ARFID In Children With Autism PANS And PANDAS
Avoidant/Restrictive Food Intake Disorder (ARFID) is a type of eating disorder characterized by a persistent failure to meet appropriate nutritional and/or energy needs. Individuals with ARFID may fear certain foods or strongly dislike certain textures and may also experience weight loss or nutritional deficiencies. It is more common in children with autism, PANS, and PANDAS.
ARFID is a serious condition that can significantly impact a child’s growth and development. It is important to seek medical and nutritional support as soon as possible to help manage the condition and ensure that the child receives the appropriate care.
Top 5 tips for dealing with a child with ARFID from a medical and nutritional perspective:
- Work with a team of healthcare professionals. A child with ARFID should be evaluated and treated by a team of healthcare professionals, including a paediatrician, a registered Nutritional Therapist or dietitian, and a mental health professional. This team can work together to develop a treatment plan that addresses the child’s physical and emotional needs.
- Ensure that you address health issues such as acid reflux, impaction in the colon from backed-up stool, constipation, tongue tie, food allergies, coeliac disease, IBD (inflammatory Bowel Disease), environmental toxins such as mould, and underlying infections such as streptococcal infection, viral infections like EBV, or Lyme and co-infections.
- Encourage small, incremental changes. Children with ARFID may be resistant to trying new foods or expanding their food intake. It is important to start small and encourage the child to make incremental changes to their diet. This can be done through exposure therapy, where the child is gradually exposed to the feared food over time.
- Provide consistent and structured meals. Children with ARFID may benefit from a consistent and structured meal routine. This can help them feel more in control and less anxious about eating. It is also important to provide a variety of food options and to involve the child in meal planning and preparation.
- Address underlying emotional issues. Children with ARFID may have underlying emotional issues contributing to their eating disorders. It is important to address these issues through therapy and counselling and to provide support and encouragement for the child to work through their feelings.
Top 5 Things to Avoid when Dealing with a Child with ARFID:
- Pressure or forcing the child to try new foods or expand their intake. This can lead to increased anxiety and resistance.
- Ignoring or minimizing the child’s feelings or concerns about food.
- Using food as a reward or punishment.
- Making meal times a source of conflict or stress.
- Neglecting to seek professional help and support from healthcare professionals.
Top 10 supplements that may be beneficial for a child with ARFID:
- Multivitamin: to ensure adequate intake of essential vitamins and minerals
- Omega-3 fatty acids: for brain and heart health
- Probiotics: to support gut health and digestion
- Vitamin D: for bone health and immunity
- Vitamin B12: for energy metabolism and nervous system function
- Iron: for oxygen transport and immunity
- Zinc: for immune function and wound healing
- Calcium: for bone health
- Protein powder: to support muscle growth and repair
- Prebiotic supplements like psyllium husk, inulin, FOS, mucilage (a type of soluble fibre derived from various plants’ seeds, roots, and leaves), and resistant starches from rice, potatoes, green bananas, legumes (beans and lentils).
It’s important to note that supplements should be used in addition to, not as a replacement for, a balanced diet. A child with ARFID should work with a Registered Nutritional Therapist or dietitian to create a personalised meal plan that provides adequate nutrition. And also, it’s important to consult a qualified professional or your doctor before giving any supplement to a child.
ARFID is a complex condition that requires a multidisciplinary approach and an individualized treatment plan. By working with a team of healthcare professionals, encouraging small changes, providing consistent and structured meals, addressing underlying emotional issues, and monitoring the child’s growth and development, parents and caregivers can help a child with ARFID manage their condition and improve their overall well-being.
PRO TIP: Cooking and then cooling down rice, pasta, and potatoes can increase their resistant starch levels by up to sixteen times, even if they are reheated before consumption!
- American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Arlington, VA: American Psychiatric Publishing.
- Lock, J., Le Grange, D., Agras, W.S., Moye, A., Bryson, S.W., Jo, B., & Kraemer, H.C. (2016). The Academy for Eating Disorders position paper: Eating disorders are serious mental illnesses. International Journal of Eating Disorders, 49(3), 187–193.
- National Institute of Mental Health (NIMH). (2022). Eating Disorders: About More Than Food. Available online: https://www.nimh.nih.gov/health/topics/eating-disorders/index.shtml
- American Academy of Pediatrics. (2021). Pediatric Feeding and Swallowing: From Basic Science to Clinical Practice. Available online: https://www.aap.org/en-us/about-the-aap/aap-press-room/pages