Pica withrapid improvement after dietary zinc supplementation

and delivery. Herbirthweight was 3,300 gand length 51 cm. Her mother's and father's heightswere 163cmand 185 cm,respectively. Apartfromherphysical growth, her development was quite normalduring infancy and she had no serious illnesses. Herweight centile, whichwasat the 50thuntil the age of2months, declined to the 3rd by 6 months of age, andsubsequently remained at this centile (Fig.). Herheightcentile, whichwasonthe90that3monthsofage,alsodeclinedinlaterinfancytothe25thby11 monthsofage; and then, between 18 and 24 months, to the 10thcentile. Her appetite was initially good and her earlyfeeding habits wereunremarkable. At4monthsofageshewastaking 720mlmilkformulaand3mealsofsolidfoodsperday. However,fromtheageof6monthsherappetite was 'not so good', andat 18 monthsofage hermotherreported a markeddeterioration in appetite.At the age of 18 months she began to eat metallicobjects and, to a lesser extent, her own hair. Thesemetallic objects, whichshe inserted into her mouthforextensiveperiodsoftime,included,forexample,keysandaluminiumfoil. Shewasalso observed to be gnawingfrequently at the metal stripping on the edge of thecarpets.