Picky/pica

Mara really isn’t a picky eater at all, though she likes some things better than others and isn’t afraid to express those preferences. (She’s picked up “disgusting” from Val, but all three kids understand that both that and “looks/smells like yuck” are off limits at the dinner table, though this sometimes requires reminders.) She is, though, fascinated by another sort of Picky, her name for Pippi Longstocking, whom she adores in the vaguely awful mid-80s musical movie version and now the book that we’re reading.

I’ve been thinking a little more about Pippi lately, about to what extent her bravado covers up her fears or whether I’m being silly to even think about that. I think about how Val really isn’t a good liar and yet she sure seems to want to be believed when she’s telling her stories, so I try to let her know that I don’t believe but that I respect her need to feel heard. I think about how Mara alternates being fearless and too nervous at the playground and how I wish Alex would show a little more of the latter, though his feats of athleticism haven’t led to injury yet. I see how gentle all three of them are with our animals. They all have that mix of too old and too young for their ages that is really probably just part of being their age but also part of having complicated histories.

Mara’s sisters called on Saturday. I was supervising one of the other kids in the bathtub and my phone rang with a chipper nine-year-old on the other end. Mara was so excited about the call, but from what I could hear mostly talked in nonsense words rather than trying to explain herself. She was ecstatic about it when I talked to her about the call, just glowing. Then she had a horrible night where she didn’t feel comfortable in her own skin and seemed to be fighting bad dreams, after which she woke up itchy and eventually frighteningly bumpy. The hospital diagnosed hives when I got her there and it was a relief that they went away as quickly as they’d arrived. I can’t think of what other than that unexpected family contact was something new that might have been a trigger, but if family visits mean we’ll have to load up on benadryl, I’m okay with that and I know Mara would be too.

One essential thing we learned on our last visit with Mara’s family was that one of her older siblings also has pica, that in fact this sibling once ate almost an entire shoe, which is funny in retrospect but I’m sure scary at the time. While Mara’s preschool director had suggested her pica could be part of a sensory processing disorder of some sort, I’m more inclined to think it lies somewhere on the OCD spectrum and that it’s one of several self-soothing techniques she developed as an underparented baby. When she drinks out of a cup with no lid, she often won’t touch her hair, but drinking out of a sippy cup or a straw seems to take her back to her “bottle” feeling and she immediately starts tugging gently on her hair, which is also something she does at bedtime.

Because of the pica, we get Mara’s lead tested twice a year and she’s still in the safe range and I’m pretty sure the documentation shows that the one time she tested high (well before she came to us) was because of contamination on her finger rather than in her blood. She knows not to eat her hair if she pulls it out when she’s bored at naptime or her blanket when she’s bored at naptime, but eventually being bored will take over and she’ll do those things if one of her teachers doesn’t notice and pass one of her chew toys to her, in which case she’ll chew that and not eat anything and also not pull out her hair, though she may pat or tug it. We still rock her to sleep at night in part because I don’t think she’s ready to go to sleep on her own without eating inappropriate items if she’s frustrated. The incident report from when she ate a plant at school last week signals that it, too, was during naptime, so we know that’s the key.

Beyond that, though, I just have to be aware that things might go in her mouth for her to chew and possibly eat. I’ve been trying to avoid hair beads because I want protective styles for her fast-growing healthy hair, but also because beads and barrettes often end up in her mouth and then maybe her stomach. She’s only eaten a few really worrisome things, but occasionally there will be a stick or some dirt or ice (and I’m so guilty of that last one, and yes, I’m probably generally anemic) and no real pattern to what might have made them appealing one day and not the next. Well, ice is always appealing to her and to me, but she doesn’t show any of the deficiencies that sometimes can trigger that. She doesn’t have unfettered access to the freezer, so ice is a rare treat and usually only available when we go out to eat.

We had to reschedule her four-year checkup because she had a sinus infection back at her birthday time, but she’ll get checked by a dentist and by her doctor in the coming weeks and I’m sure we’ll have more official input from people who know more about what we should expect and what’s going on. For now, I’m inclined to think (as I said) that this is partly a remnant of her time alone as a baby and the nutritional deprivation that at least sometimes went along with it. It’s also probably got a genetic component since a sibling she was never raised with and who had (I think) a different sort of upbringing has the same issue. I’m not sure if I’m inclined not to call it sensory just because I’m inclined not to or if I’m missing out on insight there, so I’ll check into that and also maybe let her start trying gum and seeing if I can get her to spit it out rather than swallow it.

Part of all of this is that I want Mara to be healthy, but it doesn’t really bother me if to some extent she wants to metaphorically walk backwards, do some of her Pippi thing. She needs to learn that she doesn’t eat anything that isn’t food (or, um, ice, which is basically a food because hello, water!) and we’ve been working on that since she was first placed with us, with considerable success. That doesn’t mean she’s not going to eat anything inappropriate or that I’m going to take away her chew toys, but her pica episodes are getting much more rare and (at least until the potted plant) less dramatic. Because I see progress, I’m hoping that as she gets more attached to us and more comfortable with her life, she’ll feel less need for the satisfaction pica brings her. She’s growing up, and I hope pica is one of those childish things she’ll be able to put aside, at least to some extent as she finds her way. As usual, I have faith in her.

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