What is ARFID?
All children go through stages when they become more picky about the foods they will eat. This is a natural developmental stage, and in the majority of children passes quickly. However, occasionally it becomes more of an issue. This blog gives some information on ARFID and when to seek support.
Common Questions about Avoidant Restrictive Food Intake Disorder
What is ARFID?
ARFID is a relatively new condition (2013) and is classed as an eating disorder. It is important to distinguish between ARFID and the usual fussy eating stages toddlers go through and know when to seek medical support. ARFID can start at any age and is seen in teenagers and adults. There is also an overlap with autism and ARFID.
What are the symptoms of ARFID ?
A child with ARFID will avoid certain foods or even entire food groups and/or often eat very small portions of food, much smaller than expected for age. The reason for avoiding the foods can be linked to an experience they have had with food such as choking, seeing someone else choke, a strong aversion to the sensory aspects of food such as texture, colour, smell, appearance or taste, general disinterest in food.
What are the differences between ARFID and Fussy Eating?
Generally, children who are fussy eaters will eat enough variety and volume of food to grow, will eat with their family, and their food choices do not impact on their social interactions. A child with ARFID will generally only eat a small number of foods, whole food groups will be missing and they often (although not always) will not be growing appropriately for their age. Children with ARFID will often not eat with their families or with other children at nursery or school as they are so sensitive and become distressed by the smells and appearance of the food being eaten at the table. They may even vomit or gag if they remain at the table. The children often do not experience hunger and will not ask for food in the same way as other children. They will not ‘eat when they get hungry’ if the foods they prefer are not offered.
When should I be worried and seek support?
You should seek support if you feel your child is not growing as you would expect or you are worried about the variety eaten. Perhaps your child is very brand specific, eating only one particular brand or flavour of an item. Packaged foods are often preferred as they always look and taste the same. The impact of the food avoidance can impact on social interactions such as not being able to join the mealtime at nursery, or visit friends.
Where can I get support ?
If you are concerned speak to your GP or Health Visitor. They will be able to signpost you, assess growth and may suggest an appointment with a dietitian in order to review your child’s diet. You may find that even with a small range of foods your child is still meeting their nutritional requirements. A multivitamin and mineral supplement appropriate for age might be advised. Some children might need a referral to a paediatrician or multidisciplinary team that includes a psychologist, paediatrician, dietitian, occupational therapist, speech and language therapist for a diagnosis and treatment.
Thank you to Clare Thornton-Wood RD BSc (Hons) PhD – Paediatric Dietitian – for writing this blog all about Avoidant Restrictive Food Intake Disorder, also known as AFRID.
Clare Thornton-Wood RD – Registered Dietitian in Guildford with Specialist Paediatric Interests. Alongside Clare’s private practice, she works as a Lead Principal Dietitian on the South Coast.
Useful Resources
Clare Thornton-Wood RD Website – Clare offers one to one support for families with ARFID (private and online), so do get in touch with her for support.
And do check out my blog series on Neurodiversity and Nutrition, as well as my factsheet:
A parents guide to navigating feeding difficulties with your neurodivergent child.