Pregnancy and Eating Disorders

If you have or have had an eating disorder, a planned or unplanned pregnancy will have a big impact on your life. Words: Steve Bloomfield: Head of media and communications, Eating Disorders Association.

For a number of reasons the pregnancy, birth and the time after the birth are likely to be very challenging. Worry and even guilt about the effect of an eating disorder on your unborn baby is quite usual, indeed every mother-to-be has concerns and worries during pregnancy.

As amenorrhoea (not having periods) is part of the definition of anorexia nervosa, you are unlikely to be acutely anorexic at the time you became pregnant, nevertheless the impact of pregnancy may prove difficult to deal with. Bulimia nervosa is less likely to have an impact on conception and you may find your symptoms diminish, some people find they don’t return after the birth. However maintaining healthy eating patterns without bingeing or purging will be vitally important to ensure your own and the baby’s health.

To grow a healthy baby you will have to gain a significant amount of weight, 10-13 kilos (22-28 lbs).  This may be emotionally exhausting, particularly as you experience the ‘normal’ side effects of pregnancy such as vomiting, bloating, fatigue and breast enlargement. The weight gained by the baby during the third trimester (the last three months of pregnancy) can make this a particularly difficult time. Being weighed is an important part of monitoring the progress of your pregnancy, you may find it is helpful if you don’t look at the scales and ask the person weighing you not to read out the weight. Don’t be afraid of discussing your concerns about weight and body image as otherwise the medical team may not clearly understand your worries.

Healthy eating ‘for two’ is important and there is a serious risk to the baby if the mother does not eat appropriately. Many people do find that pregnancy allows them to eat a healthy diet and that they begin to recover from their eating disorder, for a few this may even lead to over-eating which can bring other complications, particularly high blood pressure. You may find you are prescribed additional vitamin, mineral and nutrient supplements. Keeping fluid intake high is important, you may benefit by drinking fruit juice, but plain water is perfect to achieve proper fluid levels.

Having antenatal carers who understand the problems you may experience is important, so do be honest about the issues you may have around food. If you have not discussed your eating problems with your GP you should do so now as otherwise they may not be able to detect potential problems or give you appropriate advice.  Your midwife, the health visitor and the obstetrician will be better able to support you and your baby properly if they know about your eating disorder. It is possible that you will be referred to an eating disorders specialist who will be able to work with the other medical staff supporting you and provide them with specialist medical information and advice. As your diet will be very important, you should also be prepared to ask for nutritional advice from a dietician or nutritionist if it is not offered to you.

If you have associated drug or alcohol dependency you must discuss this with the team looking after you, as this can have a serious impact on the health of your baby. If you are currently receiving prescribed medication including antidepressants you do need to talk to your doctor or consultant about your treatment during pregnancy. Some forms of medication are safe, however a few should not be taken during pregnancy. It is important to follow the doctors’ advice, just stopping your medication may do more harm than good.

Your partner may be better able to help you if they can share your feelings and concerns and be involved with the medical team who are looking after you. If you don’t have a long-term partner think about confiding in a friend or relative you trust so that they can support you when you need it

You may find your doctor wants you to spend some time in hospital prior to the baby being born. This is fairly common even with ‘normal’ pregnancies as you may experience temporary anaemia, your blood pressure may fluctuate or perhaps you just need some bed rest away from other pressures at home.

While ‘breast is best’ is as true today as it was in grandmother’s day, some people do find difficulties with breastfeeding because of a lack of understanding, confidence or discomfort in the first few days. Inverted nipples, sore nipples, and engorgement are not generally seen as a serious problem and may be overcome with the help of a breast feeding counsellor from the National Childbirth Trust, LeLeche League (contact details below) or your health visitor. They will be happy to talk about any anxieties you may have before, or after the birth.

Many people are worried about a low birth weight, but research shows that during infancy, low weight babies tend to catch up with average birth weight infants.

After the baby is born, a healthy diet for both of you will help baby develop properly, and you cope with this new, wonderful but very demanding small person. Sometimes a baby does not gain weight at the expected rate.  This ‘Failure to thrive’ or ‘Faltering Growth’ can be due to a number of different reasons and your health visitor or GP should be the first people to discuss your concerns with.  The Children’s Society (contact details below) have information about Faltering Growth which you may find helpful.

Many women experience ‘the baby blues’ in the early days after birth, however there does not seem to be any clear evidence that an eating disorder is more likely to lead to post natal depression, nevertheless many women are affected by it after the birth of their baby. Your GP and Health Visitor will be able to provide help and support for you and your partner if you find you do feel the effects of depression.

For some people pregnancy with or without an eating disorder can be fraught with problems, but for many many more it is a liberating and exciting time.

Organisations which may be useful:
National Childbirth Trust, for help with pre and postnatal and Breastfeeding advice. Alexandra House, Oldham terrace, London, W3 6NH   Tel 0208 992 8637

LaLeche League (for help with Breastfeeding)   Tel 0207 242 1278

The Children’s Society, Edward Rudolph House, Margery St,  London, WC1  Tel: 0207 841 4436

Eating Disorders Association
First Floor, Wensum House, 103  Prince of Wales Road, Norwich, NR1 1DW
Helpline:   0845 634 1414   Monday-Friday,  8:30am - 8:30pm    Saturdays  1:00pm - 4:30pm
e-mail:  info@edauk.com      Website:  www.edauk.com  © 2000/2003