Mother with Eating Disorder

Dear Anonymous, 

This definitely is a complicated situation. You have your wife's history and dignity to respect yet, at the same time, you are concerned her current behavior is impacting your daughter's development. Bare with me as I dissect this to answer your questions. Obviously, all I have to go on is what you have shared with me but, I'll try and give you some things to consider that may or may not be helpful. Let's jump right in to some things to try:

1. Pediatrician: Get regular appointments set up (more than you would typically have for an 18 month old). I'm sure you pediatrician already recommends healthy eating habits for your daughter but it might be a good idea for you to have them get more specific (meal plans, calories, etc.) so you have concrete numbers. I would also ask the pediatrician at what BMI or weight does it become a safety issue. You may also want to, if possible, be home for at least either breakfast or dinner so you can help feed your daughter. I'm concerned that the pediatrician may not really understand what's going on. Lastly - Pediatricians like many other healthcare providers are what are called mandated reporters. If they suspect neglect or abuse of a child, they are required to contact the local department of health and human service to file a report. They do not have to tell you they are doing it. The more contact you have with them, the less likely they will surprise you with reporting. I'm certainly not saying that they will definitely report you and your wife - I just want to make you aware of a possibility if your daughter's weight does not pick up and they suspect your wife is restricting her food. 

2. Couples Counseling: Addressing this with her is important but you may want to use a neutral third party to help facilitate this. Your wife may be defensive but she may also need help hearing you are not attacking her but concerned for your daughter. A really good counselor that specializes in couples work would be able to help tremendously with this. This is a good space for you to ask what she likes and dislikes about being a new mother. What are some things she wishes she could do if she had more time or support. Questions like these help disarm someone who is prone to being defensive. 

3. Additional Stuff Going On: From the little you described, I wonder if there is more going on with her. She may have some dormant obsessive compulsive-like symptoms that popped up during her pregnancy or during the first few months of your daughter's life. She may also be secretly concerned about her mommy-figure. She may be experiencing some post-partum. If she does not like the idea that she may have regressed, she may deny and bury how she's actually feeling and what she's actually thinking. Depending on what your relationship is like with her, you may want to address your concerns in therapy. It may take awhile for her to feel comfortable enough to bring it up. We often have this fantasy that once an issue in counseling is dealt with, it's fixed forever. More than likely she has psychological programming for diet and behavior restriction that may pop up now and again. Stress can definitely trigger new episodes and catch her off-guard.

4. Your Mother: If she is hypersensitive to judgement right now (which it sounds like she is) having your mother or anyone come in to 'help out' while you're at work will only entrench her position. It has to come from her and be her idea. I also find it interesting that you did not mention her family at all.

5. You: Get involved with the child-rearing as much as possible right now. I suspect there is alot going on with your wife and your involvement will provide oversight as well as support. It might also be a good thing to talk about her going back to work or looking for work (ie. or finding time for herself since she may feel consumed by care for your daughter). It might cost you more money on the front end to find day care or babysitters but malnutrition and an unhappy wife/mother is WAY more expensive in the long run. 

Best of luck. The professionals will be the most helpful support for this issue. If you do not know how to find competent therapists or pediatricians, contact our office and we'll help you out. www.fonthillcounseling.com/contact