Avoidant/Restrictive Food Intake Disorder (ARFID) is a feeding disorder that limits how much food a person eats and can cause poor growth and development in children.
When your child has ARFID, learning what to feed them can be overwhelming. If your child only eats a handful of foods or avoids whole food groups, identifying their “safe foods” and using higher calorie food options are some ways to support their physical and mental development.
Unsure if your child has ARFID? Use the PSA-Eat to see if your child has indicators for ARFID.
Understanding “safe foods” in ARFID
“Safe foods” are foods that your child willingly eats without a struggle.
For children with ARFID, safe foods are essential for both nutrition and reducing mealtime stress. (1) They are the foods your child can reliably eat, helping them get consistent calories and nutrients even if variety is limited. Having at least one familiar food on the plate can lower anxiety and help your child feel calmer at meals. When kids feel calm and well fed, they can become more open to slowly trying new foods and building variety over time.
If you are unsure on how to expand your child’s safe foods, start by looking for patterns in the foods they already eat. Do they prefer crunchy foods or smooth ones? Warm foods or cold? Bland flavors? A specific brand? Even the way a food looks can matter.
These clues can help you find new foods with similar textures, temperatures or flavors that your child may be more willing to try. As your child adds more “safe” options to their list, their diet can slowly expand, making it easier to meet their nutritional needs while building confidence and comfort around food.
Read more: How to Treat ARFID in Children: A Parent-Friendly Guide
What foods are sensory-friendly for ARFID?
Some children with ARFID avoid certain foods due to sensory sensitivities. (2) As mentioned above, safe foods can be based on sensory properties of food.
Here are some examples of foods categorized by their sensory properties:
- Crunchy: crackers, pretzels, dry fortified cereals.
- Smooth: yogurt, applesauce, pudding, mashed potatoes.
- Dry foods: plain pasta, white rice, toast.
High-calorie foods for children with ARFID (3)
Children with some types of ARFID often eat less than needed to support proper growth and brain development.
Parents can learn how to increase calorie intake through serving higher calorie foods or adding in calorie boosters to food.
Which foods have the highest calories in each food group?
- Highest calorie fruits: bananas, mangoes, grapes, avocados, dried fruits.
- Highest calorie vegetables: potatoes, sweet potatoes, corn, peas, fried vegetables.
- Highest calorie protein foods: full-fat yogurts, whole milk, cheeses, breaded chicken nuggets, chicken with skin, fatty fish (e.g. salmon or tuna), marbled red meats, eggs scrambled or fried in oil or butter.
- High calorie additions: oils, butter, full-fat dairy (heavy cream or half & half added to sauces, cereals, etc.), ground nuts and nut butters, ranch, sour cream, ketchup, sweeteners.
Learn more about how to add calories to your child’s food.
When a child can not meet all of their nutrient needs through regular food, oral nutritional supplements can also be helpful.
Foods for possible nutrient deficiencies
ARFID can lead some children to restrict their food intake and sometimes whole food groups. Some children with ARFID may eat less meat, protein foods and vegetables, leading to concerns for low iron and protein. (4)
Protein sources
If your child is low on protein foods, you might try a high-protein version of bread or bagels, protein granola bars and Greek yogurt. You can also try blending cottage cheese into pasta sauce for some extra protein!
Iron sources
If your child’s diet is low on iron, you might try iron-fortified dried cereals or grains, nut butters on toast, or adding beans or hummus to meals for added iron. Make sure to pair the iron-rich foods with vitamin C foods. If your child likes fruits, pairing fruits like oranges or strawberries (high in vitamin C) with iron-rich foods increases iron absorption. If they don’t like fruits, you can try juice or another food fortified with vitamin C.
Vegetables
If your child does not eat or like traditional vegetables, try serving them in a different way. You might try freeze-dried veggies, potatoes, corn or beans, a great source of fiber and iron. You can also try cooked frozen vegetables which have a different texture than fresh vegetables and may be better tolerated by your child.
If your child won’t eat vegetables, to help them meet their vitamin and mineral needs, you can try adding more fruits to meals and snacks. Fruits can be added to smoothies and yogurt parfaits, or served by themselves as sides to meals. If your child doesn’t like fruits because they’re wet, there are also dried or freeze-dried versions of many fruits.
Learn more about ARFID and nutritional deficiencies here.
Feeding your child with ARFID
We work with families who have kids who have ARFID and extreme picky eating and we know how hard it is. ARFID is unique to each child, and you know what your child likes and what they don’t like. By varying the foods they already like or adding calorie boosts to their foods, you can help your child with ARFID get enough calories and the nutrients they need. You’re doing great.
If you’re wondering if your child has indicators of ARFID or extreme picky eating, take the PSA-Eat.
References
1. Białek-Dratwa A, Szymańska D, Grajek M, Krupa-Kotara K, Szczepańska E, Kowalski O. ARFID-Strategies for Dietary Management in Children. Nutrients. 2022;14(9):1739. Published 2022 Apr 22. doi:10.3390/nu14091739
2. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.).https://doi.org/10.1176/appi.books.9780890425596
3. Society for Adolescent Health and Medicine. Medical Management of Restrictive Eating Disorders in Adolescents and Young Adults. J Adolesc Health. 2022;71(5):648-654. doi:10.1016/j.jadohealth.2022.08.0064.Taylor CM, Northstone K, Wernimont SM, Emmett PM. Macro- and micronutrient intakes in picky eaters: a cause for concern?. Am J Clin Nutr. 2016;104(6):1647-1656. doi:10.3945/ajcn.116.137356
