PICA IN CHILDREN
- It’s not uncommon for infants and toddlers to explore their world with their mouth. Babies will often find things to chew on when growing new teeth.
- Pica is a disorder that goes beyond normal and healthy developmental behaviors. It is characterized by the craving to eat or mouth non-nutritive substances for at least one month, beginning when children are around 18- 24 months.
- It is common for children with mental difficulties to display pica behavior. Children can have pica with almost anything, including dirt, hair,paper,paint , chalk and wood .
- If pica is suspected, a medical evaluation is important to assess for possible anemia, intestinal blockages, or potential toxicity from ingested substances.
- If symptoms are present, the doctor will begin an evaluation by performing a complete medical history and physical exam.
- The doctor may use certain tests — such as X-rays and blood tests — to check for anemia and look for toxins and other substances in the blood, and to check for blockages in the intestinal tract. The doctor also may test for possible infections caused by eating items contaminated with bacteria or other organisms. A review of the person’s eating habits also may be conducted.
- Before making a diagnosis of pica, the doctor will evaluate the presence of other disorders — such as mental retardation, developmental disabilities, or obsessive-compulsive disorder — as the cause of the odd eating behavior. This pattern of behavior must last at least one month for a diagnosis of pica to be made.
How Is Pica Treated?
- Given the risk of medical complications (such as lead poisoning) associated with pica, close medical monitoring is necessary throughout treatment of the eating behavior.
- Additionally, close collaboration with a mental health team skilled in treating pica is ideal for optimal treatment of these complex cases. General behavioral strategies as the most effective treatment approach for pica, with training in which foods are edible and which foods cannot be eaten through the use of positive reinforcement.
What Complications Are Associated With Pica?
There are many potential complications of pica, such as:
- Certain items, such as paint chips, may contain lead or other toxic substances and eating them can lead to poisoning, increasing the child’s risk of complications including learning disabilities and brain damage. This is the most concerning and potentially lethal side effect of pica
- Eating non-food objects can interfere with eating healthy food, which can lead to nutritional deficiencies.
- Eating objects that cannot be digested, such as stones, can cause constipation or blockages in the digestive tract, including the intestines and bowels. Also, hard or sharp objects (such as paperclips or metal scraps) can cause tears in the lining of the esophagus or intestines.
- Bacteria or parasites from dirt or other objects can cause serious infections. Some infections can damage the kidneys or liver.
- Co-existing developmental disabilities can make treatment difficult.
WHY ALL CHILDREN NEED VITAMIN D SUPPLEMENTATION?
- Children need vitamin D for bone growth and development. So do babies developing in the womb. This is because vitamin D helps us absorb calcium and build strong teeth and bones .
- Serious vitamin D deficiency can cause rickets, delayed motor development,it can also keep a child from achieving his/her genetically programmed height and peak bone mass, muscle weakness, aches and pains, and fractures.
- Vitamin D also functions as a hormone with many other jobs in the body, including regulation of the immune system, insulin production, and cell growth.
How much vitamin D does my child need?
Infants up to 12 months old need 400 international units (IU), or 10 micrograms (mcg), a day. Children older than 1 need 600 IU, or 15 mcg, a day.
Your child doesn’t have to get enough vitamin D every day. Instead, aim to get the recommended amount as an average over the course of a few days or a week.
The best sources of vitamin D
- Vitamin D is called the “sunshine vitamin” because the body can produce it when the skin is exposed to sunlight. But your child’s body isn’t able to make vitamin D when covered with clothing or sunscreen to block the sun’s rays.
- Other obstacles to vitamin D production from sun exposure include smog ,clouds , dark skin and geographic location.
- Though it’s hard to estimate how much time a person needs to spend in the sun to make the recommended amount of vitamin D, some researchers say spending 5 to 30 minutes outside between 10 a.m. and 3 p.m. at least twice a week should do it.
- But experts warn that UV radiation from the sun is the main cause of skin cancer, and it’s hard to judge whether you can get enough vitamin D from the sun without increasing your risk of a potentially deadly skin cancer.
- So consider finding other ways to get the vitamin D you need. Though it’s hard to estimate how much time a person needs to spend in the sun to make the recommended amount of vitamin D, some researchers say spending 5 to 30 minutes outside between 10 a.m. and 3 p.m. at least twice a week should do it.
- The amount of vitamin D in a food varies somewhat, depending on the brand of the product.
- Kids may eat more or less than the amounts shown, given their age and appetite. Estimate the nutrient content accordingly.
- Other good dietary sources include fatty fish and egg yolks. Most children in industrialized countries receive vitamin D via fortified foods, especially formula and milk (both of which contain 400 IU/L) and some breakfast cereals and breads.Supplemental vitamin D may be vitamin D2 (which comes from plants or yeast) or vitamin D3.
- Breast milk has a low vitamin D content, approximately 12-60 IU/L.
- Most cases of nutritional rickets can be prevented by universal administration of 400 IU of vitamin D to infants who are breastfed. Older children should receive 600 IU/day. Vitamin D may be administered as a component of a multivitamin or as a vitamin D.