Motherhood and Eating Disorders:
Information for clients and carers
Women with eating problems may find it harder to get pregnant, particularly if they are
underweight. The majority of women with an eating disorder who do get pregnant
experience a normal pregnancy. However, eating disorder symptoms or a past history
of an eating disorder can present physical and psychological issues throughout the
different stages of pregnancy and motherhood. It is important to access help early on.
Getting pregnant
Never assume that losing your periods means that you are not fertile. If you are
sexually active, you should use appropriate contraception until you decide to try for a
baby. Ideally you should achieve a healthy weight before trying to conceive. Getting
back to healthy eating and a healthy weight will maximise your fertility, and gives you
and your baby the best chance of being healthy. It is recommended that all women take
folic acid for 3 months before getting pregnant. This is particularly important for women
who have had an eating problem and are therefore more at risk of vitamin deficiencies.
You should also try to tackle psychological issues about weight, shape and food before
pregnancy and get appropriate treatment for symptoms of depression and anxiety. This
will help you to cope better with the challenges of pregnancy and motherhood.
Occasionally antidepressant medication can be a helpful part of treatment for people
with eating disorders and/or depression. If you want to get pregnant, plan ahead and
discuss your medication with your doctor. If you are taking antidepressants and
discover that you are pregnant, you should not stop them suddenly, but seek advice
from your GP or psychiatrist immediately. It may be OK to stop, or it might be best
continue taking them. This decision should be made with a specialist.
Pregnancy
In the early stages of pregnancy, we recommend that you let your GP know as soon as
possible. You should also let your eating disorders specialist know if you are still having
treatment. They should help you to put together a care plan that ensures you get help
and support with eating, weight and psychological issues if and when you need them.
This care plan can go in your maternity notes.
Women with past or present symptoms of anorexia tend to have smaller babies and are
also more likely to have their baby early. Babies that are born small are more likely to
become overweight in adulthood. You can minimise these risks by ensuring that you
are at a normal weight when you get pregnant and by not smoking during pregnancy. It
is normal to gain 10-12 kg in weight during pregnancy. If you were underweight when
you got pregnant, you will need to gain more than that to maximise your health and the
health of your baby. If you were underweight when you got pregnant, or are slow to
gain weight through the pregnancy, you may need extra ultrasound scans to monitor
the growth of your baby. It is important to get help from the obstetric (maternity) team
early in pregnancy.
About half of women of child bearing age are overweight. A BMI of over 30kg/m2
increases the risks to mother and baby. However, dieting during pregnancy is not
recommended. Additional monitoring from the obstetric team is recommended.
In the general population about three out of ten pregnancies end in miscarriage. Past or
current symptoms of bulimia can increase this risk of miscarriage. It is likely that a
period of being well before pregnancy will reduce this risk. If you do experience a
miscarriage, don’t despair and don’t blame yourself. Miscarriage is very common and
most women go on to have a healthy child.
Some mothers experience a reduction in eating disorder symptoms during pregnancy;
others find that the physical changes in pregnancy increase anxieties about weight and
shape. Eating disorder symptoms often come back, or get worse after having a baby.
Post natal depression is also common in mothers who have had an eating disorder. If
you feel blue, speak to your health visitor or GP as soon as possible so that you can get
help and treatment if you need it. There is no need to feel ashamed – hormone
changes, lack of sleep and the hard work of caring for a baby can make anyone feel
depressed. You will enjoy motherhood more and have a healthier, happier baby if you
feel better in yourself. If you have trouble with your eating after you have your baby,
ask for specialist eating disorder care early on. It will help you and your baby to have a
healthy relationship with food, now and in the future.
Breastfeeding and parenting
Mothers who have had eating difficulties often feel particularly anxious about
breastfeeding. You may feel very uncomfortable with the whole process of breast
feeding. Or you may worry about establishing a routine or judging the frequency of
feeds. Don’t be afraid to share this with your health visitor or GP. It’s often helpful to
meet other women with similar experiences. You can access local groups through NCT
(www.nct.org.uk).
As your baby grows up, they will want to start taking more control of feeding
themselves. It can be hard to know what they want, and hard to cope with the mess
around mealtimes. Mothers who have had an eating problem often find this a
particularly difficult time. If you have worries about how to manage weaning and
establishing appropriate feeding routines, don’t be afraid to talk about your worries with
professionals involved in your care. Sometimes meeting other mothers with eating
difficulties can be helpful. You can access local groups through (www.beat.co.uk/HelpandSupport).
Vincent Sq Clinic J Arkell 2/8/2010
Vincent Sq Clinic M Raikkonen 04/04/2013
This document is also available in other languages, large print, Braille, and audio format upon request.
Please email communications.cnwl@nhs.net
Dokument ten jest na życzenie udostępniany także w innych wersjach językowych, w dużym druku, w
alfabecie Braille'a lub w formacie audio.
Mediante solicitação, este documento encontra-se também disponível noutras línguas, num formato de
impressão maior, em Braille e em áudio.
Dokumentigaan waxaa xitaa lagu heli karaa luqado kale, daabacad far waa-wayn, farta indhoolaha (Braille)
iyo hab dhegaysi ah markii la soo codsado.
Be belge istenirse, başka dillerde, iri harflerle, Braille ile (görme engelliler için) ve ses kasetinde de temin
edilebilir.
Central and North West London NHS Foundation Trust
Stephenson House, 75 Hampstead Road, London NW1 2PL.
www.cnwl.nhs.uk