Feeding Disorders in Children: From Clinical Care to Courtroom Evidence

Feeding disorders in children are complex

Not every child who refuses broccoli has a feeding disorder. But for some families, mealtimes are a battleground, with children refusing whole food groups, struggling with textures, or relying on tube feeding.

Feeding disorders are complex, often misunderstood, and sometimes mishandled — which can spill into medico-legal disputes. Here’s what parents, clinicians, and solicitors need to know.

Not every food refusal is a feeding disorder

What Are Feeding Disorders?

• ARFID (Avoidant/Restrictive Food Intake Disorder): Severe food restriction without body image concerns.

• Feeding difficulties in medical conditions: Cleft palate, neurological impairment, prematurity.

• Tube dependency: Children unable to transition to oral feeding.

Clinical Pathways for Management

• Comprehensive assessment: medical, nutritional, psychological, sensory.

• Involvement of MDT: dietitian, speech & language therapist, psychologist.

• Gradual exposure and behavioural therapies for ARFID.

• Nutrition support plans to prevent malnutrition.

Medico-Legal Context

Feeding disorders can cross into law when:

• Tube feeding is delayed or mismanaged.

• Feeding difficulties are dismissed as “fussy eating.”

• Lack of multidisciplinary care leads to malnutrition or growth faltering.

• Educational settings fail to provide safe feeding environments.

Case Example

A child with ARFID was repeatedly dismissed as “just fussy.” No dietetic referral was made despite dropping two centiles. By the time help was sought, the child required tube feeding. In legal review, the lack of timely referral and assessment was considered negligent.

Role of the Dietitian in Courtroom Evidence

• Reviewing feeding histories, growth data, MDT records.

• Establishing whether care met accepted standards.

• Advising on causation — did delayed management cause measurable harm?

• Providing expert testimony on safe feeding protocols.

FAQs

Is ARFID the same as anorexia? No — ARFID is not driven by body image or dysmorphia, but by fear, sensory issues, or medical trauma.

Can children recover from feeding disorders? Yes — with early, multidisciplinary intervention.

Why is this relevant legally? Because delayed or inappropriate management can result in severe harm, including tube dependency and growth failure.

Closing Thought

Feeding disorders are more than “picky eating.” They require careful, evidence-based intervention. When care fails, families suffer — and sometimes, the law must intervene.