Is there something more serious going on with your picky eater – baby daily tips gas house pike frederick md


Stephanie Elliot’s daughter, McKaelen, was always finicky about food. gas after eating As a toddler, she subsisted on a diet of dinosaur-shaped chicken nuggets, French fries, peanut butter sandwiches, peeled apples, cake and pizza (with the cheese and sauce scraped off). McKaelen’s two brothers, one older and one younger, would eat anything, so Elliot just figured her daughter would eventually accept new foods into the mix—like most toddlers and preschoolers eventually do—after the worst of the fussy phase was over.

ARFID stands for avoidant/restrictive food intake disorder. It was first classified as an eating disorder in the American Psychiatric Association Diagnostic and Statistical Manual (DSM-5) in 2013. Essentially, it’s picky eating to the point where a child will fail to meet growth milestones; start losing weight; develop a nutritional deficiency such as anemia; require supplements or enteral feeding (tube feeding) to maintain health; or whose food avoidance interferes with other aspects of everyday life, says Mark Norris, an adolescent health physician and a member of the eating disorders team at the Children’s Hospital of Eastern Ontario in Ottawa. (For an ARFID diagnosis, a child would need to exhibit at least one of these symptoms, not necessarily all of them.)

Kids with ARFID prefer white or beige foods that are soft or crumbly and easy to chew—bread, rice, plain pasta, cake, cookies, cereal or processed meats such as chicken nuggets or fish sticks. This list also describes what parents of kids with autism spectrum disorder (ASD) call the “autism diet.” Coincidentally, it’s also a pretty comprehensive tally of what many toddlers will willingly eat, which can be quite alarming for new parents.

Many children go through a picky-eating stage at age two or three when they gain language and begin to categorize foods into “likes” and “dislikes,” or “safe” and “not safe,” says Harris, who is also a consultant clinical psychologist at the Birmingham Food Refusal Service in the U.K. For example, a toddler might eyeball a cookie and think, “Yum!” But she will look at an asparagus spear and think, “That’s not food.” Most kids get past this when asparagus keeps making an appearance at dinnertime, or when they’re introduced to new foods at daycare or preschool and see peers gobbling up their veggies.

Kids with ARFID, however, don’t outgrow the picky eating, and over time it may begin to impact their growth or health. They may fail to meet height and weight milestones, or begin to lose weight. They may also develop nutritional deficiencies, such as anemia or a lack of vitamin A, B, C or D. However, since several foods that typically appeal to ARFID kids (and picky eaters) are fortified—such as bread, cereal and milk—even children with limited diets grow on track and are surprisingly healthy.

ARFID almost always negatively interferes with other aspects of life, like mealtime, friendships (avoiding playdates for fear of having to eat something new) or the ability to travel because of the rigid diet. gas evolution reaction Parents will also want to watch for signs of co-occurring conditions, such as anxiety and autism. (More on that later.) But food is good. Why do ARFID kids avoid it?

The final reason a child won’t eat has to do with appetite signalling or food indifference. These are kids who say they just aren’t hungry, ever—they don’t recognize that they’re hungry or feel their stomachs grumbling, or they’ve gotten used to smaller meals. They might pick at their plate or get away with just grazing during mealtimes, but they start falling off the growth charts when puberty hits. This is when their food intake will be a lot lower than their energy requirement, says Norris. Getting an ARFID diagnosis

If you’re worried about your child’s eating, raise those concerns with a doctor. Because picky eating has been normalized as a rite of childhood, sometimes parents’ concerns might be brushed off, especially if the child looks healthy and is gaining weight, says Harris. But be persistent. Norris says there’s been a big push around ARFID awareness in Canada, and your family physician should know what resources are available in the community.

Because ARFID has only recently been classified as an eating disorder, experts aren’t sure yet how many kids in Canada have it. A community-based surveillance study on ARFID was recently completed; doctors hope it will soon give a better sense of ARFID rates in Canada, as well as highlight the similarities and differences across a range of cases. A community-based study in Switzerland found that 3.2 per cent of Swiss children aged eight to 13 met criteria for having ARFID. n game In the U.K., says Harris, it’s about one in 600 kids. She estimates that there will be at least one child with ARFID in every primary school.

Experts stress that picky eating does not equal ARFID, which is actually quite rare among neurotypical children, Harris says. gas quality comparison It is much more common in children on the autism spectrum, however. In her experience, 50 to 60 percent of kids with ASD also have ARFID. Children who had reflux as babies are also at greater risk of developing ARFID, she says, because the vomiting and regurgitation causes “hyper-responsiveness in the throat and mouth.” This means that children will find any stimuli in the mouth—including food—unpleasant.

Harris says treatment often focuses on reducing anxiety around food, and on desensitizing, if it’s a sensory issue. For young children, this might involve getting comfortable around food without any pressure to try something: talking about it, going to the grocery store to look at it or venturing into a garden to touch different vegetables. Desensitizing can include massaging a child’s face, counting their teeth or—for younger kids—providing chew toys, all in an effort to get them used to different textures inside their mouth.

Treatment can be more successful after age eight, when a child is able to generalize about food, says Harris. For example, kids this age can understand that bread is bread, no matter the brand or packaging, or rationalize that an apple might be OK to eat, since they already like carrots, which are also crunchy. Children this age and older are more motivated to change and may have luck with cognitive behaviour therapy or relaxation therapy followed by tiny tastes of new foods, says Harris.

McKaelen underwent somatic experience therapy (also called touch therapy) during her treatment for ARFID. Over a number of sessions, a trained therapist touched where her adrenal and pituitary glands are located. quadcopter gas motor This helped her relax, lowered the “fight or flight” response from the adrenal glands and gradually helped her overcome her revulsion to new and non-preferred foods. The therapy was part of a 20-week outpatient program that also included consultations with nutritionists, peer group discussions, twice-weekly peer dinners with other kids with eating disorders and group therapy for the parents.

Now 19, McKaelen is living in a university apartment and cooking for herself. After two or three years of touch therapy, she gradually reduced her sessions. She now goes out to eat at restaurants and will order a hamburger, or even chicken parmesan. She’s still not what you’d call an adventurous eater, says Elliot, but it’s a long way from ARFID.