Many kids go through a picky eating phase, where they only want grilled cheese, pizza, or chicken nuggets. As a parent, it can be difficult to get your child to eat healthy foods, especially things that are green! There are some kiddos that grow out of this phase and others who don’t. 

Local mother, Carolyn Witrock, knows all too well how hard it can be to have a picky eater in the family. Carolyn gave birth to her daughter Ella, who was born three weeks early and appeared to be a healthy baby. 

“We first started noticing there was an issue when baby food was introduced, and she refused most of it. She was able to eat enough of a variety to sustain her, up until she started getting sick,” Carolyn recalls. 

At the young age of seven, Ella, an exceptionally caring and loving girl, contracted a virus that resulted in her going into septic shock. Ella was admitted to the Intensive Care Unit (ICU) for weeks. Eventually, she was discharged, but after a series of illnesses and hospitalizations, Ella grew anxious about going into septic shock again. This led to her being diagnosed with Emetophobia (fear of throwing up) and Avoidant/Restrictive Food Intake Disorder (ARFID). 

Picky vs. ARFID
“A picky eater will typically still eat foods from each food group (might just prefer bananas to strawberries or corn to peas), and the family isn’t concerned about the child’s nutritional intake or behavior surrounding meal time,” says Dena Kelly, the Founder and CEO of Focused Approach.

Walden Eating Disorders adds that picky eaters do feel hungry and interested in food, while people with ARFID tend not to be hungry or even think about food. If your child is hungry but only wants mac and cheese for breakfast, lunch, and dinner –they’re a picky eater, but could still benefit from intervention. 

On the contrary, Kelly explains, “A child with feeding difficulties, or ARFID, is more than likely cutting out full food groups, shows extreme rigidness towards food presentation, and lacking in nutritional intake.” 

In Ella’s case, she was always a fairly picky kid, but the biggest concern was when she began to refuse her favorite meals like mac and cheese and lasagna. 

“Not only was she not eating a high enough quantity of food, but the variety of what she ate whittled down to nothing,” Carolyn explains.

Behavioral Signs of ARFID
Picky eating is common in children, but ARFID is a more serious condition. Here are some behavioral signs to look out for. 

• Lack of interest in food or eating
• Avoidance based on the sensory characteristics of food
• Significant weight loss (or failure to achieve expected weight gain or faltering growth in children)
• Significant nutritional deficiencies
• The child’s food refusal is significantly impacting the entire family

If your child begins struggling with eating, first see if it’s a medical concern (sick or growth change). If it’s not an illness or other medical issue and it persists for a few months, seek out feeding therapy. 

In Ella’s case, Carolyn saw her daughter’s weight go from a normal range to dangerously low, and she became malnourished. 

“This affected her physically but also mentally and socially. She became too anxious to be in the school cafeteria and ultimately needed to be admitted to the hospital for treatment,” Carolyn says. 

Steps to Help a Child with ARFID
While Ella was in the hospital, she was being treated as if she had an eating disorder, but ARFID is a feeding disorder. The nursing staff tried things like “You need to eat this meal within 30 minutes,” but none of the hospital’s approaches worked. 

Eventually, Ella was taken to Focused Approach, where she tried the Applied Behavioral Analysis Program (ABA). When Ella started the program, she was getting most of her nutrition from a feeding tube. By the end of the six-week program, she was eating more than 2,500 calories a day. 

By going through the treatment, Carolyn now knows the best way to help her daughter. Carolyn shares that Ella is doing extremely well, and she dreams of becoming a veterinarian when she grows up because she loves animals. 

Each child is unique, and treatment will look different. It’s important to reach out for help if your child is severely struggling with eating. 

“Feeding therapy is hard work, but it isn’t scary, and families will usually say they learn so much to improve interactions with their child across the board, not just at mealtime,” Kelly shares. 

“The word therapy is often paired with a stigma that families struggle to associate with, but there are so many benefits to accessing the services.”

Helping a Picky Eater
If your child is just a picky eater, set reasonable expectations when it comes to meal proportion. It can also help to explain to children why eating a certain food is important. Popeye the Sailor Man got big muscles from eating spinach!

Kelly also suggests avoiding constant snacking throughout the day so the child is hungry when mealtime swings around.  

“Keep track of their preferences and food refusal. If you notice it is getting worse, it may be time to seek help,” Kelly adds. 

Myth Buster
Again, ARFID is not an eating disorder like Anorexia Nervosa or Bulimia Nervosa. Eating disorders tend to be stemmed from body dysmorphia or body dissatisfaction. ARFID, on the other hand, can be triggered by phobias, anxiety, and sensory issues. ARFID is also common in people who have Autism. 

If your child is struggling with eating food, whether it’s a picky eater who’s gotten significantly worse or someone who is struggling with their body image, reach out for help. The sooner parents seek out help, the better. 

“We did not expect this much progress so quickly, but this ABA-focused approach has done wonders,” Carolyn shares. “It’s what we’re most thankful for this year – the gift of quality time with our daughter with as few stressors/anxiety as we’ve all had in a long time.”