DH + Pregnancy & Anorexia

[DH2R]

My DW (do you use DW for the counterpart to DH? am new!) has anorexia and is also ~6 months pregnant.

We live together away from both of our families and so have little in the way of a support network.

I have experienced anorexia before in the past when my sister suffered, and at the time I learned that the best way with her to deal with it was to completely butt out of any conversations about what she ate. Until now I've, on the whole, done the same with DW.

All tests of blood and scans of baby so far have showed no problems whatsoever. Medical professionals have all seemed happy with how things are going.

However... in the last few weeks DW's face has started to show the signs that I spot when her weight is dropping. Her temples and cheeks are a little more sunken than normal and she has quite a development of downy bum fluff on her jawline (which I know may all also be as a result of pregnancy).

She's actually upped her daily calorie intake from circa 1000-1200 before pregnancy, to 1300 to 1400 during it. And since I started to moan at her as a result of this recent facial change it has now gone up to ~1500.

She is ~5'4" and looks healthy when not pregnant when she's about 8.5 stone. When I punch these numbers into calorie intake calculators (there are a few on the net) it suggests she should have been on around 1900 before now, but now at 6 months gone should be on well over 2000.

I'm trying to convince her to up her intake - not an easy task with an anorexic. I keep saying to her that although it might be OK for baby at the level's she's eating it also might not and that there's no risk whatsoever if she was to up her intake. Obviously there is a risk with this to the anorexic mind - she might gain weight.

Result of this is that each time I approach the subject she becomes extremely (and I mean extremely) stressed about it. The anorexic mind comes to the fore and she turns nasty. It's a very jeckyl and hyde thing. This is extremely upsetting. I feel hated to the fullest extent and I have to work hard not to run away, curl up into a ball and cry, or lash out at the walls.

But if I don't say anything she will continue to eat around 1500 calories a day, which might perhaps be detrimental to the development of my unborn child. But then so might the stress that is casued every time I bring it up.

She eats fantastically healthily - fruit and veg aplenty - but is it enough?

I'm really struggling with this.

[Newmummytobe79]

Hi DH2R,

What a caring husband you are!

I don't think I can offer too much advice but I didn't want to read and run.

I've had issues in the past but since getting pregnant have developed an unhealthy love of cake (!) - but I am scared my issues will come back after baby is born. Anyway - that's another story!

What I'm trying to say is that the good news is that your wife is actually eating and has upped her intake - she's not starving herself which would be harmful to baby.

Could you ring your Dr just to check on calories etc? Or maybe call her midwife? I know it's not ideal but as long as she is gaining weight and the baby stays on track - that's good.

Could you cook her evening meal? I know it sounds a bit daft, but when my husband does that I feel I have to eat it as I know how much effort he has gone to :) ... she may even end up like me and go back for seconds!

[bigmacandhappymeal]

Hi DH2R
My name might give away the fact that I don't have any experience of this illness - sorry if it seems insensitive in the context of your post.

I wanted to ask if you were aware of charities who may be able to give you support or advice. One I am aware of is called Beat
www.b-eat.co.uk/
They have a telephone support function and it may help just to talk to people who know what you are going through so that you don't feel isolated, particularly in the times when your wife is struggling which is clearly impacting you. They may also have practical advice that could help. There may well be other organisations.

Do you go to the antenatal appointments? I'm not entirely clear whether your antenatal team are aware of her anorexia. Is there a safe way you can bring it up? Could you call them directly? I wonder if there is more support the NHS could offer you both?

Have you confided in any friends or spoken with your family? I realise there is distance between you and your family and I imagine some sensitivity to eating disorders, but you need support as well.

Sorry if i've suggested things you have already done/thought of/tried.

I wish you all the very best. You sound like a loving and caring husband and father to be who is doing admirably in very difficult circumstances. Pregnancy and impending parenthood is challenging enough without the added pressure of an illness like anorexia.

Take care

[nunnie]

Hello concerned and caring husband to lucky lady.

I am currently on my 3rd pregnancy and almost at the end. I had bulemia as a teenager which I had got under control, with my 1st pregnancy I had a low BMI, but am now normal.

Anyway my point, this pregnancy has been difficult for me and I have felt myself relapse and conciously cut back as I really can't look at my body without it repulsing me.

I eat fruit and veg a plenty, and have over the last few weeks increased my intake and forced myself to think about the baby and not selfishly about myself (which has been hard).

I have never in any of my pregnancies or prior to them eaten the calories advised and have never gained the ideal weight in pregnancy. I can't physically eat large meals and tend to stick to little and often.

Has she been for scan yet? Have they mentioned anything about the baby growth pattern (doesn't happen till 28 weeks when they start measuring bump).

