Stephanie posted about a client with low potassium levels and anemia,
nursing a 2 year old a few times a day, and "her diet is not good, (skips a
lot of meals because she is 'busy'").

I would suggest that this client may actually have an eating disorder that
she has not discussed with her physician.  Low potassium (hypokalemia) does
not occur with a basic poor diet.  It occurs with frequent vomiting like
that with Bulimia.  It is also common for bulimics to alternate between
rigid dieting/deprivation (her "skipping meals because she is busy), and
binging and purging.  A client struggling with bulimia may be of normal or
above normal body weight so, unlike anorexia, may not be something obvious
to ask about.
This client would be waving a red flag for me, to be screened for both an
eating disorder and depression.  If present, behavioral or cognitive
therapy and/or certain antidepressants (compatible with BF), will help this
woman when she is ready to seek help.

Good luck.
Nancy
Nancy Holtzman RN BSN IBCLC
Great Beginnings New Mothers Groups &
Boston Breastfeeds!
64 Ledge Hill
West Roxbury MA 02132
617.323.9977
http://www.great-beginnings.com/group.html

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