Beyond Picky Eaters: What To Look For – And What You Can Do

Beyond Picky Eaters: What To Look For – And What You Can Do 

Does you child prefer bland foods, with minimal texture or flavour? Are foods like pasta, soup and bread a staple in your home? Does your child drink an excessive amount of milk, or prefer cheese and crackers to other foods. Is there a lack of colour in your child’s diet? Do you struggle daily to get your child to try new foods, and worry that your child is missing important nutrients?

I see patients like this every day in my office. Some meet criteria of eating disorders, some are just picky, but all have a commonality – stressed parents who want desperately for their child to eat a well-rounded diet with less food refusal.

Essentially, sufferers of ARFID are particularly sensitive to foods with certain textures or smells. Common ‘safe foods’ include carb-heavy foods like bread and cereal, cheese, yogurt, milk and highly processed options like crackers and candy.

A recent commentary in the Journal of Adolescent Health showcases a ‘new’ eating disorder, that even paediatricians do not know about. Drs Katzman and Norris, two Canadian adolescence medicine physicians performed a study to gauge the level of knowledge of Avoidant/Restrictive Food Intake Disorder (ARFID) amongst paediatricians. Only 37% had heard of this condition. I imagine that fewer non-physicians have heard of it.

Many kids with ARFID will thoroughly avoid whole food groups like vegetables and fruits. Some exclude foods based on colours, sticking to one colour palate like white.

Essentially, sufferers of ARFID are particularly sensitive to foods with certain textures or smells. Common ‘safe foods’ include carb-heavy foods like bread and cereal, cheese, yogurt, milk and highly processed options like crackers and candy. Many kids with ARFID will thoroughly avoid whole food groups like vegetables and fruits. Some exclude foods based on colours, sticking to one colour palate like white. Many are sensitive to textures and temperatures, refusing foods with too much or too little ‘crunch’ or those that are too hot or cold. Sauces are often a deal breaker.

What should you do if you think your child (or you yourself) has ARFID? First, please speak to your health care provider.

What should you do if you think your child (or you yourself) has ARFID? First, please speak to your health care provider. Even if your doctor has not heard of this disorder, they surely know of a therapist or physician that has. ARFID is often treated through management of anxiety and systematic desensitization, gradually rewarding the trial of new foods not previously deemed ‘safe’. Relaxation techniques are used to minimize stress.

Meals are a social experience, and kids tend to eat better when enjoying the meal along with the adults. Offer a variety of foods, as early as you can.

Though we aren’t yet sure if we can prevent ARFID, there are strategies to prevent picky eating in general. I suggest incorporating your child into family meals as early as possible. Our 6 month old sits at the table along with the rest of the family. Meals are a social experience, and kids tend to eat better when enjoying the meal along with the adults. Offer a variety of foods, as early as you can. Speak to your doctor about when to start solids. In our family, our children were eating a variety of fruits, vegetables, grains and proteins early on, and started eating the same foods as us at 9 months, albeit in smaller pieces. Finally, avoid turning mealtime into a battle. Avoid fighting about eating, as much as you can. It only sets the stage for a negative relationship with food.

Let’s make the meal table a fun place where you and your children can try new things, share a conversation and a social experience.

If you think your child may have developed an unhealthy relationship with food, please discuss with your health care provider.

Full article in The Globe and Mail.