With mom 2 weeks post-partum, I would strongly suspect some PPD as a factor
in the exacerbation of her bulimic symptoms, and would get a GOOD psychiatric
consult ASAP. Once the acute symptoms are under a bit more control as the PPD
is treated, she will be less distressed and more able to deal with baby
and/or lactation issues.

Unlike anorexia, bulimia is rarely life-threatening, although it certainly
can make its sufferers miserable.  Unless she is purging to the point of
frank dehydration(You probably need to find out how and how often she is
purging)milk quality /volume is unlikely to be the major issue in lactation.
The ability to interpret feeding cues and to respond appropriately is more
likely to be a factor.  Remember, this is a mom who is unable to interpret
and respond appropriately to her own hunger cues.     Binging usually follows
a period of mom attempting to ignore her (reasonable) hunger.  Additionally,
any PPD also compromises her ability to be a responsive parent.

On the plus side, learning to respond to baby's hunger  cues can be a healing
 experience for a mom with an eating disorder.

Good luck with this case.

Karen Kavesh in Philadelphia

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