I don't know how it works with midwives but GP won't be able to do much unless it is her that contacts them. You could try the midwife I am sure she/he will be able to advise you and monitor the situation and above all help you in approaching her with the subject.

Not sure if any of this has been helpful to you, but didn't want to read and run.

[Isthreetoomany]

Hi -as others have said you sound like a very caring husband.
Similar to nunnie, I am pregnant with my third and had anorexia as a teenager, I was fine through my first 2 pregnancies but am struggling this time around.
I have spoken to my GP about my own situation and been told that the baby takes what it needs and so I should not worry too much or feel too guilty about how little I ate in the first trimester (although I am eating better at the moment, I am 6 months pregnant now, so I do not know whether it continues to be the case into the second/third trimesters that the baby can just take what it needs).
Is your wife receiving counselling/help with her anorexia, and do the midwives know? I only ask as I imagine that the postnatal period may be especially difficult for her. I know that I am worried about how things will work out with trying to lose weight immediately after the birth, but also I am wanting to breastfeed.
Good luck.

[user59457812]

Hi DH2R,

I really feel for you. You sound incredibly caring and understanding, and I'm sure your DW feels awful every time she loses her temper with you - pregnancy hormones combined with such a deep seated emotional issue must be an explosive combination to deal with.

The fact that she is able to increase her intake in the way you have described would suggest that she is able to 'manage' her anorexia, which in itself is promising. Knowing a little about anorexia I would ask how you know she is definitely eating the amount she says she is, especially as she appears to be losing weight? I second the suggestion of bigmac above about seeking expert advice from an anorexia organisation who may have experience of the specific issues anorexics experience with pregnancy, and how to intervene. If your wife's medical team aren't aware of her eating disorder then it would seem essential to inform them, although clearly this would be better coming from your wife than from you, as they will be able to act on the information.

In terms of health, I would be more concerned about your DW's nutritional status than your baby's. Many women suffer from chronic morning sickness and can't keep any food down during their pregnancies and the babies still take all the nutrients they need from the mother's body (my mother had it with me and I am fine, as far as I know!). My consultant told me an amazing story about a patient he had who had such terrible iron deficiency (due to an extremely severe condition) that she was in heart failure. Her baby was born healthy with a perfect iron level! Nature really does everything to protect the bub. Is your DW taking any supplements by the way, esp. iron, calcium and vitamin D that might protect her from nutritional deficiency?

Not sure if that helps - the best of luck xx

[cherryjellybelly]

You seem like such a supportive husband - keep hanging in there!
I suffered from anorexia as a teenager, and was doing really well until I became pregnant and became so sick in the first 20 weeks. I lost a lot of weight due to the severe sickness and when my baby started to grow I found it emotionally really hard seeing my body change. I also felt a lot of guilt when my DH pointed out that I wasn't getting enough in me which was hard as I couldnt always control it.
Ive been able to eat up to 2000 calories in the last bit of pregnancy but the health of my baby before this worried me and I talked to the doctors about it. They said thebaby would take all of my supplies and as long as ate nutrients and things like fruit and veg then the baby would grow fine and it would only be my body that would suffer. (unless I ate too little for the baby to grow - and my baby is the right size apparently) They also weren't so worried about the calories even if i wasn't getting to 2000 as long as the stuff I ate was good.
Hope this reassures you about the health of your baby a bit... is she taking vitamin supplements?
And asking for support is always a good idea :)

[lucysnowe]

I suggest you speak to your GP about this. 1500 calories obviously isn't loads - but some women who suffer from sickness all through their pregnancies may well be at this kind of level - or even less - with no ill effects. Babies are kind of parasites and take what they need - and if your DW is eating v. heathily, that's obviously good. And she's been healthy thus far.

Remember she is pg and being nasty and lashing out is a common side effect!

[DH2R]

Thank you everyone.

[Dorje]

If the doctors are happy, well then you should listen to them.

I was a very fit and healthy 8 stone when i fell pg and then went up to about 9 and three quarters at birth. In no way did I eating for two, or anything like that rubbish.
I ate 450 cals extra as was recommended by my doctor - a tuna sandwich.

At about 6 months I had that hollow look for a few weeks, but it went. I ate a few more light snacks - hummous and almonds and apples.

I used to have anorexia - stress related, not food obsessive if you know what I mean, and can honestly say that the most annoying thing about being pregnant for me was everybodys 'concern' over how much pregnant women were supposed to eat, and look- it's pervasive, in the media - and everyone even on public transport has an opinion about how big a pregnant woman should look.

