If you have a child who eats a very small range of foods or has ARFID, mealtimes can become stressful for everyone.

You may worry about whether they are getting enough nutrition, feel frustrated when they refuse foods, or wonder whether you should be encouraging them to try more. Your child may also be experiencing something very different: anxiety, sensory discomfort, gut discomfort, fear of choking or vomiting, a lack of interest in eating, or simply finding unfamiliar foods incredibly difficult.

For some children, selective eating is part of normal development. For others, food restriction can be significant enough to meet the criteria for Avoidant/Restrictive Food Intake Disorder (ARFID).

Regardless of where your child sits on that spectrum, one principle can be incredibly helpful:

Parents decide what, when and where food is offered. Children decide whether they eat and how much.

This doesn’t mean leaving your child to manage their nutrition independently. It means creating a predictable environment where food is available without making eating a battle.

What does “parents decide, children decide” actually mean?

More info here & image credit: https://www.ellynsatterinstitute.org/how-to-feed/division-of-responsibility/

Parents and carers are responsible for providing regular opportunities to eat.

This generally means deciding:

• What foods are offered
• When meals and snacks are offered
• Where eating happens

Your child then has some control over:

• Whether they eat
• How much they eat

For example, you might offer dinner at the table with a familiar food alongside the family meal. Your child may choose to eat the familiar food, try some of the new food, eat a small amount, or not eat much at all.

The goal is to think about your role as providing opportunities for eating and learning about food, while allowing your child to retain some control over their eating.

This can be particularly important for children with ARFID, where perceived pressure to eat can increase anxiety and make food feel even less safe.

Start with foods your child already accepts

When we’re trying to expand a very limited diet, jumping straight from a “safe” food to a completely unfamiliar food can be too big a step.

This is where food chaining can be useful.

Food chaining involves gradually connecting foods that share characteristics such as taste, texture, appearance, temperature, brand or shape.

For example, for a child who only eats one particular brand of chicken nuggets, you might gradually explore:

Preferred chicken nugget → different shape of the same nugget → another brand → crumbed chicken strips → panko chicken → plain chicken

The exact chain will be different for every child.

The important part is that you are looking for very small steps rather than one giant leap.

Food chaining doesn’t have to mean eating the new food straight away either. A child might initially tolerate having it on the table, then on their plate, then touching it, smelling it, licking it, taking a tiny bite and eventually eating a larger amount.

These steps can take a very long time.

Think “tiny steps”, not “just try it”

A common expectation is:

“They need to try it.”

But for a child experiencing significant food anxiety or sensory sensitivity, even interacting with an unfamiliar food can be a meaningful step.

Progress might look like:

• Allowing a new food to sit on the table
• Having it on their own plate
• Touching it
• Smelling it
• Cutting it
• Taking it out of its packaging
• Preparing it for the family
• Licking it
• Taking a tiny bite and spitting it out

What about nutrition in ARFID?

This is where a dietitian can be particularly helpful. Expanding food variety is important, and parents are acutely aware that nutrition shouldn’t be forgotten while you’re working on variety.

A dietitian can assess your child’s current intake and look at whether they are getting enough:

• Energy
• Protein
• Iron
• Fibre (particularly important for prevention & management of faecal loading)
• Vitamins and minerals
• Fluids
• Other nutrients relevant to their individual needs

Sometimes a child with a very restricted diet can meet their nutritional needs from a surprisingly small range of foods, and sometimes a child needs supplementation to help them meet their requirements while they experiment & explore increasing their variety.

For some children with ARFID, supplements can provide important nutritional support while they work on expanding their diet.

Depending on the child’s individual situation, a dietitian may recommend practical ways to increase the nutritional value of accepted foods, adjust meal and snack patterns, introduce foods through food chaining, or use fortified foods or nutritional supplements when needed.

You don’t have to choose between nutrition and reducing pressure

Parents can sometimes feel caught between two worries:

“If I don’t make them eat, they’ll never try anything.”

and

“If I pressure them, I’m making their anxiety worse.”

This can make it particularly stressful and hard for parents to stay within their window of tolerance but there is another option:

You can continue offering opportunities for learning and eating while reducing pressure to consume.

You might say:

“You don’t have to eat it.

Or:

“I don’t mind whether you eat it or not.”

Simply having the food within reach and available is doing your job with offering the food. Food acceptance is a very slow process which builds confidence & trust with time.

Building flexibility beyond food in ARFID

For some children with ARFID, increasing flexibility around food works best when flexibility is practised in other areas of life too. This can be an easier route to take, especially where PDA is involved.

If change is difficult generally, suddenly expecting major changes to food can be overwhelming.

Look for small, low-stakes opportunities to practise flexibility.

For example:

Change small things in routines such as:

• Taking a slightly different route to school
• Sitting in a different chair
• Changing the order of two activities
• Using a different cup occasionally

Practise flexible thinking helps ARFID

Instead of:

“I can’t do it that way.”

Try:

“That’s one way. What is another way?”

Or:

“We don’t know if we’ll like it yet. We can be curious.”

The goal isn’t to make your child comfortable with every change.

It’s to gradually build the message:

“I can cope when things don’t happen exactly the way I expected.”

That skill can eventually become useful around food too.

And don’t forget self-compassion

Supporting a child with ARFID or significant selective eating can be exhausting for both you and your child/children.

There can be enormous pressure on parents to get food “right”, particularly when you’re worried about nutrition, growth or your child’s health.

Try to remember that you are not failing because your child finds eating difficult.

You can care deeply about your child’s nutrition and still feel frustrated.

You can know that pressure isn’t helpful and still occasionally lose your patience.

You can wish things were easier and still be a loving, supportive parent.

Self-compassion might look like:

• Taking a break when mealtimes become overwhelming
• Sharing the responsibility with another trusted adult
• Choosing a simple meal rather than making something complicated
• Reminding yourself that one difficult meal doesn’t determine your child’s health & wellbeing
• Speaking to yourself in the same way you would speak to another parent or friend in your situation
• Celebrating small improvements rather than focusing only on foods your child still can’t eat
• Asking for professional support when you’re struggling

And importantly, self-compassion applies to the person with ARFID too.

A child who is struggling with food doesn’t need to feel that they are “bad”, “fussy”, “difficult” or disappointing their parents.

“Food is hard for me sometimes, and I’m learning how to manage it.”

There is no perfect ARFID journey

Occasionally, children will expand their diets quickly but most may take months or years to make meaningful changes.

Some foods may become accepted and then disappear again.

Some days your child may be adventurous and other days they may return to their safest foods – that doesn’t necessarily mean you’ve gone backwards.

Food intake can change with illness, tiredness, stress, sensory overload, changes in routine and many other factors.

Moving the goal posts to supporting your child to have adequate nutrition, a safe and manageable relationship with food, and gradually increasing flexibility where possible.

You don’t have to do it alone, a dietitian experienced in selective eating and ARFID can help you work out what your child needs nutritionally, identify realistic opportunities to expand their diet, use food chaining appropriately, and consider nutritional supplementation when required. Learn more about our team.

Most importantly, you can support food exploration without turning every meal into a battle. We talk more about rigid thinking here.

Sometimes the most valuable step forward isn’t getting a child to eat a new food.

It’s helping them feel safe enough to keep learning about food.

Want to talk? Book an appointment.