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?

My ARFID child is now 16 and eats NOTHING!!! Wants to eat toast so badly but can only bring it to his nose. He's been fed via a tube since he was 3 and he's 40kg.

ARFID is not a fussy eater. Those KFC chips are the same every time, these kids like shit food because it always tastes the same....

But yep...probably just a shit mum....tell her it will make her day !

My son had this. He is 16 now and he has managed to get over it - mainly as he really really wanted to be able to eat out with his friends with help of Felix. He had a phobia about all fruit all vegetable and all pulses. Luckily we spotted the issue before he turned 2 and we stopped buying or giving him access to any junk food or empty carbs so his safe food ended up being mostly protein (meat) pasta and rice. He never ate bread or cake though. It wasn’t as bad as some children but he wasn’t able for example to eat a strawberry even if I gave him (say) £100.

It was easier age 18m- 24m to expand palette though “food chaining” but after about 4 he was much more fixed and I didn’t manage to introduce anything new. At around 12/13 he was annoyed and bored of it and really wanted to move on. We saw Felix and since then he’s been able to manage new foods. But Felix won’t treat a child until he wanted to get over it.

My 4year old son has ASD and ARFID . As others have said , processed food is often preferred as it’s the same every time. My son refuses any meat or fish so he can’t even bloody eat chicken nuggets. He has the same pasta dinner every night. We went to an all inclusive a couple of weeks ago and I packed pasta and sauce from home just in case he refused everything on holiday … which he did. Even refusing cakes and desserts, chocolate croissants etc from the hotel as it was ‘different’. He will eat chocolate cake but not a chocolate muffin/brownie as it’s different.

Luckily he eats fruit. We spend about £30 a week on his strawberry/raspberry habit 😮‍💨

It is a bit of a coincidence that the "safe foods" are all ultra processed junk foods though isn't it?

This in no different to me feeding my dog steak for 4 years, then being shocked when he doesn't want kibble

I don’t have experience with ARFID but I do have experience with bottle aversion. My baby was 3 months old when she started refusing bottles and not eating (bottle fed from birth). It was all physiological even at that age. She had a sore in her mouth, associated drinking the bottle with pain and point blank refused pretty much everything for 2 months at least bar an ounce or two here and there. We saw a private consultant and she told me “aversion babies will drink enough to survive but not enough to thrive” and that’s what was happening. So all these people that say “babies will drink when they’re hungry” Not always the case so definitely not always the case in a 4 year old!

When my son was was about 18 months old we went Greece on holiday and he was loving the moussaka and any other local foods he could get his hands on. I will admit I was a “well my child will eat anything” kind of parent.

Arfid doesn’t discriminate though and by the age of 9 he ate so little he had a feeding tube fitted which is still there at the age of 16. Looking back I’m ashamed of my cocky attitude!

My daughter ate absolutely everything until she turned 2. I'm a cook . I make everything from scratch. Then she stopped.

She ate dry toast and a bowl of Euro Shopper brand spaghetti hoops, plain yoghurt and plain crisps for nearly a year. Sometimes bread sticks but the "wrong" ones put her off those for good.
She's 7 and now I've managed to get her eating cheese sandwiches, apples, baked beans (Asda), strawberries, grapes, very occasionally broccoli, chicken burgers (Birds Eye, plain, no bun, no sauces), plain pasta, plain rice. Sometimes she'll agree to fish fingers but a "bad" one puts her off for weeks.
Recently she started eating the chicken burger and plain rice on the same plate which felt like an enormous victory. Before that it was all separate plates.

I have ARFID, have done since i can remember. Mine was due to sensory issues, but Autism wasn't diagnosed until i was an adult, in the 90's it wasn't really heard about. My parents did the don't leave the table until finished & the eat if your hungry enough tact..it actually made it worse.

It also wasn't at only 'healthy foods' i had it with chips, pizza, meat..i only ate apples, pasta, milk and cheese ..that was it.
I use to get through 4 pints of milk a day and the dinner ladies at school would swap the water for milk and they kept cans of spagetti hoops back for me every single day for the whole of primary school 😅

If i ate the 'ughhh texture' i would just start retching, spit it out or if forced i would sit holding it in my mouth until i vomited. I could not swallow it, it was a big repulsive feeling and aversion to the texture..so the horror if you ate and chewed worms..for some reason was the reaction my mind & body did to chewing pizza or other foods down to the texture😅

With the old school methods, i then just felt anxiety & fear around dinner times to add to the aversion and gag reflex with it.

