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Pica

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pica eating disorder clinical overview causes treatment Merck Manual

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Pica is a feeding and eating disorder in which a person repeatedly eats nonfood, nonnutritive substances for at least a month, such as soil, clay, chalk, paper, paint chips, hair, ice, or starch.
It is diagnosed only when the behavior is not developmentally normal, culturally accepted, or part of a practice such as infancy mouthing objects. DSM-based diagnosis generally uses a minimum age of 2 years. Kaplan and Sadock's Synopsis of Psychiatry, pp. 530-531.
Associated factors
  • Iron deficiency, and sometimes zinc deficiency
  • Pregnancy
  • Autism spectrum disorder or intellectual disability
  • Psychosocial stressors or neglect in some children
Risks
  • Lead poisoning, especially from paint chips
  • Intestinal blockage, particularly from hair, stones, or other indigestible objects
  • Infection or parasites after eating soil or feces
  • Dental injury and nutritional deficiencies
Assessment and treatment A clinician should identify exactly what is being eaten and check for iron deficiency, nutritional problems, lead exposure, and complications. Management includes treating any deficiency or complication, making the environment safer, and behavioral interventions. Merck’s clinical overview notes that behavioral modification can help, although evidence for one specific treatment is limited.
Seek urgent medical care for severe abdominal pain, persistent vomiting, inability to pass stool or gas, suspected ingestion of paint/metal/sharp objects, or possible poisoning.

Neonatal care

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“Neonatal care” covers routine care of healthy newborns and intensive management of ill or preterm infants.
  1. Immediate care at birth and neonatal resuscitation
  2. Routine newborn examination, warmth, feeding, cord and skin care
  3. Screening, immunization, and prevention of infection
  4. Common neonatal problems: jaundice, hypoglycemia, sepsis, respiratory distress
  5. Care of preterm or low-birth-weight babies
  6. NICU care and parental counseling
At its core, neonatal care aims to support breathing and temperature control, establish safe feeding, identify congenital or metabolic problems early, prevent infection, and promptly recognize illness. The needed level of care ranges from routine postnatal care to specialist NICU management.
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Pica is a feeding and eating disorder in which a person repeatedly eats nonfood, nonnutritive substances for at least a month, such as soil, clay, chalk, paper, paint chips, hair, ice, or starch.
It is diagnosed only when the behavior is not developmentally normal, culturally accepted, or part of a practice such as infancy mouthing objects. DSM-based diagnosis generally uses a minimum age of 2 years. Kaplan and Sadock's Synopsis of Psychiatry, pp. 530-531.
Associated factors
  • Iron deficiency, and sometimes zinc deficiency
  • Pregnancy
  • Autism spectrum disorder or intellectual disability
  • Psychosocial stressors or neglect in some children
Risks
  • Lead poisoning, especially from paint chips
  • Intestinal blockage, particularly from hair, stones, or other indigestible objects
  • Infection or parasites after eating soil or feces
  • Dental injury and nutritional deficiencies
Assessment and treatment A clinician should identify exactly what is being eaten and check for iron deficiency, nutritional problems, lead exposure, and complications. Management includes treating any deficiency or complication, making the environment safer, and behavioral interventions. Merck’s clinical overview notes that behavioral modification can help, although evidence for one specific treatment is limited.
Seek urgent medical care for severe abdominal pain, persistent vomiting, inability to pass stool or gas, suspected ingestion of paint/metal/sharp objects, or possible poisoning.“Neonatal care” covers routine care of healthy newborns and intensive management of ill or preterm infants.
  1. Immediate care at birth and neonatal resuscitation
  2. Routine newborn examination, warmth, feeding, cord and skin care
  3. Screening, immunization, and prevention of infection
  4. Common neonatal problems: jaundice, hypoglycemia, sepsis, respiratory distress
  5. Care of preterm or low-birth-weight babies
  6. NICU care and parental counseling
At its core, neonatal care aims to support breathing and temperature control, establish safe feeding, identify congenital or metabolic problems early, prevent infection, and promptly recognize illness. The needed level of care ranges from routine postnatal care to specialist NICU management.

