Lead, Lead Poisoning, and Pica

by T. Berry Brazelton, M.D., author of Feeding: The Brazelton Way

Lead Poisoning

Lead poisoning is a very serious disorder because it can interfere with brain development in fetuses and in children in the first 5 years of life, and lead to hyperactivity, poor attention, and other learning and behavioral problems. It can also cause anemia (a weakening or shortage of red blood cells). Before it causes any symptoms, an elevated lead level can be detected in cord blood at birth and later with blood tests done at routine pediatric appointments. If you live in an old house, you should be sure your pediatrician checks your child's blood for elevated lead levels and anemia. Flakes of paint and dust containing lead peel off onto windows, sills, and the floor. When a crawling 8-month-old baby finds that lead paint chips taste sweet, she'll quickly learn to search for and savor them.

Take some chips to the doctor with you so that they can be tested too. You can then find out if you need to strip your house of the offending paint or plaster. Early symptoms of lead poisoning include irritability, sleep and appetite problems, and constipation. Later, vomiting and headaches occur, along with stomach aches, clumsiness, weakness, confusion, seizures, and finally even coma. Long before this, effective treatment for lead poisoning is available—the sooner the better.

Lead poisoning is all too common and can be prevented by protecting young children from any exposure to lead—in old lead water pipes, lead paint, house dust from lead paint, soil contaminated with lead (from lead paint and other sources), and cookware containing lead. If you live in an older home, have your water tested for lead. Lead paint should be removed from homes in which young children live—before they arrive, or else when the family is staying elsewhere, and never while they are living there. The stripping and chipping of paint and wood will leave chips and dust particles of lead all around. In some towns and cities, financial assistance is available for lead paint removal. Check with your local public health department.

Pica

As soon as a child finds that she can use thumb and index finger to pick up tiny objects (pincer grasp), at around 8 months, she must be watched more carefully. Now she can pick up and eat any tiny object she finds on the floor. A baby will eat hair, wool objects, paper, pieces of string, flakes of paint and plaster chips, clay, dirt, tacks—any object small enough to fit in her mouth and swallow. Fortunately, she's likely to spit out objects that have no taste or are inedible, but parents can't count on that.

Pica is the medical term for frequent and repeated attempts to eat non-edible materials. In some cases, for example, prolonged, repetitive eating of clay or dirt, it appears that an iron or zinc deficiency causes the behavior. Although it is normal for infants to explore their world by putting all kinds of objects in their mouths, this behavior should subside by about age 4 or 5.

If a child's hunger for foreign objects persists and is a problem, try bits of food to distract her. If these do not work, consult a behavioral clinic at a children's hospital for ways to treat pica with other positive reinforcement techniques.

Excerpted from Feeding: The Brazelton Way © 2004 by T. Berry Brazelton, M.D., and Joshua D. Sparrow, M.D. All rights reserved including the right of reproduction in whole or in part in any form. Used by arrangement with Perseus.

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