Anorexic mothers as parents

A patient who is improving may conceive despite having a suboptimal weight and still not menstruating. (81) A mother may also develop the illness after having borne children. In a series of eight mothers, nine out of 13 of their children suffered from food deprivation, identified by reductions in weight for age and in height for age as shown on Tanner-Whitehouse charts.(96) The anorexic mothers had no intention of abusing the children and indeed were affectionate towards them. They adopted different ways to ration their children's food intake according to their age. They might prolong breast feeding, dilute the bottle feeds, reduce the amount of food available in the home, confine eating to meal times, forbid the consumption of sweets, and prevent others giving them food. The privation of the children resulted from the anorexic mothers' abnormal concern with body size being extended to their children. An important part of the management was the recognition of the children at risk through tactful enquiries. A whole-family approach should be adopted, focusing on the children's needs for food. The children should be followed up to ensure that they gain weight and catch-up growth is established.(96)

Similar findings have been described by other authors.(83) An elegant observational method has been applied to mothers found to have an eating disorder during the postnatal year.(9Z> They were video recorded while feeding their 1-year-old infants. In comparison with controls, infants of these mothers were found to be lighter, with the weight being inversely related to both the amount of conflict during meal times and the mother's concern about her own shape. The mother's concern about her body shape led her to want a thinner child.

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