Background. Women with anorexia nervosa have a reduced
fertility but they may have borne
children before the onset of their illness or after partial
recovery. Little is known on how to identify
the anorexic mothers who underfeed their children and how to manage
them. This article aims to remedy these gaps.
Methods. The clinical scientific method is the only
means of identifying the children of anorexic
mothers who are at risk. Eight such mothers were identified as
a result of obtaining serial
measurements of the children's weights and heights over time.
Tanner–Whitehouse charts were used
to plot weight for age and height for age. A simple rating scale
was devised to measure the
acceptance of treatment involving both mother and child.
Results. Nine children (eight boys and one girl) were
found to have suffered food deprivation: with
severe reduction in weight-for-age in six and in height-for-age in
eight. Five siblings were not
affected. Catch-up growth was correlated with the degree of
engagement in treatment of both
mother and child. Long-term treatment of one mother, combining
family therapy with admissions
to hospital, resulted in catch-up growth in her two sons.
Conclusions. The mechanisms underlying the privation of
the children stem from the anorexic
mother's abnormal concerns with body size extending to her
children. The children may become
unduly accepting of the underfeeding. It is essential to obtain
the confidence of anorexic mothers
suspected of underfeeding their children and to adopt a whole
family approach to treatment.