The influence of eating disorders on mothers’ sensitivity and adaptation during feeding: a longitudinal observational study

Abstract

BackgroundParents with past and current eating disorders (ED) have been shown to report troubles nourishing their infants. This could increase the risk of infant feeding problems linked to maternal anxiety and depression. It is not clear how mothers’ eating difficulties before pregnancy and at the time of birth can affect infant’s feeding. We aimed to specify the impact of eating disorders on mothers’ adaptation and sensitivity to their offspring during feeding, by comparing a population of mothers with eating disorders and controls.MethodsTwenty-eight women agreed to participate in interviews and filmed mother-baby interactions. Pregnant women consulting at an obstetric unit for care follow-up were screened and tested for symptoms of eating disorders with the EDE-Q Questionnaire (Eating Disorders Examination Questionnaire) and the EDE Interview (Eating Disorders Examination Interview). Infant functional troubles and mothers’ sensitivity were investigated through the Symptom Check List. Reciprocal adaptation during feeding with their new-borns was filmed and analysed with the Chatoor Infant Feeding Scale. Before pregnancy, two women suffered from anorexia, three suffered from bulimia, three had binge eating symptoms and two were diagnosed with EDNOS (Eating Disorders Not Otherwise Specified).ResultsMothers suffering from ED tended to show more difficult interactive patterns in terms of dyadic reciprocity when feeding their babies compared with mothers with no symptoms of eating disorders. In the interviews, other than the behavioural data gathered, ED mothers expressed feeling more dissatisfaction and uneasiness during feeding.ConclusionsPregnancy seems to be an useful period for interviewing women on eating disorders, allowing for the design and implementation of prevention programmes based on mothers’ narratives and infant/mother observations and treatment.

Development of the Parent‐child Play Scale for Use in Children With Feeding Disorders

“…Consistent with previous research (Ammaniti et al., ; Chatoor et al., ; Chatoor et al., ; Chatoor et al., ; Chatoor et al., ; Hommel, ; Lucarelli et al., ; Squire et al., ), this study on the development and validation of the Parent‐Child Play Scale presents a reliable tool which can be used for research and clinical practice to assess mother–infant/toddler interactions during free‐play. The assessment of the quality of mother–child interactional patterns using specific, validated tools promotes a better understanding of the impact of mother–child interactional patterns on the development of psychopathology.…”

“…Following a transactional model (Sameroff, ), which points to the interconnectedness of the individual characteristics of the child and his or her environment, if a child has a difficult temperament, this may contribute to poor affective communication, poor reciprocity, and dyadic conflict not only during feeding but also during play. At the same time, mothers’ insecure attachment to their parents and mothers’ drive for thinness, bulimia, anxiety, and depression also correlated significantly with mother–child conflict during feeding (Chatoor et al., ; Lucarelli & Speranza, ; Squire et al., ; Stein, Woolley, & McPherson, ; Tambelli, Odorisio, & Lucarelli, ). Finally, mother–child conflict during feeding strongly correlated with the child's weight: the more conflict between mother and child, the lower the child's weight (Ammaniti et al., ; Chatoor et al., ).…”

“…More recently, the ratings of observations of mother–child interactions with the Feeding Scale also have been used in the context of maternal eating disorders (anorexia and bulimia nervosa) with the aim to evaluate the possible influence of maternal preoccupation with eating and weight on mother–child interactions during feeding. This study (Squire et al., ), using the Symptom Check List adapted from Robert‐Tissot et al. (), showed that mothers with eating disorders expressed feeling more dissatisfaction and uneasiness when feeding their infants.…”

Clinical management of females seeking fertility treatment and of pregnant females with eating disorders

“…Several large studies have shown the negative impact of EDs on pregnancy outcomes, such as premature birth, low birth weight, low Apgar scores, and even perinatal death. Long-term effects on the offspring's physical and mental health have also been demonstrated (e.g., Easter et al, 2011;Kimmel, Ferguson, Zerwas, Bulik, & Meltzer-Brody, 2016;Linna et al, 2014;Micali, Stemann Larsen, Strandberg-Larsen, & Nybo Andersen, 2016;Solmi, Sallis, Stahl, Treasure, & Micali, 2014;Squires, Lalanne, Murday, Simoglou, & Vaivre-Douret, 2014;Watson et al, 2017). In the study by Linna et al (2014), n = 2,257 females in treatment for EDs between 1995 and 2010 and n = 6,319 females without ED were compared with regard to birth outcomes.…”

Role of Community Nurses in Improving Caregivers' Ability in Caring Children with ARFID (Avoidant Restrictive Food Intake Disorder)

“…The eating disorder in infants and toddlers is caused by several factors, including: genetic and biological factor, environmental and sociocultural influences, and psychological stress (Campbell & Peebles, 2014;De Luca & Napoletani, 2015), mother and family factor (Allen et al, 2014), and dysfunctional interaction between mother and child (Goulding et al, 2014;Gueron-Sela, Atzaba-Poria, Meiri, & Yerushalmi, 2011;Kröller & Warschburger, 2009;Sacrato et al, 2010;Squires, Lalanne, Murday, Simoglou, & Vaivre-Douret, 2014). The prevalence of affectionate tension between parents and child is 13 -82%, depending on the risk factor in the family such as negligence or maltreatment to the child (Skovgaard Vaever, Smith-Nielsen, & Lange, 2016).…”