Welcome to The Visible Embryo
Home-- -History-- -Bibliography- -Pregnancy Timeline- --Prescription Drugs in Pregnancy- -- Pregnancy Calculator- --Female Reproductive System- -Contact
Welcome to The Visible Embryo, a comprehensive educational resource on human development from conception to birth.

The Visible Embryo provides visual references for changes in fetal development throughout pregnancy and can be navigated via fetal development or maternal changes.

The National Institutes of Child Health and Human Development awarded Phase I and Phase II Small Business Innovative Research Grants to develop The Visible Embryo. Initally designed to evaluate the internet as a teaching tool for first year medical students, The Visible Embryo is linked to over 600 educational institutions and is viewed by more than one million visitors each month.

Today, The Visible Embryo is linked to over 600 educational institutions and is viewed by more than 1 million visitors each month. The field of early embryology has grown to include the identification of the stem cell as not only critical to organogenesis in the embryo, but equally critical to organ function and repair in the adult human. The identification and understanding of genetic malfunction, inflammatory responses, and the progression in chronic disease, begins with a grounding in primary cellular and systemic functions manifested in the study of the early embryo.

WHO International Clinical Trials Registry Platform

The World Health Organization (WHO) has created a new Web site to help researchers, doctors and
patients obtain reliable information on high-quality clinical trials. Now you can go to one website and search all registers to identify clinical trial research underway around the world!




Pregnancy Timeline

Prescription Drug Effects on Pregnancy

Pregnancy Calculator

Female Reproductive System

Contact The Visible Embryo

News Alerts Archive

Disclaimer: The Visible Embryo web site is provided for your general information only. The information contained on this site should not be treated as a substitute for medical, legal or other professional advice. Neither is The Visible Embryo responsible or liable for the contents of any websites of third parties which are listed on this site.
Content protected under a Creative Commons License.

No dirivative works may be made or used for commercial purposes.


Pregnancy Timeline by SemestersFetal liver is producing blood cellsHead may position into pelvisBrain convolutions beginFull TermWhite fat begins to be madeWhite fat begins to be madeHead may position into pelvisImmune system beginningImmune system beginningPeriod of rapid brain growthBrain convolutions beginLungs begin to produce surfactantSensory brain waves begin to activateSensory brain waves begin to activateInner Ear Bones HardenBone marrow starts making blood cellsBone marrow starts making blood cellsBrown fat surrounds lymphatic systemFetal sexual organs visibleFinger and toe prints appearFinger and toe prints appearHeartbeat can be detectedHeartbeat can be detectedBasic Brain Structure in PlaceThe Appearance of SomitesFirst Detectable Brain WavesA Four Chambered HeartBeginning Cerebral HemispheresFemale Reproductive SystemEnd of Embryonic PeriodEnd of Embryonic PeriodFirst Thin Layer of Skin AppearsThird TrimesterSecond TrimesterFirst TrimesterFertilizationDevelopmental Timeline
CLICK ON weeks 0 - 40 and follow along every 2 weeks of fetal development

Google Search artcles published since 2007

Home | Pregnancy Timeline | News Alerts |News Archive Jun 29, 2015 

There is a new diagnosis — Avoidant/Restrictive Food Intake Disorder (ARFID).
A disorder many parents experience and fear, but should they?




Picky eaters — a serious problem for some

Eating disorders experts weigh in on Avoidant/Restrictive Food Intake Disorder — two years after classification as a mental health condition

Jessie is a five-year-old girl who doesn't like foods with much texture or flavor. She prefers to eat foods that don't require lots of chewing, like soup, pasta, or oatmeal. Jessie has difficulty eating a range of foods and her mother struggles daily with getting her to consume the nutrients she needs to grow and thrive. Jessie is the smallest child in her class and has been severely underweight for two years.

Jason is a 10-year-old boy who was not a picky eater at all, until he nearly choked on a hot dog eight months ago. The hot dog dislodged and he did not require medical attention immediately after the incident. However, since that day Jason has been reluctant to eat out of fear of choking. He refuses most foods most of the time, but occasionally accepts milk, yogurt and soft cheeses. He has not gained weight since the incident, and with puberty looming ahead, his parents are growing more concerned by the day.

For years, doctors did not have the necessary tools to diagnose children like Jessie and Jason. Did they have "traditional" eating disorders like anorexia nervosa? No, because they did not have distorted body image or a desire to lose weight.

In May 2013, a new eating disorder emerged in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) a psychiatric diagnostic tool used across North America. The diagnosis of Avoidant-Restrictive Food Intake Disorder (ARFID).

Now, two years later, a new commentary by experts from The Hospital for Sick Children (SickKids) and the Children's Hospital of Eastern Ontario (CHEO) reflects on the clinical impact of ARFID, and the work that remains in terms of treatments and improved outcomes. The commentary is published in the June 18 online edition of the Journal of Adolescent Health.

The classification of ARFID expanded upon a previous diagnostic category of Feeding Disorder of Infancy or Early Childhood, which was rarely used or studied. ARFID is described as substantial restrictions or challenges with food intake, associated with weight loss or lack of expected weight gain in the context of significant physiological and/or psychosocial distress. Drs. Katzman and Norris have led or participated in a variety of studies on the diagnosis since its introduction and are planning future studies in the area as well.

