Medicine: Hand to Mouth

When a baby is at the stage of putting everything that comes to hand into his mouth, and often trying to swallow it, most parents figure that he will soon grow out of it. What far too few parents realize, according to the findings of a Washington research team, is how often this stage of development, natural up to the age of about 18 months, turns into a prolonged and unnatural craving for substances other than food. Nor do the parents of such children realize their own responsibility for the condition.

Doctors call the disorder pica (rhymes with Micah), from the Latin for magpie. But whereas the magpie merely collects assorted, useless objects, the pica victim eats them. Favorite items are newspapers, toilet and handkerchief tissues, clay and sand, wood, cigarettes and butts, used matches, laundry starch, crayons, grass and leaves, soap, aluminum foil—and even bugs. One girl of 14 ate several pages of newspaper every day, and found the classified ads especially tasty.

Crippled for Life. Pica presents doctors with two totally different problems—one involving physical poisoning, the other involving emotional relations. At Children’s Hospital in the District of Columbia, researchers headed by Dr. Reginald S. Lourie began to concentrate on pica when they found that it was only half the battle to get the lead out of children who had poisoned themselves by chewing old, lead-based paints—usually from window sills. The lead alone is enough to cause permanent brain damage, and leave the victims mentally crippled for life.

Pica, the investigators found, occurs in more than half the children aged four to six in the most deprived, lowest-income bracket. More surprisingly, it occurs in almost one-third of children in middle-and upper-income homes. It does not result from lack of food, or of any particular kind of food. It is, says Psychiatrist Lourie, a signal from the child that there is something wrong with his mothering; either he is not getting enough of it or is getting the wrong kind.

Checked for Pica. Working mothers and those busy with community causes or a new baby may give a child too little attention, so that he seeks gratification by the readiest means available. Maladjusted mothers unconsciously encourage pica by handing a child a bottle, or other food, whenever he demands attention. Many of these are mothers with addictions of their own always overeating or chain-smoking.

At Children’s Hospital, every preschool child is now checked for pica, and every child with pica is checked for lead poisoning. Psychiatric social workers try to cleanse the poisonous emotional atmosphere in a pica child’s home; once that is done, it is relatively easy to cure the child of pica. But if the trouble persists beyond age six, the child usually develops some other form of deviant behavior. Now the Washington researchers are checking to see whether, as they suspect, a pica child becomes easy prey to other addictions later in life, such as compulsive eating, alcoholism or the drug habit.