A newly introduced feeding disorder, Avoidant Restrictive Food Intake Disorder(ARFID). It affects infants to early childhood. Although the symptoms on the surface appear the same, the criteria is different to the likes of anorexia.
ARFID is a food restriction (or avoidance) that leads to persistent failure to meet nutritional needs. This causes for one or all of the following to happen when a feeding disorder has surfaced:
• Significant weight loss
• Significant nutritional deficiency
• Dependence on tube feeding or oral supplements
• Psycho-social impairment
What it is not:
• Due to lack of available food
• Fear of weight gain or body image disturbance
There are 3 prototypical ARFID presentations:
1: Food selectivity due to sensory sensitivity: ie: preference for branded foods, packaged, consistency and predictability
2: A lack of interest in food or eating and when mealtimes become a chore
3: Fear of aversive consequences: choking, vomiting, diahorrea or abdominal pain
We are still some way from knowing the cause of ARFID. But I do wonder if the neurological symptoms came first or if it was the lack of treatment contributing to the cause? To date there are no clinical studies to detangle the chicken and egg scenario.
In my five years of therapy, patients under the age of 10 will present at least one, but often two, of the ARFID presentations. Although, some will overcome these symptoms, a small percentage will develop unorthodox coping mechanisms. This can slow down the secretion of ghrelin, which is the hormone that helps us to feel hunger and satisfaction.
Vitamin and Mineral deficiency
There were three common deficiencies found in completed clinical studies; Vitamin B12, Zinc and Vitamin C.
Certain types of food, such as dairy and refined carbohydrates, are known to strip the body of these important vitamins. Also, they are consistent with Pyrroles Disorder, which has similar symptoms of autism and sensory processing disorders.
How you can prevent having a child with ARFID?
Research is very much in its infancy as to the causes of ARFID but there has been clinical cognitive behavioral therapies that have proven successful.
It’s fascinating that the foods ARFID kids enjoy are considered ‘little kids’ foods: Mac and cheese, chicken nuggets, milk, chips, foods that lack fiber and impair efficiency in digestion. Sometimes this can cause constipation or delayed gastric emptying, therefore the symptoms can be self perpetuating.
If you have a child that presents symptoms of ARFID, awareness of the condition goes someway to encouraging willingness to do the therapies.
Keeping kids involved in food preparation is key to maintaining any anxiety and helping them to be aware of food and their sensory properties.
When talking about foods, try to encourage kids to use descriptive words and eliminate negative emotional words. Ie: the goji berry is rough, hard, red, smells sweet, tastes bitter.
The sensory aspects of patients are far more severe than that of a picky eater v’s problem feeder. If you are dealing with a picky eater the ole advice ‘just feed them when they get hungry’, however that advice applied to a problem feeder could be disastrous.
Take a look at my checklist here where I list the differences between a picky eater v’s a problem feeder.
If you suspect that your child has symptoms of being a problem feeder and you’d like guidance on how to avoid a future diagnosis of ARFID.
Earliest detection and intervention is always key to the best outcome.
Contact me should you have any concerns about your child’s nutrition or feeding problems.
Alternatively book a 15 minute consultation where you can meet me face to face and quiz me on the best possible treatment for your child.