We have a distorted idea now that women are supposed to get big in pregnancy, but old fashioned midwives caution against eating for two, as it can make the mother unfit, and thus less likely to have an uncomplicated birth. During the war when there were rations, women had few complications and didn't have massive issues with obesity and diabetes either, as they do now on "eat for two" thinking.

The only thing I would say to you is to look after the practical things:
make sure you can afford a cleaner and someone to come in and look after the baby a few days a week, for the first few months at least.
It will give your wife time to recover and get head space, and get comfortable with her new role and the body she now inhabits.

If the doctors are happy with your wife's weight, well I really can't see why you have a problem with her weight - unless you have unresolved issues from your sister's anorexia - which, if true, I strongly suggest you seek counselling about, and leave your wife to do her own thing, her own way.

Sorry if that's a bit blunt, but if the doctors are happy, I don't know why you're fussing.

[jan2011]

hey
i am also in recovery from anorexia and bulimia and am 8 months pregnant. i have been getting support from nHS therapist, dietitian and the obsteotrician is aware. although i have not ate the recommended amount of calories or gained the weight, the babies weight has been a healthy gain throughout my pregnancy which is an amazement to me, there have been no complications even through the times where i struggled more.
the things i did to help (maybe you could steer your wife somehow without being direct) and these were recommended to me - is take the prenatal vitamins, take iron if needed, if eating is hard go for milky drinks (lattes, steamers, or even just hot milk with honey) milk is very good for the baby. try to focus on the calcium and protein requirements such as yoghurts, cottage cheese with crackers. people with eating problems often find these foods easier to eat than proper meals with lots of carbs anyway, and they are what the baby needs. i understand your wife needs energy too, and i guess this is where i struggled - i have been exhausted at times and have managed to eat a bit more when i was really tired for me too and overall my pregnancy has gone quite well. i am hoping i can continue doing well when the baby comes. all the best for you and your wife.

[DH2R]

It's all very well listening to the doc's advice, but at the end of the day I can see that her weight is dropping and I know that it's because she's limiting her calorie intake because of anorexia. I don't care if all the doctors in the world tell me the measurements they're taking look 'OK', I know she is not eating as much as someone not suffering from anorexia would be. And while there may not be a problem, it's a hell of a risk to take when all she need do is simply eat a little more; the only risk of which would be to possibly gain (reversibly) a little weight.

Anorexia is making her (and some of you by the sound of it) take a pointless risk.

[Walnut8]

It is very likely that she knows all of this. Your comment about "simply" eating a little more indicates you don't really understand this.

As long as she keeps eating a reasonable amount, the baby will be okay.

[angfirsttimer]

Whilst your concern for your wife and your unborn child is wonderful, I really think you need to understand a little more about anorexia. As Walnut says it is not about 'simply' eating more, for an anorexic there is nothing simple about such a suggestion. Anorexia is a disease not a conscious choice.

The baby will be fine as long as what she eats is healthy/nutritious

[nunnie]

It isn't just a case of simply eating more for someone who has an eating disorder.
If you don't care what the Doctor says or other HCP's then that is your choice.
I suggest you do contact a helpline even if it is just to discuss your issues with them, because you seem very angry and I don't think this will help.

I know I should be eating more and I do know I am taking a risk, but knowing is not the same as being able to do it.

[InMyPrime]

The baby does most of its key development in the first 12 weeks so as long as your wife was taking the recommended supplements in those 12 weeks and especially folic acid, then the baby shouldn't be affected too badly at this stage by her diet. 1500 calories a day is not ideal but not a starvation regime either. It's a myth that women need to 'eat for two' in pregnancy. Ideally your wife shouldn't be dieting in pregnancy but if she's made it this far as an anorexic, I doubt there's much you can do to dissuade her now.

The biggest risk of dieting in later pregnancy is to your wife's own health and wellbeing e.g. risk of anaemia due to lack of iron intake. Her midwife should test for that at the 28 week appointment so if that shows up, she'll get advice.

If you're very worried about the baby's wellbeing, you could always book a private scan with a medical professional / private clinic and get predicted birth weight, more exact limb and head measurements to make sure the growth is right for gestation, etc.

[Isthreetoomany]

I know I am taking a risk, but as others have said it is not as simple as just eating more. For me, it is more a case of trying to balance the risk out, so that I am eating enough not to be placing the baby at any risk, but also not placing too much pressure on myself to be eating so much that I feel uncomfortable in myself - as I know that personally if I do that I will only end up restricting food more severely after the birth.

But I can appreciate that you are in a difficult position and clearly very concerned about your wife. You could try speaking to someone at the eating disorders organisation beat - they have a helpline. You could also try re-posting in the mental health section.

[Thumbelina79]

I think you are right it is simple she needs to eat more, for your baby and for herself. And the down demonstrates this.