Immunisation in pediatrics

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Immunisation in pediatrics includes:
  1. Principles of vaccination and herd protection
  2. Vaccine types: live attenuated, inactivated, toxoid, subunit/conjugate, and newer platforms
  3. Routine childhood schedule
  4. Routes, storage, cold chain, and safe administration
  5. Adverse events following immunisation and their management
  6. Contraindications, precautions, and vaccination in special situations
  7. Catch-up vaccination and missed doses
  8. Communication with caregivers and vaccine hesitancy
Pediatric immunisation protects individual children from severe infectious disease and reduces transmission in the community. Exact schedules, vaccine brands, and eligibility differ by country and change over time, so those details should be based on the local national programme.
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What would you like next? · Which country’s immunisation schedule should I use?

Pica is a feeding and eating disorder in which a person repeatedly eats nonfood, nonnutritive substances for at least a month, such as soil, clay, chalk, paper, paint chips, hair, ice, or starch.
It is diagnosed only when the behavior is not developmentally normal, culturally accepted, or part of a practice such as infancy mouthing objects. DSM-based diagnosis generally uses a minimum age of 2 years. Kaplan and Sadock's Synopsis of Psychiatry, pp. 530-531.
Associated factors
  • Iron deficiency, and sometimes zinc deficiency
  • Pregnancy
  • Autism spectrum disorder or intellectual disability
  • Psychosocial stressors or neglect in some children
Risks
  • Lead poisoning, especially from paint chips
  • Intestinal blockage, particularly from hair, stones, or other indigestible objects
  • Infection or parasites after eating soil or feces
  • Dental injury and nutritional deficiencies
Assessment and treatment A clinician should identify exactly what is being eaten and check for iron deficiency, nutritional problems, lead exposure, and complications. Management includes treating any deficiency or complication, making the environment safer, and behavioral interventions. Merck’s clinical overview notes that behavioral modification can help, although evidence for one specific treatment is limited.
Seek urgent medical care for severe abdominal pain, persistent vomiting, inability to pass stool or gas, suspected ingestion of paint/metal/sharp objects, or possible poisoning.“Neonatal care” covers routine care of healthy newborns and intensive management of ill or preterm infants.
  1. Immediate care at birth and neonatal resuscitation
  2. Routine newborn examination, warmth, feeding, cord and skin care
  3. Screening, immunization, and prevention of infection
  4. Common neonatal problems: jaundice, hypoglycemia, sepsis, respiratory distress
  5. Care of preterm or low-birth-weight babies
  6. NICU care and parental counseling
At its core, neonatal care aims to support breathing and temperature control, establish safe feeding, identify congenital or metabolic problems early, prevent infection, and promptly recognize illness. The needed level of care ranges from routine postnatal care to specialist NICU management.Immunisation in pediatrics includes:
  1. Principles of vaccination and herd protection
  2. Vaccine types: live attenuated, inactivated, toxoid, subunit/conjugate, and newer platforms
  3. Routine childhood schedule
  4. Routes, storage, cold chain, and safe administration
  5. Adverse events following immunisation and their management
  6. Contraindications, precautions, and vaccination in special situations
  7. Catch-up vaccination and missed doses
  8. Communication with caregivers and vaccine hesitancy
Pediatric immunisation protects individual children from severe infectious disease and reduces transmission in the community. Exact schedules, vaccine brands, and eligibility differ by country and change over time, so those details should be based on the local national programme.Which would you like for pediatric immunisation?
  • Exam-style short notes
  • Routine immunisation schedule
  • Types of vaccines
  • Contraindications and AEFI
  • Catch-up vaccination
For a schedule, please specify the country, for example India, US, UK, or WHO guidance.
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