Dear Lactnet,
One of the mothers who attends our local LLL meeting just called me in regard
to her sister, living in another state, who is anorexic.  The anorexic mother
has three children, ages five, three, and 5 weeks.  She nursed her first two
children, both until about a year, but the second never gained well until
solid foods were introduced.  Both children are healthy.
The mother eats less than one meal a day.  She is continuing to take her
prenatal vitamins and believes this means she is getting the nutrition she
needs.  Her sister has read that even malnourished mothers can breastfeed
their babies, but wonders how much this mother's lack of nutrition affects
her milk.  The doctor on the case is very supportive of breastfeeding, but
may not be aware that the mother is currently anorexic.  Her infant was born
weighing 6 pounds 11 ounces.  By three weeks, at the last doctor visit, baby
weighed in at 6 pounds 13 ounces, having regained birthweight plus 2 ounces.
Now, at 5 weeks, baby weighs just 7 pounds--a gain of only 3 ounces in two
weeks!  The doctor is not due to see this baby again until May 30!
Because I am getting all this information second hand, I don't know all the
particulars.  The sister says this baby is nursing for 45 minutes at a time,
on one breast only.  The mother has an inverted nipple on the other breast,
which she is pumping.  She has collected and frozen over 200 ounces of breast
milk.  The sister says the mother lays the baby across her lap and leans over
to nurse.  She doesn't hold the baby during nursing (at least not when the
sisters were together), but is always doing something else with her hands.
 These are undoubtedly some very strange circumstances!  What is going on
with all the pumping and collecting?  Why this distancing from her baby?  At
the very least, I would venture to say that there may not be very good milk
transfer in the across-the-lap position!
The sister, our League mom, is well read about anorexia and about the basics
of breastfeeding.  She is currently breastfeeding her second child.  I
reinforced her understanding that normal weight gain for a breastfed baby is
4 to 8 ounces per week during the first six months.  I reinforced her belief
that this baby is not gaining adequately and must be seen by a doctor as soon
as possible.  I offered to gather for her some information about anorexic
mothers breastfeeding.
What do you Lactnetters make of this situation?
Upset for this concerned sister,
Diane Dressler, LLLL in Rutland, Vermont