To ask what do with my silly sister?

[Onthedowns]

My sister is just 22 married and pregnant with her DH within 18 months. She is youngest very spoilt and was a little bridezilla ish at times with wedding. I am oldest and often get things in the neck if I speak out about her behaviour. This concerns her unborn baby both her and her DH -28 are extremely controlling regarding food don't cook with any oil no carbs. Her wedding day she looked stunning but extremely thin. At 14 weeks pregnant she looked skeletal. Sje was told by midwife she was underweight. She went into premature labour at 26 weeks they managed to stop baby but was in hospital for a week. Baby measuring small and consultant said only reason she didn't give birth was baby wasn't big enough to press down. She went on a cruise then a week in France didn't tell hospital, almost like she blocked it all out. Whilst on holiday she had a pedometer and hardly ate anything salads no carbs etc. She went to consultant yesterday who told her she needs growth scan every week and monitoring twice a week. Baby is just over 3oz at 31+4. It's likely they will induce her as baby better off out than in. Baby unlikely to reach 5oz even full term. I know premature labour happens often for no reason- my son was born at 35 weeks and in scbu for 3. However no one seems to be able to get through to her sisters mum she needs to be eating for growth! She's more concerned over her appearance and her DH encourages it. I am so frustrated with her and don't know what to do! My mum hates the confrontation with her and just ignores it same with my dad. Me and my sister try but falls on deaf ears! I am angry with her DH for not realising the gravity of the situation and don't know whether she is plain stupid or naive ! Help please!

She didn't inform insurance as apparently pregnancy isn't a condition?

Yes

I wouldn't worry about the cruise. She's back and didn't need any help so what good does it do to keep talking about it?

I also don't understand why such a premature baby would be better out than in- it doesn't make any sense?

She didn't inform insurance as apparently pregnancy isn't a condition?
You might be right that pregnancy itself isn't a condition but I am sure that the fact she had a threatened premature labour would be classed as a pre-existing condition.

Oh ffs, talk about dogs and bones!!!!

I also don't understand why such a premature baby would be better out than in- it doesn't make any sense?

I make sense of this as follows. If the nutrition getting into the baby is sufficiently poor, the baby might be better being nourished from another source than via the mother.

In order for this to be the case, the mother would need to be incredibly unwell herself. A fetus is like a parasite in the scientific sense in the way in which the mother's resources are directed to the baby first and the mother second. The mother's resources must be low in order for the growth of the baby to be affected. It may be that the mother's own vital organs are also at risk and if they fail then the baby will be affected.

If this is the case I would be surprised if the consultant has not already referred the mother to the perinatal mental health team. They may not have done but they may have done.

That's what I don't get- they're apparently saying induce at 31weeks? Surely you can't induce so earlier you'd have to deliver by c section. And as you say, the woman herself would likely be seriously ill. Yet this doesn't seem particularly urgent- she's just been left with the idea that they will "likely induce" either the baby is getting norishment or not?

I suspect that the op sister isn't telling the op the whole story about her medical condition.

If they were in danger of having to get a 31 weeker out, it would be a section not an induction. The concern about food groups and the sister not eating - if that was why they were having to consider getting the baby out, the op sister would be seriously unwell and in hospital with a drip up.

I really don't think the op is hearing the full story.

"If they were in danger of having to get a 31 weeker out, it would be a section not an induction."

Would it?

Sorry, had somehow misread your post, Sunny

I read it as preterm automatically=csection.

I had my 23 weaker normal breech....

Ok it may depend on the situation I suppose. But the op still doesn't seem to have the full story.

I would also have thought that if the sister was so seriously unwell, the baby's growth was being adversely affected and her own organs at risk of failure then, even if she wasn't on a drip, she'd have been kept in hospital on enforced bed rest.

Diddl surely induction wouldn't work so early? It doesn't even work that well when baby is full term 😂

I was induced with my (footling breech) 24-weeker too. Mainly because I had an infection and it was too dangerous for him to stay in.

And it worked its curtains? That's amazing!

"Diddl surely induction wouldn't work so early?"

Well there's no guarantee of course, but prems aren't automatically a csection.

Hi there,
Thanks to those who reported in, but the OP has been with us for several years now so we are inclined to let this one run. Thanks.

Instasista- it did. It was touch and go for a bit as he was in a bad position (one foot through cervix one not) and there was a risk he may not make it out "intact" - but they said that having a c-section at that point wouldn't necessarily have helped.

He was very small (1lb8) and was in hospital for a very long time (issues relating to prematurity) but is now home and doing well.

itscurtains, wow, what a story!
Glad he's doing well now

My 31 weeker was 3lbs 10 and did well

Delivering prem babies due to IUGR (intrauterine growth retardation) is normally done because of placental failure and because the risks of early delivery and trying to keep a preemie alive will eventually be considered less than leaving the baby in utero, slowly starving .

Maternal diet has very little to do with it.

This is a severe eating disorder. Your sister may end up being treated under the mental health act. Her reaction is unfortunately normal in anorexia, and I speak as a psychiatrist with considerable experience in that area.
You can contact her GP / health visitor and express your concerns - i would use the term 'eating disorder' rather than silly as I think it sounds more accurate. I would offer support and encourage her to seek help, but you may need te professionals to really get this across.
Good luck

Sorry confused about the reporting in? I am not making this up!! Only relying what I have been told my son was 35 weeks and 6.11 an exception. I am genuinely concerned for her I may not use the right words but I have conveyed what she's told me thank you for all the help and advice

dairymilkmonster So glad that as a 'psychiatrist' you are able to diagnose someone you have never met on the say-so of someone else on the internet as having a severe eating disorder. Is this the way you normally practice? Do you not fear being reported for bringing the entire medical profession into disrepute?

Sorry confused about the reporting in?

Is there something that you are specifically confused about? I agree with pp, maybe I would say "concerned that my sister may have an eating disorder" rather than silly. This is less because I think the former more accurate than the latter and more because this is how I see the situation. I am also not sure that letting professionals know that you consider for sister to be silly is wise, whereas specifying your concerns for her health might be.

Good luck OP whatever you decide to do My sister supported me throughout my recovery from my eating disorder despite getting angry with me sometimes. Our relationship remains intact. She cares about me very much, which is part of the reason she was so distressed by the situation. There was not the added complication of a pregnancy in my case; this sounds difficult to deal with.

As a psychiatrist you should know better than to diagnose over the internet, you have no idea what is wrong with the OP's sister anymore than anyone reading this thread dairy