Dr. Goday gave our group a great lecture on pediatric feeding disorders. I’ve included many of his slides along with some of my notes. There may be errors in omission and transcription on my part.

Differences between picky eating, pediatric feeding disorder, and ARFID

• 70% of picky eating is inherited.
• If there are sequelae from picky eating, this indicates that the child has a pediatric feeding disorder.  There are 4 potential domains to pediatric feeding disorders: medical dysfunction, feeding skills dysfunction, nutritional dysfunction and psychosocial dysfunction (this is more subjective than other domains)
• Pediatric feeding disorder (PFD) is a better term than “behavior” feeding disorder because many children have underlying contributing disorders like eosinophilic esophagitis (EoE) or aspiration/swallow dysfunction
• ARFID is a diagnosis used by psychologists. It is when purely psychosocial concerns leads to nutrition dysfunction. The diagnosis is likely best used in older children who are mostly neurotypical and have normal development.  In younger children, it is important to assess for underlying disorders like oromotor discoordination and EoE

Strategies to prevent picky eating:

• Breastfeeding (varied tastes in breastmilk)
• Responsive feeding (feeding when hungry)
• Solids [lumpy] (especially 6-9 months)
• Multiple-varied exposures
• Prevention/treatment: Praise at meal times, non-food rewards, Ellyn Satter’s advice (parents decide when, where, and what is offered & child decides how much

Increased risk of developing picky eating: FPIES, multiple allergies

Related blog posts:

• Food Selectivity in Children with Autism
• Mel Heyman: Past, Present and Future of ARFID
• Highly Prevalent Pediatric Feeding Disorders
• Data on Bridles -They Work!
• Fundamentals of Gastrostomy Tubes
• Impact of NG Feeding Program for NICU Graduates
• N2U -Part 2: Poor Growth and Short Bowel Syndrome

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