Arfid eating disorder in 4 year old. AIBU?

[Unyhrtsidesau]

Friend has a 4 year old daughter. I’ve known her since childhood and she’s always been a little on the bigger side and admits she doesn’t have the best diet.

I saw her throughout pregnancy and as her daughter has grown up and crisps and chocolate and fast food was the standard. She has now had a diagnosis of arfid which I hadn’t heard of until earlier this year when she was diagnosed.

She is dangerously low weight and has stopped eating anything except KFC fries. AIBU to not really get this?!

I get that anorexia etc can come with psychological problems that restrict eating but in a four year old? Surely a four year old is programmed to simply eat to survive? I can’t help but feel if she had been brought up differently this would have panned out differently? Am I being completely ignorant here?

Afrid is a psychiatric disorder but a restrictive diet can have other causes and as parents it’s possible to fight it, I did - from only eating chicken nuggets and fries plus strawberry nesquik to eating everything (well most) took 10 full years of slog but dd managed to get to the point by mid teens where she could order food or stay in someone’s house without issue. It’s not easy but never give up

Because they are not safe. Many people have a food they have an aversion too. As a teenager, once a particular cake made me feel sick. I wasn't able to eat it again, even though logically I knew it would be ok. Same with my friend and a particular alcoholic drink after a massive night out. It's sort of like that on a much larger scale. People will only eat safe foods, and the number of safe foods can be very low.

People are mentioning SEN as ARFID can often co-occur with autism, although obviously not always.

YABU. It's not easy to get an ARFID diagnosis - it has to be much more than fussy eating.

It's often connected to sensory difficulties triggering a disgust response or to anxiety about eating or swallowing, and for a diagnosis it has to have a significant impact. For a child with ARFID every meal is a bushtucker challenge - offer a cheese sandwich and you may as well have offered them sheep eyeballs with a side of kangaroo bollock and fried ants nests.

Very often children with ARFID will eat 'unhealthy' foods not because "it's all they've been offered" but because parents are programmed to feed the child, and when your child has refused food for three days you stop caring whether the food is probiotically balanced with a nutritionally dense profile and you just want some calories in.

@hahabahbag what approach do you recommend? I would love to help her and she’s open to any suggestions

Ok.

example - if a breastfed baby has a negative experience at the breast - say she bites mum and mum screams - the baby gets negative feelings about food and will often go on nursing strike for a bit,

humans of all ages are very sensitive to intestinal discomfort - children who are coeliac or have other bowel disorders can often associate eating with pain (because when they eat something they get tummy pains) and this makes them not want to eat.

sometimes in kids as in adults you eat something that makes you throw up - and you don’t want to eat that again!

it’s not as simple as you need to eat to survive. You need to eat stuff that doesn’t cause you pain and doesn’t make you throw up.

you can easily imagine a child with multiple intolerances could severely restrict eating. Well, there’s lots of other ways of getting negative feedback from food as well.

Because to them it’s not a nice treat. To them it’s like if I offered you tripe flavoured ice cream!

@RavenLaw i guess that’s why I find it confusing, why will they eat the junk stuff but nothing else?

@BillieWiper no I never said it was made up?

Because it’s consistent. A walkers crisp is a walkers crisp. Whereas traditionally ‘healthy’ foods are often inconsistent you can have two blueberries that are very different.

but it’s not always ‘junk’ food. My son’s issues are made worse weight wise because what he does eat is fruit and some veg so he can’t get anywhere near enough calories (and other nutrients) to sustain him.

"Unhealthy" foods are also reliably consistent.

That McDonald's chicken nugget is the same wherever and whenever you buy it.

That apple might be juicy and sweet. Or it might be crisp and sour. Or it might be bruised. Or it might be weird and dry.

Because what one might call junk food is always the same.
Not like an orange, or apple, or strawberries, or cucumber, or naice ham, which can differ from the next one considerably.

Safe foods are the same. Always. Until the recipe is 'improved' (sigh)

Again, HTH.

Arfud is an eating disorder strongly associated with SEN. my eldest has ASD. His eating was so restricted at 1 point he became anaemic. Yet his food looked great because he loved fruit and veg but not meat and not leafy greens so getting iron into him was a nightmare.

My now 4 yr old has dropped a centile from 25th to 10th and I'm starting to think we're headed for ARFID. she used to eat meat, eggs, all carbs, sauces, all fruit and a good few veg but since turning 4 has refused more and more and almost has a fear of some foods. Because I know my son grew out of it I've been very 'sensible' around not panicking. My son I ended up getting back from anaemia with nuggets, burgers, sausages and turkey dinosaurs. Not food I ever thought I'd feed.

My daughter won't entertain 'kid food' she eats Cheerios, a couple of other cereal, drinks milk or water only, won't entertain juice, has gone off pasta and rice so we're down to potatoes and bread for carbs, won't even eat chips or potato waffle type things, fruit she's now down to golden delicious apples, oranges, nectarines and watermelon, sometimes mango and pineapple. Veg is peas and sweetcorn only. Trying to make a meal you know she will eat is a nightmare. I was a terribly bad eater as a child, survived my pre school years on toast, bananas, mashed potatoes, chicken and kiwi fruits. I remember being horrified by beans. From my teens onwards I improved but it was an uphill battle. She won't even eat pizza or any of the foods we could always tempt our eldest to eat.

It's not psychological so much as it is sensory.

@Sirzy oh i see so it’s more that it’s predictable packaging and taste

@Unyhrtsidesau not how they think about their food
How they feel about their food (texture etc)

Nothing to do with how they're parented

I think the PP who offered the example of being offered mud and worms, how would you feel? Has explained it well

Not always the case. My sons safe foods are actually pretty healthy - fruits, certain cheeses, plain Greek yoghurt.

I'd sell my soul for him to eat a McDonald's. I'd love to be able to go out for the day and pick up food on the fly!

My son with arfid doesn’t eat junk. He doesnt eat chocolate, crisps, chips, nuggets- he barely eats anything except fruit and bread from one particular place. Its incredibly stressful to get calories into him.

@SummitWrong with you 100% there is nothing my son eats that is a meal or anything we could have out

Often they might eat more junk food items because these are more predictable - like bananas can taste pretty different and be a very different sensory feel depending on how ripe they are whereas a particular brand of chocolate bar is always going to be the same (unless of course like PP said you get a recipe change)

4 is quite young to be diagnosed with ND but as others said it usually ends up that the child is ND.

my DS best friend was diagnosed with afrid before he was 4. He’s overweight too, I can’t see that that’s connected.

I have a child with it and you have no idea hon, please try not to judge your friend. He's since been diagnosed as ADHD but his issues with food started as a baby. He had very severe reflux for 18 months and every bit of milk then food he took hurt him. He's never recovered from his fear of food and is very small for his age. I've tried everything over the years but in the end you just have to give them what they'll eat or they will starve themselves.

It used to drive me crazy when my DM used to think it was just me being silly as 'babies won't let themselves starve '. While the medical professionals in charge of his care were telling me in his case, he could. One dietician told me fast food can be a way to help them learn to like and enjoy food 🤷‍♀️ not ideal but better than nothing.

For a lot yes. For a lot a change in packing or a “new and improved” label can be down right scary.

A big part of the problem many face with ARFID though is it is so complex and everyone has slightly different triggers. Some people it may be sensory, some it may be trauma based after choking or something, others there may be no obvious reason.

I really haven’t meant to offend anyone. Thank you for helping me gain some understanding

Or not.

Regards,
Parent to NT/ARFID child