When I hear parents talking about how they stamped out fussy eating in their children, it makes me smile.
It used to hurt. In the days where I’d search the internet for tips and solutions. When I’d ask myself where we went wrong. Before I realised our problems were much more deep-rooted than the typical fussy eating that is typical of all young children.
Perhaps it’s difficult to understand severe selective eating until you’ve lived with it. Briefly alluding to my son’s struggles with food would be met with “Oh I know, my child is terrible with food sometimes. She refuses to eat X Y and Z at home but she always eats everything at nursery!”
Of course all children go through fussy stages, especially in the toddler/preschool stage. It’s a classic pushing the boundaries exercise. But this is not what I’m talking about. What we have experience with selective eating is far from the same. ARFID is an eating disorder.
Selective Eating Disorder, or ARFID
Selective Eating Disorder, now known as ARFID (Avoidant/Restrictive Food Intake Disorder), is much more complex and has nothing to do with a child trying to be difficult. I am 100% sure that my son is not trying to cause us grief at meal times. In fact, I know he would like nothing more than to make things easy for us and to be able to try new things without fear.
His issues are rooted in anxiety. In short, he is afraid of what happens when he tries something new and doesn’t like it. He is so afraid, that it prevents him from trying it. I’m not just talking healthy green things that we all strive to get our children to eat, I’m talking about a new flavour of ice cream or a different texture on a biscuit. Even if, logically, he can see that it’s made up of all the things he loves (caramel, chocolate), he won’t touch it if he’s not sure. Even if there’s nothing else to eat and even if he really wants it.
It is about fear. Not fussiness.
The problem of selective eating exacerbates itself because after a while of eating a predominantly restricted diet, taste buds become dulled, and new foods tried can often be alarmingly strong or sharp in taste.
My son has a small list of bland, beige foods that he will eat. At the point in childhood when most fussy eating is resolving itself, his list is getting smaller, and he will be nine next month.
At two and three years old, he was more willing to eat and had more safe foods than he does now. He used to love pizza. Now he won’t touch it. If he can’t remember how something tastes, he won’t touch it. He no longer eats pasta sauces or sauces of any kind, so “hidden veg” is virtually impossible. As a result of his selective diet, he can pick up on seemingly imperceptible changes to his usual meals, so “hidden veg” means I lose his trust, and we wind up with another food type he won’t touch.
My son doesn’t eat any fruit or vegetables, despite his insistence that potato is a vegetable and therefore the healthiest thing that he eats. The only fresh, non-processed food that he eats is egg (in omelette form. Plain). He doesn’t eat meat… unless chicken nuggets count.
When he was younger, I couldn’t ever imagine a point where I will ever be able to leave him alone at a friend’s party because the unknowns about the food serve, and the etiquette if he doesn’t like something, was / still is a constant worry for him and would often ends in tears, even when I was there to guide him through it.
Now that he is almost nine, he has found his own ways to cope with party food, but it is still a big source of anxiety for him leading up to an event. This school year, he has his first residential trip coming up. An overnight stay. A full year ahead of this trip, he has already voiced his worry to me about what he will eat, and not wanting to be noticed for being different.
Between the ages of two and five, we spent a great deal of time experimenting with all sorts of ways to get him to eat. I’ve sat with him at the table for hours. Offered all sorts of bribes, including ones I could never deliver on because I was getting desperate and at the same time realising that he just wasn’t going to do it anyway.
“I will get Andy from Andy’s Dinosaur Adventures, THE Andy, to come to this house, if you eat one spoon of that bolognaise”.
We all laughed at the silliness of that trade off – even my son himself could see the funny side that time. The impossibility of it all. But when he says “Mum, I will never ever eat this”. I believe him. It took me a good few years to get there, but I believe him now, and we do not battle over food any more.
He wants to eat more. He realises that he’s getting a rough deal when everyone around him is getting a treat. But even if he really wants to try the treat, he can’t if he’s unsure of it.
