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Selective Eating and ARFID

 

Please see the following link for definition: https://www.nationaleatingdisorders.org/learn/by-eating-disorder/arfid


There is no commissioned service for Avoidant Restrictive Food Intake Disorder (ARFID) in Cornwall.


RCHT does not accept referrals to the (Community or General) Paediatric or Dietetic service for ARFID assessment or management.


Management:

Restricted eating is common in many children, including those on the Autistic spectrum. The level of restriction often goes way beyond “fussy eating”.  

  • Growth should be monitored by the GP practice, supporting the parents to do home measurement where able.
  • The child should have a multivitamin and mineral preparation. There are a variety of different ones from liquids to chewy types.  Help the parent to find one their child will take.
  • Constipation and Reflux are more common and treating them will often help.
  • Further Dietetic advice on selective eating and information, and how to refer to dietetics can be found on the following page: Paediatric Dietetics

 

Referral:

RCHT Therapies Paediatric Dietetic Service will accept referrals for children with confirmed Faltering Growth or evidence of significant nutritional deficiencyas a result of ARFID. See Paediatric Dietetics for how to refer.

 

The Community Dietitian for Disabled Children will ONLY see children (referral up to age of 18 or until end of year 14 for those in Special Schools) with selective eating under the following conditions:

  1. The child has a confirmed neurodevelopmental disorder (please send confirmation of diagnosis)
     
  2. AND where the range of foods eaten is extremely limited (less than 10 individual foods)
     
  3. AND where there is evidence of under-nutrition/ weight faltering (iron deficiency/ blood tests for deficiency.)

 

Any referral must provide copies of centile charts or serial weights/heights to assess growth, as well as evidence of types/textures and number of foods eaten. Referrals will be rejected if the essential information is not provided

 

Paediatricians and GPs can make direct written referrals. All other referrals need to be made on the Dietetic Referral Form. Essential information is to be included in the referral, for the referral to be processed.

 

Referrals will be rejected in the absence of faltering growth and/or evidence of nutritional deficiencies.

 

 

 

Contributors: Dr Jo Lewis, Consultant Community Paediatrician, RCHT

            Dr S Burns, RMS GP lead paediatrics

 

Date:               March 2022

Review Date: March 2023

 

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