Eating disorders in pregnancy retard baby's growth

Women who diet during pregnancy deprive their babies of essential nutrients for growth and development, Sydney research has shown.

The study, which is the first to link retarded growth in babies with poor maternal eating, shows that the way mothers eat during pregnancy impacts directly on the weight and health of the baby.

Previously, it was thought that the baby drew essential nourishment from the mother's body to compensate for and protect itself against any shortcomings in the maternal diet during pregnancy.

Associate Professor Suzanne Abraham, from the University's Department of Obstetrics and Gynecology, and Ms Janet Conti, from the Department of Nutrition and Dietetics at the Royal Prince Alfred Hospital, have shown that the mothers of

Babies with extremely low birth weights ­ excluding babies with medical conditions that retard growth ­ have clinical eating disorders diagnosed as either anorexia nervosa or bulimia nervosa.

According to Professor Abraham, 20 per cent of pregnant women have eating problems.

"Pregnancy poses a significant challenge to women concerned with their weight and shape," she said. "Fearful that they will be unable to return to their pre-pregnancy weight, many women avoid eating, or binge-diet or exercise for prolonged periods.

"Some, who have always exercised vigorously, are unaware that excessive exercise, such as power-walking for more than six hours every day in the last trimester of pregnancy, can stunt the growth of the baby.

"In the final trimester of the pregnancy, a small number of women believe they are losing control of their bodies and begin binge eating for the first time. In addition, many women who are eating adequately believe they are overeating."

Professor Abraham said that there are many pregnant women in the community with distorted perceptions of their eating patterns who are unaware they are restricting their diet or eating irregularly. "Once the pregnancy is confirmed, they don't purge but they might not do all they can to control their vomiting," she said.

Professor Abraham pointed out that some obstetricians rewarded women for not putting on too much weight in pregnancy, which could exacerbate the problem in cases where the woman had an eating disorder such as anorexia nervosa. While not attributing blame to any of the health care professions, Professor Abraham cautioned that those involved in antenatal care should not advise women to watch their weight in pregnancy.

Frequent weighing might have a negative effect on a potentially susceptible patient and, when necessary, weighing should be done with the patient's back to the scales. When some women know their weight is going up, their eating becomes disordered.

"Doctors, aware of the risk factors, should take a thorough history of their patient's eating pattern, exercise behavior, weight and previous psychiatric or psychological problems. Throughout the pregnancy, they should ensure that women are gaining sufficient weight and that the baby is developing adequately," Professor Abraham said.

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"Women who are aware they have problems with their eating should be given the opportunity to see a dietitian or talk with professionals who can help them during the pregnancy. There is no need to eat for two but if a woman is underweight at the start of the pregnancy, she will need to eat a lot more and put on weight.

"Although 12 to 13 kilos is the mean figure for weight gain in pregnancy, women should understand that there is a range and everyone is different. Some women will put on less and others more. Women should realize that poor maternal eating can lead to complications in their babies. Anyone with disordered eating will need help during pregnancy."

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