Possible causes

• Iron deficiency or anemia - a common association, especially with eating soil, clay, ice, starch, or paper.
• Less commonly, zinc or other nutritional deficiencies.
• Developmental or sensory factors, including autism spectrum disorder or developmental delay.
• Environmental/behavioral factors: curiosity, inadequate supervision, stress, neglect, or learned behavior.
• Lead exposure can occur because of pica, especially if the child eats paint chips, house dust, or soil from older homes. It is a complication and may also worsen developmental problems.

What to do

1. Arrange a pediatric visit soon, particularly if she actually swallows non-food material repeatedly.
2. The clinician may assess growth and development and order:
   • CBC and ferritin/iron studies
   • Blood lead level if there is any risk from paint, dust, soil, pottery, toys, or an older house
   • Sometimes zinc level, stool testing, or imaging, depending on what was eaten and symptoms
3. Treat the cause, not pica with a single medicine:
   • Give iron or another supplement only if prescribed after assessment/testing.
   • Correct dietary deficiencies with age-appropriate meals and iron-rich foods, such as meat, lentils/beans, egg, fortified cereals, and green vegetables, paired with vitamin-C-containing fruit.
4. Prevent access and supervise closely:
   • Keep paint flakes, batteries, coins, magnets, soil, pet litter/feces, cleaning products, medications, and small objects inaccessible.
   • Offer safe teething toys and redirect calmly whenever she tries to eat a non-food item.
   • Do not punish or shame her.
   • Persistent cases may benefit from behavioral guidance, particularly if developmental concerns are present.