • ½ medium potato (no chips!) 
  • 1 medium tomato 

 

A standard serve of fruit is about 150g or: 

  • 1 medium apple, banana, orange or pear 
  • 2 small apricots, kiwi fruit or plums 
  • 1 cup canned fruit (no added sugar) 

 

Tip 1: Chat about Fruits and Vegetables 

Do you know what your children’s favourite fruit and vegetable is? I found it a fun exercise to ask my children. My seven year old daughter said mango and broccoli, and my three year old son said banana and carrot. This question led into a chat about fruits and vegetables and why they are so important in our diet. It is important to keep any conversation about food fun, light hearted and age appropriate.  

 I like to tell my children that fruits and vegetables are ‘super’ foods because of their different colours. For example, strawberries have folate in them which is important for our blood cells to grow. Mandarins and oranges have Vitamin C to help us stay well and heal cuts and bruises. Broccoli and baby spinach contain Vitamin A which is important to help us see at night and grow strong teeth. An easy way to find out more about fruits and vegetables is to Google them! 

 

Berry Smoothie
Serve 2
1 cup milk
½ cup baby spinach
½ cup frozen berries
2 tsp vanilla essence
½ cup ice

Place all ingredients in a blender and blend until smooth. Can add some honey to taste if desired. The spinach is hidden by the delicious berries!

Tip 2: Are they really hungry? 

If only I had a dollar for every time I heard one of my children say ‘I’m hungry’! My three year old will say this often after finishing his breakfast of three Weetbix, some oats and sultanas. So I am pretty confident that he isn’t hungry and I use this opportunity to ask him if his tummy is making hungry sounds or if he would like to play with his trains/get out his crayons or read a book. Usually it is just boredom and once I have set him up in an activity he is happy. 

Children have little tummies and can easily fill up on milk or juice (which I say doesn’t count as a serve of fruit because most juices don’t contain fibre). It can be useful to keep a food diary for a few days of what your child is eating as this can provide some clues on areas to improve. 

Tip 3: Encouragement and Praise

Children need to be offered, and encouraged, to eat foods. Vegetables are the most often rejected food – but each vegetable needs to be offered at least eight times before becoming a trusted and accepted food. I know just how frustrating it can be to see a child eat only one pea and refuse any more but the key is repetition, encouragement and praise.  

The jury is still out on rewards. The long standing ‘eat all your vegetables and you can have some ice cream’ can do more harm than good. If this is something that you are saying most nights then it probably isn’t working. The time when rewards of this nature can work is to encourage a child to try a food. If your child is refusing to even try different fruits or vegetables, a promise of a reward can work to encourage tasting, but after this it loses its value and may even cause a child to dislike a food even more. Beware of this backfiring! Noticing when they have made an effort and commenting on this goes a long way to improving eating habits. 

Tips from other Mums!

– Be creative and use cutters to cut fruit and vegetables into shapes

– Hide the vegetables!

– Eat together as a family

– Get the children to help prepare and cook the meal. From about the age of two children can start to use peelers to peel carrots/potatoes/sweet potatoes

– Grow some vegetables in your backyard

– Make fresh fruit ice lollies – puree some watermelon and add some sliced bananas, kiwi fruit and strawberries and put in ice moulds

– Frozen peas and corn make great snacks over the warmer months

– Vegetable pizzas with different vegetable pictures, such as a garden – broccoli for trees, carrot and peas for flowers

– Lots of different vegetables in small amounts often work better than just a couple of vegetables in big quantities

Tip 4: Plan to eat fruit and vegetables 

As parents we are in the powerful position of influencing what our children eat – but of course we aren’t the only influence – and our level of influence decreases as the children get older. So start early is my advice! If children see their parents eating and enjoying plenty of fruit and vegetables, then children are more likely to do the same. Children are more likely to adopt healthy eating behaviours when they have more than one person to imitate – so recruit as many family members as possible! 

 Children are often wary of foods, particularly foods that they haven’t enjoyed previously. Dinner time can be a particularly difficult time of day to encourage children to eat as they are often tired after a long day. If this is the case try lunch time and snacks to offer new fruits and vegetables when they are likely to be more receptive. Whole pieces of fruit such as bananas, apples and pears, or offering tomato and avocado on crackers or some vegetables sticks with peanut butter or a dip, are some easy, healthy snack options. 

Tip 5: Shop together 

I know that shopping with children is often one of the least favourite things to do. It is frustrating how things can take longer, packets can jump off shelves courtesy of little hands, and tantrums can occur. Consider visiting a fruit and vegetable market or your local farmers market with your child or children as an outing and opportunity for them to choose a fruit or vegetable that is in season that they would like to try. The rule is that whatever your child chooses you must buy and prepare, and you as the parent must try the food too. 

Empowering your child to make decisions about fruits and vegetables means they are more likely to try the food because they have been involved in the process.  

Finally, consistency plays a big role in getting children to eat their fruit and vegetables. There are always going to be those days where it comes down to a boiled egg and toast for dinner – but it is all about what happens most of the time.