But as you know her anorexic mind doesn't agree.

I think you need to contact the medical professionals. Because they will be objective. (Some answers here tainted by personal eatting disorders).

Contact your mid-wife and GP's. Insist on immediate support. Dietician, counsellor, therapist, more midwife contact, more scans.

Be a dog with a bone.

x

[jan2011]

i agree that you need to get a better understanding about the illness and how it affects her, that it isn't her fault, as blaming her (im not saying you are doing this) but it will make her feel worse and possibly worsen the situation if it comes to that. And to help her to get professional support - some doctors themselves are not clued in about it, therapists and dieticians and the doctor working together are the best bet - they have helped me so much and i have been able to change so much because of the help i have received - it did take awhile to find the right people but when i did it was amazing how much they were able to help. and i always thought noone could help. even if your wife doesn't want the help, ask her doctor to encourage her to get it as it will be beneficial postpartum as well since this is often a risky time for people suffering with eating disorders (tell the doctor this too - push for it) and see if she will then listen to him. if not, then do YOUR best to educate yourself and even see an informed counsellor to get tips on how to handle the situation and support her. my hubby and i used to argue a lot when we first lived together and when he began to go to a support group and find out about it, we were able to work together more and i felt much more supported and better in myself because he understood better and was able to separate me from the disorder.

[GloriaVanderbilt]

It sounds like she is already doing her absolute best in the scenario

the fact you're more concerned about the baby than how she feels, and the fact she is trying her utmost, will be making her feel very hurt indeed. It will also reinforce the guilt she will already be feeling as she struggles between wanting to be a great mother and having this devil on her own shoulder to obey/resist

it will be very very hard for her and she will do it, she WILL but if you try and make her, or in any way enforce this, you are getting between her and her nemesis and stopping her fighting it.

You'e likely to cause more detriment to the situation than good, by mentioning it. You've GOT to believe in and trust her. You've really got to or she will resent you nd possibly give up (which would mean stopping eating enough)

let her be
the medics are happy
the baby will be FINE

please...listen to me here. I understand exactly where she is at. Sorry to sound harsh but if you just try your hardest not to worry and have a laugh with her, that will be the best encouragement possible.

[LoveBeingIgnoredByMardyBra]

Hi op

I haven't read the other replies because I am assuming they are from with who are or have been in a similar position to your wife. And tbh probably not as useful as the other replies.

You know your wife and her other signs that this might be an issue. I just wanted to share my experience which as a size 16/18 has nothing to do with not eating.

I'm due to give birth next week, to my second baby. Throughout both pregnancies I have not put on any weight. Literally a couple of pounds right at the end and that's it. I am effectively losing weight. My whole body apart from by belly of course, gets thinner and slimmer. This is not die to trying to not put on weight, it's not even down to eating a better diet. I just cannot eat the volume that I did before. From very early on I cannot finish a meal. From behind people think I've lost loads of weight and then I turn round and there is my baby belly!

I just wanted to tell you that it can happen. Only your wife and you will know if there is a current problem. But that's my story. Like I said I'm can't tell you that your wife doesn't have another problem but wanted you to know that things like this do happen to women without this illness.

I don't know if that has helped or not but I hope so. Congratulations on your baby and I hope mother and baby deliver safely.

[limetrees]

I would think that the baby is OK. When I was pregnant, I was unable to eat (due to hyperemesis). Anything I did eat came back up and I was very weak, unable to walk beyond the bathroom and even that would be one hell of an effort. I lost weight, weight that I didn't really have in the first place (BMI at time of conception = 19). Anyway, docs all maintained that baby would be fine because baby is (awful word) essentially like a parasite - the baby will take everything (s)he needs from your wife's body. Both my children were totally fine, despite me essentially not eating for the entre pg.

[Jeezimacasalinga]

I'm currently pregnant with 3rd baby and read these interesting articles a few weeks ago - it made me think a lot about what my diet - too much, too little or otherwise.

www.thetimes.co.uk/tto/health/dr-mark-porter/article3135152.ece

www.timesonline.co.uk/tol/news/uk/health/article5029679.ece

I've always been very blase about my diet and nutrition in pregnancy but these articles really made me think. Knowingly restricting calories, even when pregnant, is something I am very capable of but I'm now eating at much more sensible levels. Good luck to you and your wife, annorexia is a huge thing to overcome and I hope with your support she can improve.

[GloriaVanderbilt]

HereIgo forgive me but I'm struggling to respond to that.

Could I ask if you have any experience with anorexia - either as a sufferer or a HCP?

[LoveBeingIgnoredByMardyBra]

And even I know it's not limited to girls