Pica (eating non-food items)

What it is

Pica is the persistent eating of substances with no nutritional value (earth or clay, chalk, soap, paper, charcoal, large amounts of ice) continuing for at least a month and inappropriate to the person's developmental stage. Toddlers mouthing objects is normal; a school-age child, adolescent or adult regularly eating soil is pica.

In our region this deserves an honest, respectful note: geophagy, the eating of particular clays and soils (including the soft stones sold in markets, often by pregnant women), is a long-standing practice in many communities. A cultural practice is not automatically a disorder. It becomes a clinical concern when it is compulsive, harmful or signals something underneath, and very often what is underneath is iron deficiency or other anaemia: the craving frequently fades when the deficiency is treated. Soil-eating also carries real risks of parasites, lead and other contaminants, especially in pregnancy and childhood.

How common is it

Pica is most common in young children, in people with intellectual disability or autism, and in pregnancy, where cravings for soil or clay are reported across many parts of the world, including widely in our region. It often goes unmentioned, so it is under-recognised. In children it usually fades with age.

What helps

First, a medical check: iron studies and anaemia screening, treatment of any deficiency, and screening for parasites or lead where exposure is likely. In pregnancy, this conversation belongs in antenatal care, without shame. For young children and people with developmental disabilities, where pica is most persistent, behavioural strategies (supervision, safe alternatives, reinforcing non-pica behaviour) are the mainstay. Punishment does not help; replacing and redirecting does.

Pica in the African context

Geophagy, the eating of particular clays or soft stones, sold in many markets and especially common in pregnancy, is a long-standing cultural practice in parts of the region, and a cultural practice is not in itself a disorder. The respectful approach separates culture from harm: the practice becomes a health matter when it is compulsive, when it risks parasites, lead, or other contaminants, or when it signals an underlying iron or other deficiency, which is common and treatable. In pregnancy, this belongs in a non-judgemental conversation within antenatal care.

Helping someone

If a person you care for eats non-food substances, a supportive approach helps.

• Avoid shaming or punishment, which does not work, and approach it with respect, especially around cultural practices.
• Encourage a medical check for anaemia and deficiencies, since treating these often reduces the craving.
• In pregnancy, raise it gently within antenatal care, where it is understood and common.
• For children and people with developmental disabilities, supervise, offer safe alternatives, and reward non-pica behaviour.
• Seek help where substances risk contamination or harm. Our Get Support page can help.