"ARFID is not just about picky eating - it's a very challenging diagnostic category in the DSM-5. These kids have complexity, and this condition persists for long periods of time and requires treatment to address both the medical and psychosocial aspects of the condition. If left untreated, children and teens may be left with serious, long-term complications."

Dr. Debra Katzman, staff physician in the Eating Disorders program and Senior Associate Scientist at The Hospital for SickKids, and publication coauthor.

In addition to the physiological impairments caused by the disorder, there are serious social implications, especially for teens, whose social interactions are often centred around food. "For those teens who are unable to go out to eat pizza with their friends, the condition can be socially limiting," says Katzman, who is also Professor of Paediatrics at the University of Toronto.

"Parents have a significant role in identifying unhealthy patterns in their child," says coauthor Dr. Mark Norris, Adolescent Health Physician and Associate Professor of Paediatrics within the Department of Pediatrics at CHEO. "Concerned parents should talk to their child's paediatrician or family doctor early on, rather than letting the problem persist for months or even years."

It is also critical, he explains, that clinicians on the front-lines and in eating disorders programs alike become more familiar with the diagnosis, so that the depth and range of eating difficulties among children, teens and adults can be further studied. In tandem, eating disorders specialists are working to assess outcomes and evaluate the effectiveness of different interventions.

To evaluate the DSM-5 diagnosis of Avoidant/Restrictive Food Intake Disorder (ARFID) in children and adolescents with poor eating not associated with body image concerns.

A retrospective case-control study of 8–18-year-olds, using a diagnostic algorithm, compared all cases with ARFID presenting to seven adolescent-medicine eating disorder programs in 2010 to a randomly selected sample with anorexia nervosa (AN) and bulimia nervosa (BN). Demographic and clinical information were recorded.

Of 712 individuals studied, 98 (13.8%) met ARFID criteria. Patients with ARFID were younger than those with AN (n = 98) or BN (n = 66), (12.9 vs. 15.6 vs. 16.5 years), had longer durations of illness (33.3 vs. 14.5 vs. 23.5 months), were more likely to be male (29% vs. 15% vs. 6%), and had a percent median body weight intermediate between those with AN or BN (86.5 vs. 81.0 and 107.5). Patients with ARFID included those with selective (picky) eating since early childhood (28.7%); generalized anxiety (21.4%); gastrointestinal symptoms (19.4%); a history of vomiting/choking (13.2%); and food allergies (4.1%). Patients with ARFID were more likely to have a comorbid medical condition (55% vs. 10% vs. 11%) or anxiety disorder (58% vs. 35% vs. 33%) and were less likely to have a mood disorder (19% vs. 31% vs. 58%).

Patients with ARFID were demographically and clinically distinct from those with AN or BN. They were significantly underweight with a longer duration of illness and had a greater likelihood of comorbid medical and/or psychiatric symptoms.

ARFID is typically associated with other medical and psychiatric conditions, often including gastrointestinal conditions like inflammatory bowel disease, as well as anxiety disorders.
The average time to diagnosis is 33 months.
A higher proportion of diagnoses are made in boys than in anorexia nervosa; however, like most eating disorders, ARFID is more common in girls overall (70 per cent girls vs. 30 per cent boys).

Without treatment, ARFID can cause a wide range of complications, including nutritional problems like iron-deficiency anemia and low bone-mineral density; delayed pubertal development; and problems with overall growth and development.
Treatment protocols are still being developed, but current treatment includes outpatient family counseling, as well as exposure therapy, in which new foods are slowly and carefully introduced to the child, with appropriate supports in place.
About 13 per cent of the patients seen in paediatric tertiary-care centres with eating disorders programs, like SickKids, are now diagnosed with ARFID.
About The Hospital for Sick Children

The Hospital for Sick Children (SickKids) is recognized as one of the world's foremost paediatric health-care institutions and is Canada's leading centre dedicated to advancing children's health through the integration of patient care, research and education. Founded in 1875 and affiliated with the University of Toronto, SickKids is one of Canada's most research-intensive hospitals and has generated discoveries that have helped children globally. Its mission is to provide the best in complex and specialized family-centred care; pioneer scientific and clinical advancements; share expertise; foster an academic environment that nurtures health-care professionals; and champion an accessible, comprehensive and sustainable child health system. SickKids is proud of its vision for Healthier Children. A Better World. For more information, please visit http://www.sickkids.ca.

About the CHEO Research Institute
The CHEO Research Institute coordinates the research activities of the Children's Hospital of Eastern Ontario (CHEO) and is affiliated with the University of Ottawa. Its three programs of research include molecular biomedicine, health information technology, and evidence to practice research. Key themes include cancer, diabetes, obesity, mental health, emergency medicine, musculoskeletal health, electronic health information and privacy, and genetics of rare disease. The CHEO Research Institute makes discoveries today for healthier kids tomorrow. For more information, visit http://www.cheori.org or @CHEOhospital

Return to top of page