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Infant feeding in women with eating disorders – insights from healthcare professionals
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- Author / Creator
- Stavila, Natalia
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Eating disorders (EDs) are severe mental health conditions with significant impact on physical health. EDs affect predominantly women, including during the reproductive phases of their lives. Although pregnancy and childbirth can have protective and restorative functions for some women with EDs, the relationship between pregnancy/childbirth and ED is bidirectional, as post-partum relapse is not a seldom phenomenon. In fact, the post-partum period may be a very destabilizing event for a woman with a history of an ED, which not only may negatively affect her own physical and mental health, but also her overall adjustment to motherhood and various aspects of caretaking for her child, including infant feeding.
Our research project explores the infant feeding choices in women with ED from a healthcare provider’s point of view, with a particular focus on breastfeeding in the context of the current public recommendations for optimal infant feeding which currently promote exclusive breastfeeding for 6 months and extended breastfeeding for 2 years and beyond. Specifically, we asked whether breastfeeding may carry abuse potential for excessive and/or accelerated post-partum weight loss in mothers with past or present EDs. Using interpretive description, we explored 7 healthcare provider’s (4 dietitians, 1 psychiatrist, 1 nurse, 1 psychologist) experiences with infant feeding choices of women with EDs. Interview transcripts were examined by three observers and extracted themes included women’s and healthcare providers’ personal beliefs around breastfeeding, specific ED symptoms affecting coping with pregnancy, postpartum, and infant care (i.e., body image and cognitive distortions, need for control, infant attachment, changes to the identity as a woman), denial of abusive breastfeeding practices, and support for breastfeeding. Our final analysis suggests that women with ED may engage in problematic breastfeeding practices for its caloric expenditure, however the presence and extent of these practices is difficult to establish due to denial and concealment of purging behaviors by women with ED. Healthcare providers may benefit from specific education on recognizing signs of excessive breastfeeding practices in women with (suspected) EDs, and on delivering ED-informed advice with a balanced approach to breastfeeding that is beneficial to the infant, but also attending to the patient’s values and needs. Consequently, new mothers with EDs may benefit from tailored recommendations on infant feeding choices, including support for healthy extended breastfeeding in conjunction with supports to safely lose their postpartum weight. This thesis concludes with five recommendations for healthcare providers derived from our results, aimed to promote sensitive and tailored care for mothers with suspected ED. -
- Subjects / Keywords
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- Graduation date
- Fall 2022
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- Type of Item
- Thesis
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- Degree
- Master of Science
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- License
- This thesis is made available by the University of Alberta Library with permission of the copyright owner solely for non-commercial purposes. This thesis, or any portion thereof, may not otherwise be copied or reproduced without the written consent of the copyright owner, except to the extent permitted by Canadian copyright law.