Heather,

Discussions often expand past original posts, and don't have to depend 
on everything the previous person has said to make points.  :-)

The information about the crucial nature of fats in infant development 
is both standard, and uncontested.  As is the dynamic that mothers must 
ingest adequate fats in order to produce fats in her breastmilk.  No 
studies could possibly take place in order to examine the effect of 
nutritional deficit in human milk with mothers with severe eating 
disorders, as it would be unethical to conduct them.

In terms of conception, the level of control that a women in the grip of 
a severe eating disorder has over her body, is immense, and it would not 
rule out deliberate and consistent raising of nutrition levels, and 
weight, in order to achieve conception.  (Which would then be dropped 
again in order to control weight gain in pregnancy).   Such control can 
also be employed to maintain lactation when it would normally fail.  
This point is another comparison between women in nutritional deficit 
due to disaster, as opposed to severe illness, and is again, not a 
useful comparison to make.  That is the whole of my point: that to 
compare the two is not at all useful, even as a general rule of thumb: 
there aren't that many common features. 

Anne's excellent post about the work of Dr. Patricia McVeagh outlines 
far more than I could have touched on, and I'm sure it goes a long way 
in answering LuAnn's original question. 

And lest you feel I'm once more misunderstanding you... :-), my point 
here is to make room for the concept that a woman in the grip of a 
severe eating disorders _may_ indeed be harming her child's development 
from sustained lack in her breastmilk.  To assume that all harm to the 
infant is from behaviour, is an assumption we can't afford to make.  The 
sheer level of control women can exhibit (such as the example of pumping 
to control the content of expressed milk given to the baby) means we can 
essentially, assume nothing.  Levels of extreme control exist in order 
to allow the woman to manipulate both her body, and the infant's.  We 
need to take that level of control on board, and not assume all is well 
nutritionally with the breastfed baby of a mother well capable of  using 
the whole of medical science to help her achieve the dictates of her 
illness.

As an aside, I have actually witnessed a severely anorexic mother raise 
a severely anorexic baby.  At 18 months, the 'baby' was about 11 pounds, 
unable to walk was in 3-6 months clothes, with head control and ability 
to sit up right, but lacking most other motor skills.  (She was carried 
in her mothers arms, and never set foot on the floor.)  When fed by the 
professionals who had the family in psychiatric care, the little girl 
would stick her fingers down her throat and vomit.  What her mother had 
started, she was determined to maintain. But the damage wrought to her 
health by starvation would not ever likely be remedied when the 
behaviour was addressed.   Assuming that level of damage may not be 
being inflicted, as the mother is breastfeeding, is not an assumption 
I'm comfortable with.  Thankfully, such cases are rare.

Morgan Gallagher



heather wrote:
> Morgan,  while you make some interesting points, I think you have 
> misunderstood what  I was saying. I wasn't saying that women who have 
> eating disorders are *the same* nutritionally as women in an emergency 
> food situation, though I would think they have some common features 
> with women in longer-term deprived circumstances.  I was saying that  
> the biological evidence that an eating disorder of itself would affect 
> the adequacy of the breast milk is scant - though if there is any 
> research that isolates this aspect from the behavioural aspects, then 
> it would make an interesting study.
>
> I wonder, too, if the fact that the mother with the eating disorder 
> has achieved conception brings her into a category above the very 
> worst affected.
>

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