Introduction. Feeding difficulties range from avoidance of single foods/food groups to avoidant restrictive food intake disorder (ARFID), an eating disorder recognised since 2013. Whilst 20 % of healthy young children experience periods of food refusal, the prevalence increases dramatically in children with food allergies. In non IgE-mediated food allergies 40% of parents report feeding difficulties, whlst in eosinophilic oesophagitis maladaptive eating occurs in 90%. In IgE-mediated allergy less data is available, but clinical experience indicates that issues like aversive eating are common. ARFID is also increasingly recognised in food allergic children. The origin of feeding difficulties in the food allergic population can be multifactorial, including a negative association with feeding due to discomfort and pain, the restrictive diet and the parental modelling imposed by the elimination diet itself, faltering growth, food modelling from the parents and increased anxiety related to accidental exposure and possible reactions.This impact on feeding/eating behaviour can have long-lasting nutritional, dietetic and psycho-social consequences beyond childhood. Most healthcare professionals working in food allergy see children with feeding difficulties. However, no clinical guidelines exist on the assessment and management specific to food allergy. Also, little is known about the resources available to address this problem across Europe.  Aim. This multidisciplinary Task Force (TF) proposes to review the literature on the evidence on feeding  difficulties in children with food allergy, perform a survey amongst EAACI healthcare professionals and parents on their real-life perspectives and resources in this area, and most importantly, develop a practical guideline on  its diagnosis and management. Expected impact. This TF output will help improve our understanding of feeding difficulties in children with food allergies, provide a guideline to inform best practice and identify unmet needs in this area.

Pediatrics Section

Chair: Rosan Meyer
Secretary: Marta Vazquez-Ortiz