Parental feeding strategies in children with Avoidant/Restrictive Food Intake Disorder (ARFID): Association with food refusal behavior

Avoidance/Restriction of Food Intake Disorder (ARFID) is characterized by persistent avoidance and/or restriction of food intake, with three clinical presentations: lack of interest in food, selectivity based on sensory sensitivity, and fear of aversive consequences. The strategies used by parents during mealtimes may predispose or maintain the child's food refusal.OBJECTIVEto determine the associa tion between parental strategies used during mealtimes and food refusal behavior in ARFID children.PATIENTS AND METHODCross-sectional research. Non-probabilistic sampling was used for the selec tion of participants. Twenty-four parents whose children had been diagnosed with ARFID participa ted. ARFID subtypes were considered according to DSM-5 criteria: limited appetite, selective eating and fear of eating. Exclusion criteria were ARFID of organic cause and/or pervasive developmental disorders. The Child Eating Behaviors Questionnaire and the Child Feeding Questionnaire were used for data collection.RESULTSAn association was evidenced between the parental eating strategy of pressure to eat with food refusal behavior, and with child eating behaviors of emotional underfeeding (p = 0.046), slowness to eat (p = 0.016), refusal in front of food (p = 0.019) and satiety response (p = 0.003).CONCLUSIONEating behaviors frequently perceived by parents with children diagnosed with ARFID are related to the dimension of negative approach towards food, such as satiety response, food refusal, slowness to eat and emotional underfeeding.