Gail,
A similar question arose recently in a nearby facility. Baby born early,
probably due to maternal health issues secondary to anorexia, and mom wanted
to breastfeed. Neonatologist was not impressed with parent's lack of
grasping of baby's fragility, and wondering whether mom could make enough
milk.

That was not my biggest concern, however.  Though I've had previously
anorexic moms come through my practice, they've been "recovered" and knew
both to feed themselves and their babies. The big issue with a mom who is
currently anorexic is how she will perceive her baby's appearance and
growth. Some of these moms have limited feeds because the baby was "getting
too fat," a projection of mother's own fears. If such a mother wanted to
breastfeed, I think that it would be prudent for baby's HCP to be notified,
and weekly [mandatory] weight checks scheduled.

One of the nurses working with our local mom commented that dad was a bit
heavy himself, and mom seemed ok with that. To me that is a red flag,
though-- she cannot control HIS eating, but she sure can control the
baby's---- and since active anorexia involves dysfunctional thinking, we
cannot overlook the fact that baby could become an unwitting victim of
momma's pathology.

Lisa Marasco, IBCLC

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