When you need more support

Most children go through stages of being cautious with food. A small percentage of children in Australia (around 2-3%) experience longer–lasting food refusal or reluctance to eat. You may want to seek extra support if feeding challenges cause ongoing stress or worry for parents/carers, are impacting family mealtimes, or are affecting a child’s growth or nutrition. 

The PICNIC team can help guide you to the right support. 

 A GP appointment is often a good place to start a conversation about your concerns. Some feeding challenges may need further assessment from health professionals such as dietitians, speech therapists, psychologists, or occupational therapists.

When you may benefit from more feeding support  

Your child may benefit from more feeding support if:  

• Your child has a very limited range of foods, for example, accepts less than around 30 foods or avoids entire nutrition groups e.g. vegetables, or dairy and calcium alternatives. 
• Limited food variety is affecting growth or nutrition. 
• Mealtimes involve significant stress or behaviour challenges for the child or family. 
• A medical condition or feeding skill difficulty is limiting intake.
• Sensory sensitivities, such as texture, smell, or appearance are strongly restricting food intake. 

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Feeding disorders in children 

Some feeding disorders can impact nutrition, growth, and family life. These include Paediatric Feeding Disorder (PFD) and Avoidant/Restrictive Food Intake Disorder (ARFID). Features of these conditions may overlap with feeding challenges commonly seen in autistic children. 

Paediatric Feeding Disorder (PFD) 

Paediatric Feeding Disorder (PFD) is when a child can’t eat or drink enough to meet their nutritional needs, usually involving refusal or reluctance to eat, or leaving the table. It most often causes poor growth. It may be short term (less 3 months) or ongoing (more than 3 months).  

PFD usually involves challenges in one or more areas: 

• Medical: conditions that make eating difficult or uncomfortable, e.g. reflux, allergies, gastrointestinal issues, breathing or heart conditions.  

• Nutritional: intake that doesn’t meet needs, e.g. poor weight gain, nutrient deficiencies, reliance on supplements. 

• Feeding skills: difficulties with sucking, chewing, swallowing, or managing textures. 

• Psychosocial: stress or behavioural challenges for the child or family around feeding.  

Management often involves a team approach, which may include dietitians, speech therapists, psychologists, occupational therapists, and feeding specialists.  

Avoidant Restrictive Food Intake Disorder (ARFID) 

ARFID is a mental health, eating disorder where restrictive or avoidant eating is not related to weight or body image concerns, but related to anticipatory anxiety. Children under the age of 3 years would not be diagnosed with ARFID. Food restriction may be due to: 

• Low appetite or lack of interest in food 

• Sensory sensitivities or avoidance (e.g. texture, smell, appearance). 

• Fear of unpleasant experiences related to eating (e.g. choking, vomiting). 

ARFID can lead to poor growth, weight loss, malnutrition, and sometimes reliance on nutritional supplements. It can cause significant challenges during family mealtimes. Assessment and management usually involves a team approach, with a psychologist involved in diagnosis. 

Feeding challenges in Autistic Children 

Feeding challenges are common in autistic children, and may include:  

• Extreme food selectivity (often based on texture, colour, or brand) 

• Strong sensory sensitivities to taste, smell, or texture 

• Rigid mealtime routines and resistance to change 

• Behavioural challenges such as refusal, distress or tantrums 

While not all autistic children meet criteria for PFD or ARFID, many experience overlapping feeding challenges and benefit from individualised, supportive approaches. 

Contact us

If you would like to talk further about the need for extra feeding support, please go to our contact page 

References