Many children experience picky or selective eating. This is especially common among toddlers and during the early grade-school years. Picky eating is typically a temporary phase in which a child might have strong preferences for certain foods and reject others. They might refuse to eat anything green. Or insist on eating the same foods day after day. They might even have a specific food they'll eat on Monday but completely refuse it on Tuesday.
While it can be frustrating for parents, picky eating generally causes more frustration for parents than the child. It usually doesn't interfere with a child's growth or cause nutritional deficiencies. And children often outgrow these habits as they get older.
However, there is a spectrum of selective eating. And sometimes, what seems like pickiness could be something more complex. So, it's important to know the signs.
Avoidant restrictive food intake disorder (ARFID) is a feeding disorder characterized by persistent, limited food intake. And it's much more severe than temporary picky eating.
Understanding ARFID can help parents navigate feeding challenges and seek proper support.
What is ARFID?
ARFID is a feeding disorder in which children have an extreme aversion to certain foods, which can lead to complete avoidance. They may be fearful of certain tastes or textures or believe certain foods will cause them pain or discomfort. They may also have little interest in eating. ARFID can cause significant health concerns and severely impact a child's daily life.
Due to limited food choices, ARFID can lead to vitamin deficiencies, inadequate weight gain and even conditions like scurvy. Kids with ARFID can also be overweight because their selected food choices are calorically dense. However, they may still have nutritional deficiencies due to lacking essential vitamins.
ARFID can also significantly impact a child's social and emotional well-being. They may avoid social situations like birthday parties or school cafeterias due to anxiety or fear about food. ARFID can affect a child's functioning in a lot of different ways. And they don't just outgrow it without proper treatment.
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When Your Child's Eating Habits Could Be Cause For Concern
Food is often at the heart of social gatherings and family traditions. However, when a child struggles with eating, it can affect their ability to take part in these important activities. It can also cause them to miss fun moments with family and friends. Or even refuse to sit down at the dinner table.
If you're concerned about your child's eating habits, ask yourself these questions:
- Does my child have a limited diet, causing noticeable weight loss or concern for vitamin deficiencies?
- Is my child avoiding social situations like birthday parties because of the food?
- Does my child become distressed to the point of complete refusal to eat unless provided with the foods they're comfortable with?
Kids with ARFID might refuse to eat with their peers at school because of the way their friends' food looks or smells. They might also avoid these situations because of what it sounds like when their friends are chewing and swallowing their food. They may also experience distress at the idea of eating new or nonpreferred foods.
If eating issues are affecting their everyday lives, it's time to seek help.
What Causes ARFID?
There’s no single cause of ARFID. It can occur due to a mix of factors.
Some children may be supertasters, meaning they have a more sensitive sense of taste. They may also have family members with a similar history of selective eating. Other children develop ARFID after an illness or traumatic food-related event. They may have vomited with an illness or had an allergic reaction in the past, making them fearful of eating. Others with ARFID may lack an appetite or fail to recognize hunger cues, leading to minimal food intake. This differs from eating disorders such as anorexia or bulimia, as ARFID is not about a desire to control weight. It's also not caused by a negative self-image.
ARFID is highly correlated with generalized anxiety, ADHD and neurodevelopmental disorders such as autism. For children with autism, the rigidity in their routines might contribute to their selective eating habits rather than a fear of new foods. Some children can have sensory sensitivities that make certain textures, colors or smells unbearable, complicating their eating habits. It's not about being picky — it's a genuine sensory response that can cause real distress.
When to Seek Support
If you suspect your child has a feeding disorder such as ARFID, start by having a conversation with their pediatrician. They can help rule out any underlying medical issues, such as food allergies or gastrointestinal problems.
Often, children who are diagnosed with ARFID will work closely with a behavior therapist specializing in feeding disorders. This can make a world of difference. Behavioral therapy can help them become more comfortable with new foods and eating situations. And small, gradual exposure to new foods can help them slowly expand their diet without overwhelming them.
If you're on this journey with your child, you're not alone. Know that there's hope for your child to have a healthier relationship with food. With the proper support and patience, we can help them find joy in eating and taking part in life's important moments.
