If you have a child who is a picky eater, then you may have come across the term Avoidant/Restrictive Food Intake Disorder (ARFID) while looking for answers about your child’s eating habits.
But ARFID is much more than simply just being a picky eater. While many children go through phases of refusing certain foods or having strong preferences, ARFID can significantly affect a child’s nutrition, growth, health and everyday life.
If your child eats a very limited range of foods, avoids certain textures or appears anxious about eating, it can be helpful to understand what ARFID is and when to seek support.
ARFID is an eating or feeding disorder where a person restricts or avoids food, resulting in difficulties meeting their nutritional or energy needs.
Unlike some other eating disorders, ARFID is not driven by concerns about body weight or shape. Instead, food avoidance may be linked to sensory sensitivities, a lack of interest in eating, or fear of unpleasant consequences associated with food.
ARFID can affect children, teenagers and adults, although signs may first become noticeable during childhood.
A child with ARFID may experience one or more of the following:
It is important to remember that every child with ARFID may experience food differently. Some children may primarily avoid food because of sensory sensitivities, while others may restrict food following a negative experience, such as choking or vomiting.
Picky eating is relatively common in childhood. Many children have favourite foods, refuse vegetables or go through periods where they are reluctant to try something new.
With ARFID, however, food avoidance can have a more significant impact on a child’s health, development or daily life.
For example, a child may only eat a small number of foods and become extremely distressed if those foods are unavailable. Their restricted eating may affect their nutritional intake, growth, energy levels or ability to participate in everyday activities.
Mealtimes can also become a major source of stress for both the child and their family.
If you are concerned that your child’s eating habits are becoming increasingly restrictive or are affecting their wellbeing, it is worth seeking professional advice.
There is no single cause of ARFID. Different factors may contribute to the way a child experiences food and eating.
Some children may have heightened sensitivity to textures, smells, tastes or the appearance of food. For example, they may find certain textures overwhelming or feel distressed when different foods touch each other on a plate.
Others may develop a fear of eating following an unpleasant experience. A child who has choked, vomited or experienced significant pain while eating may begin avoiding certain foods or eating altogether.
Some children may also have a low interest in food and struggle to recognise feelings of hunger. They may become distracted during meals, forget to eat or feel full after eating only a small amount.
ARFID can also occur alongside other developmental, sensory or health concerns. However, every child is different, and a thorough assessment can help identify the factors contributing to their eating difficulties.
If you are concerned about your child’s eating habits, the first step is to speak with a qualified healthcare professional.
A GP or paediatrician can assess your child’s overall health, growth and nutritional needs and help rule out any underlying medical conditions that may be affecting their appetite or ability to eat.
Depending on your child’s needs, support may also involve a multidisciplinary team, which could include a:
Occupational therapists can play an important role when sensory processing difficulties are contributing to food avoidance. They may help children gradually build tolerance for different food textures, smells and experiences in a supportive and structured way.
It is important not to force, punish or pressure a child to eat. While it can be understandably frustrating and worrying when your child is refusing food, pressure around mealtimes may increase anxiety and make food avoidance more difficult.
Instead, professional support can help families understand why a child is avoiding food and develop strategies that are appropriate for their individual needs.
While professional guidance is important, there are also ways to create a more positive and supportive environment around food.
Try to keep mealtimes as calm and predictable as possible. Where appropriate, continue offering a variety of foods without placing pressure on your child to eat them.
Allowing your child to explore unfamiliar foods in small, manageable ways can also be helpful. This may initially involve looking at, touching or smelling a food before they feel comfortable tasting it.
Progress may take time, and small steps are still progress.
It can also be helpful to avoid labelling your child as “fussy” or “difficult”. ARFID is not simply a child being stubborn. For some children, eating certain foods can cause genuine distress, anxiety or sensory discomfort.
Understanding the reason behind your child’s food avoidance is an important part of finding the right support.
It is important to seek professional advice if your child’s restricted eating is affecting their health, growth, nutrition or ability to participate in everyday life.
You may also wish to seek support if your child:
Early support can help identify the factors contributing to your child’s eating difficulties and provide strategies to make mealtimes less stressful.
If you think your child may have ARFID, we’re here to help. Our licensed and experienced occupational therapists are here to help your child address the sensory, emotional, or physical barriers that make them unwilling to eat certain types of food.
Combining science-based therapy methods with patient and compassionate support, our occupational therapists can help your child get closer to a more balanced diet, and an overall healthier life.
Call 02 8808 4000 to enquire or send us a message here.