Feeding Disorder of Infancy or Childhood

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KEY POINTS

• Feeding disorder of infancy or childhood is when an infant or a child refuses to eat enough to be healthy. It is not due to a medical condition such as a stomach problem.
• The first step is usually to increase the number of calories your child eats. This may be done with high-calorie formula or other special foods and liquids. If symptoms are severe, your child may need to be treated in the hospital.
• Changing when and how often your child is fed, the texture of foods, or the position of your child’s body while feeding may help.

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What is feeding disorder of infancy or early childhood?

Feeding disorder of infancy or early childhood is when an infant or a child refuses to eat enough to be healthy. It is not due to a medical condition such as a stomach problem. As a result, the infant or child does not gain weight normally. This problem is also called avoidant/restrictive food intake disorder (ARFID).

Children with ARFID who are not treated may get very sick and even die. Children with ARFID who are treated early are more likely to avoid serious eating disorders in adulthood.

What is the cause?

The exact cause of ARFID is not known. The risk is greater for children who are:

• Born prematurely or had a low birth weight
• Developmentally delayed
• Fed too much or not fed when they are hungry
• Abused or neglected

Children who have choked on a food may also restrict what they eat due to fear that they cannot swallow it.

What are the symptoms?

If symptoms last for at least a month, your child may have ARFID. Symptoms may include:

• Eating only a few foods or refusing to eat solid foods or liquids
• Irritability and crying
• Temper tantrums during meals
• Weight loss or failure to gain weight and grow normally
• Choking or vomiting when eating
• Trouble swallowing some food textures

How is it diagnosed?

Your healthcare provider will ask about your child's symptoms and medical history and examine your child. Your child may have tests to check for other possible causes of symptoms, such as problems with the nervous system, stomach, or intestines.

If your child is an infant, a trained specialist, usually a nurse, will watch you feed your infant.

How is it treated?

The first step is usually to increase the number of calories your child eats. This may be done with high-calorie formula or other special foods and liquids. It is important to make sure that your child gets all needed nutrients for healthy growth.

If symptoms are severe, your child may need to be treated in the hospital. Treatment usually involves a team approach. The team may include healthcare providers, a dietitian, a social worker, and a behavior specialist. Your child may need to be fed through an IV (a tube placed in a vein) or an NG tube (a tube placed through the nose into the stomach) until he or she can eat normally.

Changing when and how often your child is fed, the texture of foods, or the position of your child’s body while feeding may help. Do not try to force your child to eat or punish your child for not eating.

Your child may need therapy to help change how she thinks about herself and food. Cognitive behavior therapy (CBT) is a way to help your child identify and change views she has of herself, the world, and the future. CBT can make your child aware of unhealthy ways of thinking. It can also help her learn new thought and behavior patterns.

How can I take care of my child?

Follow the full course of treatment prescribed by your child’s healthcare provider. Ask your provider:

• How and when you will get your child’s test results
• How long it will take your child to recover
• If there are activities your child should avoid and when your child can return to normal activities
• How to take care of your child at home
• What symptoms or problems you should watch for and what to do if your child has them

Make sure you know when your child should come back for a checkup. Keep all appointments for provider visits or tests.