I struggle today, but as an adult being able to cook, prepare and be incontrol of textures through cooking has widened by food options. When i am stressed it gets worse as i become more conscious (i think they call it introspection) over the texture and process of eating, so i miss swallow cues 😅 the longer i chew the more the ugh texture gets (warm lumpy mush) which then causes the retching/gagging..and i don't know about you, but if your urging to be sick it puts you off eating 😅

This isn’t the case.

i had lactose intolerance as a child (only worked out as an adult) and my safe foods were plain white rice, plain bread and eggs.

lots of other people are describing situations where it is not ultra processed junk foods that are safe.

Oh my god OP don’t upset the ARFID lot!! Honestly, tells everyone no one understands it. Someone asks and get complete abuse.

I'm no expert, but from what I have learnt, Afrid often comes with extreme fear of the unknown. So when you or I eat something, that we've eaten before, we "know" to a large extent, what it will taste like. There will be a percentage that we don't know like

• this brand could be slightly different from other brands
• this one might be riper or less ripe
• this one might have been cooked or prepared with some different flavourings
• this one might be slightly colder or hotter, harder or softer, saltier or less salty, etc

But our brains tell us it's a fine (whatever) provided it tastes similar to what we've had before.

In someone with Afrid, their brains seem unable to cope with that "normal" unpredictability, so a dish cooked two different ways or a piece of fruit that's riper, and another of the same fruit which is less ripe, will taste radically different for example. Often fruit and veg WON'T be a "safe food" for this reason. Often "safe foods" will be highly processed foods because every box of the same food will taste identical.

Often (but by no means always) Afrid will be linked to Autism - both the need for predictability and the heightened sensitivity to sensory inputs are common to the two conditions. I recommend looking at My Afrid Life, on Facebook - at 9 years old (I think) Hannah is very good at explaining her thought processes when she challenges herself to try new food, whether it goes well or not.

Because it's not logical. It's almost primal, defies logic and reasoning.

My daughter doesn't quite meet the criteria for ARFID but it's definitely close and lots of her doctors have suggested it. She eats cherry tomatoes, cucumber and water melon. Pasta and cheddar cheese - in a block, not pre-grated. She will eat aldi rice Krispies but not kellogs, and she can tell. If you try and get her to eat a different brand by putting it in the box, she'll know when she smells or tastes it, and then won't eat that food again, even if it's the right one. She doesn't eat cake, but will eat frosting. She will eat chocolate ice cream but no other and will eat part rings, but no other biscuits. She will eat McDonald's nuggets but no others and no other fast food or junk food. She will literally starve herself if not allowed to eat her safe foods and at 5, was underweight (because I starved her, something I now feel so incredibly guilty about). I breastfed and did babyled weaning. I did everything "right".

My eldest is a proper foodie so had no idea what was happening with my youngest.

They are not thinking, responding to texture and feel of foods, we all do to an extent

DD used to eat everything, until she didn’t. Texture being the culprit.
It’s an ongoing battle but she does try things now at least. Everything has to be smooth or well cooked.
she ate some satsuma the other day unprompted which was great.

I had a limited diet as a child, but then we also only ate a limited amount of things at home. No spice, no foreign foods, very overcooked veg. I think the variety of things available now is overwhelming.

Seriously… you are saying that all these parents on here, who have children ended up needing tube feeding etc, ‘shouldn’t’ be surprised’ that it ended up that way 😳

Not a comment on the thread because I don't know the true facts but always remember that it is in the interests of the "health professionals" to medicalise everything!

So many things that a generation ago would have been obvious bad parenting have become medicalisef giving bad parents an excuse.

I can't know if that's true here but the wider trend is unmistakable.

Without medical intervention the only statistic DS would have been was child fatality. Thankfully he was born at a time when medicine knew more

I’d never heard of ARFID before MN, and although I would never have said it out loud, back then, I believed that kids wouldn’t starve themselves.

But as with this thread, others here have taught me a lot about ARFID, and it’s been eye-opening. I know it must be exhausting for posters who are dealing with it to have to explain it repeatedly, but in ways small and large, you’re helping people understand the realities of it, which has to be a good thing.

Wishing all of you well.

I think you are being ignoring to be honest. Dd is 26yo now and never had a diagnosis of anything but was more than just a fussy toddler. Would only eat chips and white bread. As a baby I religiously made up home made puréed food, had the Anabel Karmel baby Cookbook and introduced her to a wide range of tastes and textures. I really don’t know where it went wrong.

HV happily told me not to give in and not feed her if she didn’t take what was offered. Said no kid will starve themselves. So I did as I was told. Then my mum who hadn’t seen her for a few weeks and was shocked by how thin she was and insisted I took her to the GP. I think i hadn’t really noticed the gradual weight loss or the bones sticking out. GP was shocked and we had an urgent dietitian referral. Dietician said we had to feed her anything she’d eat and she would gradually improve.

