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'They're Refusing': Some Australian Children Aren't Eating In Fear Of Coronavirus

As a parent of a child with a restricted diet, I've been on the receiving end of a number of raised eyebrows.

My youngest son lived entirely on sausages, chips, chicken nuggets, fish fingers and two-minute noodles -- with any of those foods likely to fall off the menu at a whim, further restricting his already limited diet.

“You know what you need to do, don’t you?” a previous manger of mine said when I told her about my son.

“Stop buying those things. No child is going to starve. When he gets hungry, he’ll eat what’s available.”

I’ve heard various iterations of this, ranging from well-meaning advice from concerned friends and family, to downright nasty comments insinuating my son is a spoiled brat who just gets given what he wants.

But neither of those things is true. My youngest simply has a severely restricted diet.

Yet given he doesn’t even eat bread, school lunches are a nightmare and I live in fear of lunchbox shaming and welfare concerns for the child with a lunchbox devoid of colourful fruits, vegetables or even a Vegemite sandwich.

It's for this reason the recent panic-buying of food and other grocery items in the midst of the COVID-19 outbreak impacts families battling food issues in children more than most people might realise.

While many are just grabbing what they can, I've been looking in despair at the empty pasta aisle, wondering if my son is going to be able to eat because the one specific brand and style of pasta he eats is gone.

Kelly James has found it difficult to find food for her son who has a restricted diet. Image: Supplied

Fortunately, kind friends, family and co-workers who knew about our problems grabbed a few packets of penne when they saw it so we're okay for now, but a lot of families with these kids will be struggling through this period.

We’ve made numerous attempts to improve the situation over many years, to no avail and we’ve now realised that this is beyond our capabilities and it’s time for expert help.

People who haven’t experienced this issue like to dismiss kids with restricted food intake as naughty, fussy or spoiled.

But these issues are being recognised more and more among the medical community as legitimate disorders which require intensive treatment, often both physically and psychologically.

The difference between 'fussy eating' and restricted eating

Dr Brooke Harcourt is a paediatric and maternal dietitian and feeding therapist at Sensational Kids in Melbourne. Speaking to 10 daily, she said there is a lot more to kids’ problematic eating than them being “fussy” or just not liking certain foods.

Her goal is to teach kids how to eat different foods they might be avoiding and reintroduce foods if they’ve started to exclude things from their diet or if they have physical reasons why they’re not eating certain things.

And according to Dr Harcourt, the family environment can play a big role in restrictive eating in kids.

“Sometimes what determines how restrictive a child might get with foods is how the parents might respond to them being fussy,” she said.

True fussiness is often fixed by not telling kids what to eat and rather having a family dinner environment where foods are offered and we stop giving negative attention -- which can be taken positively by children.

"We should concentrate on talking about our own food and how we eat it, the process of eating it and leaving them to learn or pick up or become engaged in foods without the prompting."

Giving children the mental space around foods instead of closing them off for them in our language is really important, according to Dr Harcourt.

When it's more than just fussy eating

One commonly diagnosed eating disorder in young children is Avoidant Restrictive Food Intake Disorder or ARFID. Although there’s a good chance you’ve never heard of it, Dr Harcourt said it’s not a new condition, but rather a new name for an existing condition.

“With the update to the DSM, ARFID got its name and a higher recognition of the contribution it was making towards children choosing when, where and what they eat. It acknowledges that it’s an avoidance of food without the intention to lose weight or change how they looked; that it was avoiding foods for other reasons,” she said.

“So it’s not sitting under your Bulimia or Anorexia Nervosa umbrellas, but it’s definitely an unhealthy avoidance of food. It co-localises quite often with anxieties and other distressing conditions and trauma -- physical or emotional -- or changes in environment and it is exacerbated in times of stress."

The impact of coronavirus on eating in children

Dr Harcourt said the impact of stress and anxiety on children who exhibit disordered eating patterns is particularly apparent at the beginning of the school year, when she frequently sees an influx of new patients.

This year, she said it has been busier as a result of triggering stories in the media -- and in the home -- about coronavirus or COVID-19.

“I’ve got children at the moment that are refusing to eat food that may or may not have come from China because of the media,” she said.

They’re looking for Chinese writing on packets and refusing to eat those sorts of foods. They might be worried about germs and whether other people breathed on their food and therefore given them germs.

“These are children under 10-years-old. They are listening and I think we need to be responsible with what we’re doing with that.”

Diagnosis of ARFID

When it comes to diagnosing a child with ARFID, Dr Harcourt said there are a range of factors to consider and ARFID doesn’t have a number benchmark for the amount or variety of foods a child eats.

“I’ve got children that’ll eat, but it might be that they don’t eat enough foods. ARFID could also be that they were worried about vomiting and therefore they restrict the amount that they eat," she said.

"It could be that they were told earlier on in life that ‘this is how much food you eat’ and they’ve never updated that to associate with their changing size."

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Dr Harcourt said a lot children with developmental conditions can be quite rigid in their thinking and you need to be careful about how you deliver messages.

"They may not have updated that they need to eat for their size or they do a lot of peer comparisons and what peers are or aren’t eating or ideas about what health is and restrict for those reasons," she said.

"It could be that ARFID is 20 foods but it’s the idea of why they’re restricting to that amount of foods around it.”

Encouraging healthy relationships with food

Ultimately, the healthiest relationship you can encourage your children to have with food is for it to just be food, rather than obsessing over its health properties and feeling guilty about them eating certain things.

“Food should not be a reward, it should not be a punishment and it should not be for boredom," Dr Harcourt said.

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Unfortunately, kids with problematic eating and disorders such as ARFID don’t tend to just 'grow out of it' and often need more intensive, active therapy to learn about foods and how to eat.

“We actively have to work towards eating certain foods and children need to be involved in the process too," Dr Harcourt said.

"It doesn’t really work if these foods are hidden -- they need to involved in making them, buying them, putting them away or all those other levels of exposure that aren’t just sitting at a table and putting that food in your mouth."

Once you know what you’re dealing with as a parent, you can take the next steps to establishing a healthier relationship with food for your child and often by extension, the whole family.

Featured image: Getty