Eating Disorders in Pregnancy and Breastfeeding

Eating disorders in pregnancy and breastfeeding jeopardize the health of mother and child and the bond between them. Find out more.
Eating Disorders in Pregnancy and Breastfeeding

Last update: 24 June, 2022

Weight, figure, and nutrition become extremely important issues for women during pregnancy and breastfeeding. Not only because their own and their baby’s well-being depends on them, but also because of the impact on their image, aesthetics, and social judgment. The physical and emotional changes that take place during pregnancy and postpartum are so drastic and intense that the high frequency of eating disorders during pregnancy and breastfeeding isn’t surprising.

Many mothers-to-be face gynecological visits with fear because they’ve gained too much weight. Others suffer when they look in the mirror and contemplate the new shape of their body after having given birth. It’s not easy to process these transformations, even less so if they’re added to the uncertainty and responsibilities involved in being a new mom.

Therefore, it’s possible that inadequate emotional management, coupled with a certain personal vulnerability, can end up triggering an eating disorder during pregnancy and breastfeeding. If you want to know the warning signs, possible consequences, and ways to act, we invite you to keep reading.

Eating disorders in pregnancy and breastfeeding: A very present reality

There are certain mental conditions associated with motherhood that we’re very aware of, such as postpartum depression. However, we’re less aware of the high frequency of occurrence of other types of disorders. Despite this, the epidemiological data are revealing.

It’s estimated that more than 5% of pregnant women and about 12% of postpartum women suffer from an eating disorder. Moreover, if there’s already a history of an ED, it’s very likely that a relapse will occur during these periods.

Despite knowing these numbers, it’s not always easy to detect that one is suffering from an ED. Firstly, socially, it’s very normalized to worry about weight and body image and even to adopt diets and intense exercise routines. Therefore, it seems natural to us that a pregnant woman or a nursing mother should feel dissatisfied with her body and try to return as soon as possible to the established standards of beauty.

Secondly, eating disorders are diverse and of variable expression; they don’t all present the same symptoms and manifestations. And, if we don’t know about them, we can overlook certain thoughts and risky behaviors.

A woman crying into her hands while holding measuring tape.
The obsession to lose weight quickly or changes in mood due to the extra pounds should alert us to the possibility that the pregnant woman is going through an ED.

The main eating disorders during pregnancy and the postpartum period

Here are the most common EDs that occur in pregnant women and new mothers. Knowing them will help you identify their symptoms quickly.

  • Anorexia nervosa: In this disorder, there’s a great concern for image and a strong association between appearance and personal worth. For the same reason, there’s a great fear of gaining weight that moves the person to restrict food intake and caloric intake and to stay below the recommended weight.
  • Bulimia: In this case, image is also strongly associated with self-esteem. However, the typical pattern includes binge eating, followed by purging behaviors. The latter are performed to prevent weight gain and may include the use of laxatives, excessive exercise, or self-induced vomiting.
  • Binge eating disorder: A binge is an excessive intake of food that occurs in a short period of time. The person eats without being hungry and can’t stop until they’re uncomfortably full. They usually opt for fatty and not very nutritious foods and it’s common for this intake to occur in secret and when they’re alone, due to the shame generated by not being able to control impulses. Unlike the previous cases, here there are no purgative or compensatory behaviors to maintain weight.
  • Pica disorder: This is a disorder that produces an irresistible desire to ingest substances of no nutritional value, such as sand, chalk, soap, hair, or ice. Despite knowing how useless and even harmful it is to consume these items, the woman can’t help it.

Why do eating disorders occur in pregnancy and breastfeeding?

EDs aren’t exclusive to pregnancy and the postpartum period – far from it. However, these periods have certain characteristics that contribute to an increased risk of developing them. These include weight gain, change in body shape and form, anxiety and uncertainty about childbirth and motherhood, and the change in roles and priorities involved in becoming a mother.

In short, physical, emotional, and social factors combine to make pregnancy and breastfeeding a particularly vulnerable time of life. It’s therefore essential that women receive the support and accompaniment they need, both from their environment and from health professionals.

Suffering from any of the eating disorders during pregnancy and breastfeeding puts the well-being of mother and baby at risk. Miscarriages, unplanned cesarean sections, and complications during childbirth can occur. Also, it’s possible for women to suffer from gestational diabetes and affect the proper development of the fetus. Finally, there’s also an increased risk of postpartum depression and difficulties in bonding with the baby.

An eaten apple in front of a mirror that's reflecting an uneaten apple.
Body image distortion is one of the main aspects of eating disorders. Therefore, gestational and postpartum changes predispose women to the recurrence of certain difficulties.

If you experience these symptoms, ask for help!

With all of the above in mind, if you feel that your image concerns are excessive, if you engage in restrictive or purging behaviors, or if you have unusual eating patterns, don’t hesitate to seek help. A perinatal psychologist can accompany you and guide you to ensure your well-being and that of your baby.

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  • Makino, M., Yasushi, M., & Tsutsui, S. (2020). The risk of eating disorder relapse during pregnancy and after delivery and postpartum depression among women recovered from eating disorders. BMC pregnancy and childbirth20(1), 1-7
  • Pettersson, C. B., Zandian, M., & Clinton, D. (2016). Eating disorder symptoms pre-and postpartum. Archives of women’s mental health19(4), 675-680.
  • The National Eating Disorders Collaboration. (2015). Pregnancy and Eating Disorders: A Professional’s Guide to Assessment and Referral. https://nedc.com.au/assets/NEDC-Resources/NEDC-Resource-Pregnancy.pdf