I've had a couple of Mums online, who had serious eating issues.  A 
couple of pointers I've used in general discussion of factors, raised 
alarm bells.  One was the reaction to the questions as to what types of 
fats they were ingesting.  Both mothers reacted to this as if I'd asked 
how much toxic waste they were consuming, and when discussed further, 
one revealed her diet was totally fat free (as it had been during her 
pregnancy).  The other was practically fat free.  She was also consuming 
vast amounts of water per day - presumably to fill herself up.   The 
water one is quite easy to raise, as you can enquire if they are 
drinking enough, and then aim to find out how much that is.

Both were asking for help on green poo and the normal run of answers 
hadn't helped at all. 

So I'd suggest trying a talk round on what she's eating, on a general 
basis of "Fats in are important for brain development, what sort of fats 
are you taking in?" and this will often allow discussion of volumes of 
fats (she should be having at least 30% of her daily calories from good 
fats - most of us struggle to keep it down to that!).   Likewise, how 
much water is 'enough' and you can discover it's too much. 

One anecdotal thing I've noticed is that mothers with eating issues 
often fixate on their diet being 'healthy' - as in, I can't take in any 
fat, as fat isn't in a healthy balanced diet.  So counters on taking in 
required nutrition based on 'that's not healthy' can also be a red 
flag.  But given how we have a culture wide problem with food, this is a 
difficult thing to describe as a flag - on some level, everyone of us 
will react to a discussion on 'healthy' food.

Morgan Gallagher

LuAnn Smith wrote:
> Dear Wise Ones,
>
> Wondering if any of you have worked with moms who have an eating 
> disorder severe enough to impact a baby's weight gain and if so, what 
> symptoms did you see in both mom and/or  baby and how did you come to 
> suspect and then realize that this was the case? My hunch is that I 
> have such a mom as a client and am looking for more insight on how to 
> tease out that info and to work with her to have a thriving breastfed 
> baby.
>
> LuAnn Smith RN, BSN, IBCLC
> York, PA

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