They were right, it took a few years though and was gradual improvement. She’s very much into healthy eating now, doesn’t eat processed food. Is vegetarian.

oh and she is autistic which might explain it.

I had this as a child and remember it like it was yesterday, there was quite literally no way you could get me to eat anything that I didn’t want to and I mainly lived off chips. I remember going round a friends house when I was about 8 and her mum served mac and cheese and I put some in my mouth because I was riddled with anxiety over looking rude and immediately started gagging at the texture. Luckily the friends mum was the nicest person in the world and immediately said I didn’t need to eat it and she would find me something else. My mum used to get frustrated at judgement to the tune of “just give her what you have and tell her she can’t leave the table until she eats it” as I was already underweight, and she said if she didn’t give me one of the very few things I’d eat, I just wouldn’t eat at all. I’d have sat at the table all night if needed to avoid eating something I didn’t want to.

I eventually got over it when I was about 17, and now I’m the easiest person to feed as I’ll eat everything. But there were many years prior to that where I’d be riddled with fear over being invited to peoples houses or out for meals because I’d think “there’s not gonna be anything to eat and everyone will think I’m weird”

It’s really just far beyond the realms of “fussy eater” or kid trying their luck to get junk.

I'm not sure weight is red flag in children as there are many girls who are naturally extremely skinny. I know three girls (5-7) who literally look like skin and bones but are all NT and eat fairly normally. Their legs are stick thin with the kneecaps clearly bulging out on both sides. In an adult it would be a clear sign of anorexia but as far as I know, none of the girls have been flagged for any health issues. They also come from well-off families so money isn't a factor.

Adult with ARFID here.

It does often develop around 3/4 years old as thats one of the stages where kids start to become aware that food might be linked to digestive discomfort, they become more more aware of sensory differences, textures, and naturally averse to anything their brains tell them 'might poison/choke you' - but kids with ARFID have that dialled up to 11, it's gone overboard and its telling them a huge range of things are dangerous and not food and if they try to eat them they can't swallow, will retch, gag, vomit.. etc.

As everyone else has said, preferred, safe foods, tend to be those that are uniform, fairly plain, more likely to be dry than wet, and predictable.

Some of us are also 'super tasters' so what tastes bland to you tastes great to me, and what tastes nicely seasoned to you is horrifically salty/spicy/strong to me.

I can tell the difference in brands of frozen potato tots, by taste alone. I can tell when himself didn't rinse the dishes as I can taste the washing up liquid he can't taste. I know when we move to a new bag of potatoes as it tastes subtly different to the old bag.

I am marginally better as an adult as I choose what we buy, I have input into the prep and cooking and no ones going to yell at me or pinch my nose and force it down if I don't eat it.

And yet, I am now 3 years in to cycling through:

Quorn nuggets and airfryer potatos
Salad 'mulch' and quorn nuggets
Cashew nuts
Protein works shake

And that is basically it. Theres the odd raspberry or blueberry or nectarine but these are very variable and whilst a good one is delicious a bad one has me retching which I really don't enjoy.

• Don't pressure kids to eat - put it out, not touching, not on the same plate even, leave it be. No 'just try it' and no 'there see it WASN'T horrible' if they do.
• Offer a safe food every meal - you can put out other things too, but make sure the safe option is always there.
• Don't use food as bribery or punishment.
• Do model good cooking/food prep etc choices.
• Do not tell kids 'you've never tried it how do you know you don't like it' - their brain tells them its poison, its horrible, it will make them sick. They do not know why and cannot put that into words, but that is the truth for them.
• Do NOT doctor or hide other foods in safe foods. This does not expand the range of safe foods, it ruins trust in you, trust in the safe food and will almost certainly remove that safe food from the list! Similarly, hiding one brand of a product in the safe foods packaging is a shitty idea that will almost certainly fail (particularly if your kids a supertaster. We can tell!!)

To be underweight as a child, you need to be in the bottom 2 percentile. That's extremely thin and usually comes with other health issues, lanugo, sunken eyes and exhaustion. It's not normal kid-thin which is appropriate and common. And not all children with ARFID are underweight as many safe foods are high calorie. Same as adults, the vast majority of people with eating disorders are overweight.

You comment is totally unnecessary!
You've obviously never been in the situation of trying to get your child to eat even a basic amount. I tell you, it takes over your (and the child's) life.
There are plenty of posts here that are trying to educate and inform the OP- there's no "complete abuse" going on in this thread.
Maybe you should think more carefully before you post.

You are being unreasonable and judgemental. I don’t think a diagnosis of ARFID would be handed out Willy nilly.

as many others have said, it’s linked to neurodivergence and is entirely possible that her only safe food is McDonald’s fries. I’ve taught many children with ARFID. They’d literally rather die if starvation than eat an ‘unsafe’ food.