I have two other children, both are much more typical eaters. A protest about eating can be dispelled with a bit of encouragement. They have foods they like sometimes and at other times don’t. If they refuse to eat, they will eat later when hungry enough. My son with ARFID will starve himself and get very distressed about it, because in his head, it’s the only option he’s been left with, and no one is helping him. “They will eat when they get hungry” is not something that works in people with ARFID.
Imagine if someone put a plate of bugs in front of you and expected you to eat it. The hesitation and repulsion you feel is akin to how someone with ARFID feels when presented with an “unsafe” food.
If I just had the experiences of my two typical eaters to go by, I would probably be one of those parents congratulating myself on the success of my child’s eating. Instead, I have learnt the hard way that “fussy eating” is not the parent’s fault. Same weaning process, same parents, same food on offer and same food routines. And yet one child has an eating disorder that is not a result of anything I did or didn’t do. If you have a child that willingly eats a varied diet, the credit 100% deserves to go to them. If you have a child that is suffering with food anxiety and selective eating, you should not be blamed or shamed.
I actually hate the term “Fussy eating”. Being picky with food is a normal and expected developmental phase that occurs in the early years. ARFID is a much more serious physiological condition. It doesn’t go away with time. And yet is consistently gets lumped in under the umbrella term of fussy eating.
ARFID is often talked about as something shocking. “Extreme fussy eating”. More shame and guilt heaped upon parents of children with ARFID, who have tried everything possible. More shame and guilt for sufferers of ARFID who already know they should be eating better for the sake of their health, but physically cannot do it. Calling ARFID “fussy eating” draws attention away from a greater understanding of ARFID. ARFID is an eating disorder that needs a lot more attention, research, resources, and support.
The reason I don’t talk much about my son’s eating issues, is because people tend to either not understand that I’m not taking about “fussy eating”, or the immediate reaction is to baulk in surprise.
“No fruit or vegetables?? AT ALL??”
Take note – if someone tells you their child won’t eat fruit or veg, please try not to react like this, however surprising that fact is to you. The parent will already be aware of how serious a predicament this is, and will likely have tried everything they can to change matters. It is a highly emotive matter, we all want the best for our children, and reactions like this only make the matter all the more distressing for us parents.
The future with my son’s eating lies uncertain. It’s clear at this point that this is not a phase. These issues aren’t going away. He currently sees a dietitian at the hospital, although this is mainly a monitoring process where they check his weight and the foods he is eating, but do not offer any psychological support or therapy to help him eat a wider variety of foods. This is an area of support for ARFID that is distinctly lacking, particularly if you cannot go private.
My son has packed lunches at school, the same meal every single day. In the infants, this affected him socially as pretty much all his class mates opted for the free school meal and he was usually the sole person from his class on the packed lunch table. I worry about what he will do for food on school trips later in life, and what happens as he becomes more and more aware that his eating is “other”.
These days, I’ve moved on from feeling hurt by people thinking “fussy eating” is all down to the parent’s approach. I’ve stopped searching for the missing miracle thing that I did or didn’t do to make him like this. If I simply didn’t try hard enough to ensure he grew up eating a balanced diet, surely the theory would follow that my younger two children would also have become selective eaters. But they didn’t. So I can finally accept that it isn’t MY fault. Nothing I did or didn’t do would change the fact that my son has an eating disorder; ARFID.
These days, my main concern is trying not to create any further unnecessary anxiety around food for my son, and to make sure that he doesn’t feel excluded at social gatherings focused around food. To make sure he never feels like his eating issues are a huge barrier. To make sure he feels he can socialise around food rather than excluding himself, cutting himself off.
So, at mealtimes, parties and BBQs at home and when eating away from home, there will always be “safe” foods available. There will be no pressure to clear his plate or to try anything new. No food rewards or withholding of treats. No conversations designed to induce guilt.
I want him to hear me when I say “I believe you when you say you won’t eat this”. I want him to know that I am there to help him and not try to control him. I want him to know that no matter what, we support him, and we won’t push him. His trust is the most important thing to me, and also the only tool that I believe will be of use whenever the time comes that he does decide he wants to try something new.
And should he decide one day that he is ready to try a new food or drink, we are right here to help and to take things at his own pace.