MOTHERS WITH ANOREXIA-NERVOSA WHO UNDERFEED THEIR CHILDREN - THEIR RECOGNITION AND MANAGEMENT

Background. Women with anorexia nervosa have a reduced fertility but t hey may have borne children before the onset of their illness or after partial recovery. Little is known on how to identify the anorexic mot hers who underfeed their children and how to manage them. This article aims to remedy these gaps. Methods. The clinical scientific method is the only means of identifying the children of anorexic mothers who ar e at risk. Eight such mothers were identified as a result of obtaining serial measurements of the children's weights and heights over time. Tanner-Whitehouse charts were used to plot weight for age and height f or age. A simple rating scale was devised to measure the acceptance of treatment involving both mother and child. Results. Nine children (ei ght boys and one girl) were found to have suffered food deprivation: w ith severe reduction in weight-for-age in six and in height-for-age in eight. Five siblings were not affected. Catch-up growth was correlate d with the degree of engagement in treatment of both mother and child. Long-term treatment of one mother, combining family therapy with admi ssions to hospital, resulted in catch-up growth in her two sons. Concl usions. The mechanisms underlying the privation of the children stem f rom the anorexic mother's abnormal concerns with body size extending t o her children. The children may become unduly accepting of the underf eeding. It is essential to obtain the confidence of anorexic mothers s uspected of underfeeding their children and to adopt a whole family ap proach to treatment.