Anorexia, grief and pregnancy ...

I posted a while back saying how I was suffering from anorexia following the death of my daughter six months ago. Well I have made some small steps forward and weighed 7st7lb today ...

Wel today i found out I am pregnant.

I am THRILLED as we want a baby so much after losing two daughters in three years, but having lost 5 stone in 6 months, I am scared.

I will NOT damage this baby by not eating, but I am worried how to go about moving back to a healthy eating plan.  Do I stay healthy and just gradually increase my portion size, or do i keep my portion size small and go for high fat / carb?

I want to get better, I want this baby to live and i am ready to listen and take advice.

Thanks,

Lisa

CONGRATULATIONS!! i am so happy for you and wish you a happy and healthy pregnancy!!

now, i'm not a professional and i really really suggest that you go to your doctors, explain everything and LISTEN and TAKE to their advice!

However my view, for what its worth would be that right now your body needs calories in any form more than anything- eating healthily is good for your baby yes but getting the right AMOUNT of calories is more important first of all. Don't ban or restrict anything from your diet (other than foods not recommended for pregnancy e.g. i think peanuts??)- BUT don't do low fat, low carb low anything just eat anything that will result in you taking in enough calories- which i'm guessing, as not only do you need to gain weight but also nurture a child will be quite high- i'm not sure how much and i'm sure someone else will have a more acurate numebr but i would guess that seeing as you probably need 2500 to gain and then maybe an extra 500 for your baby it will be at least 3000. Now this will probably be daunting but it is completely neccesary and so important for both your health. I would also suggest that you get to this number as soon as possible- you don't have time for gradual gradual!

i think that as long as you are eating a varied diet and not restricting anything you should just focus on getting these much needed calories and then when you have done this you can focus more on the types of food you are eating.

i really hope you can get to a healthy weight as soon as possible and focus on enjoying this amazing time in yuor life!

congratulations!

Honestly, I would talk to your ob and be 100% honest and tell her your medical history.  You need someone to be watching you during your pregnancy and make sure you are gaining appropriately and that your health is being taken care of.  With your history, your body is very vulnerable and you should be watched more closely.  You can also get a referral to a dietician who can help you with a healthy meal plan for your pregnancy.

Congrats!

Like the other posters, make sure your honest an in tune with all your doctors. Maybe seeing a therapist as well? Pregnancies can cause all sorts of moodiness, and with a history of AN, it may be a good idea to have someone to talk to, to avoid any chance of a relapse!

Dare I say it, but Nicole Richie is quite inspirational (for once) in this area. It was obvious she had some kind of problem (dude, she was a walking skeleton), but carried out a successful pregnancy. 

Congrats on being pregnant!

I think it is important to note here, that in the first trimester, you only need to be eating about 150 extra calories a day for your baby, it's about as much as an extra low fat yoghurt cup.

In the last trimester it builds up to an extra 300-500 per day, but you're probably a long way away from that.

You DO need to see your OBGYN and talk to them about pregnancy nutrition, they can help you formulate a plan. Most importantly though, dont freak out, you dont need to each an extra pizza a day, in the beginning an extra yoghurt, and gradually the equivalent of 4 extra yoghurts, it's do-able!

i think that an extra yoghurt would be fine ON TOP of a normal healthy amount but she isn't eating a normal healthy amount and isn't at a healthy weight. therefore it is important that you eat enough to GAIN to a healthy weight and then on top of that add the extra yoghurt. sorry i just don;t think that in this particular situation an extra yoghurt is going to be enough! thats why i suggested the 3000 number.

well, i respect your opinion jade, but the fact is no one can tell her here what she has to do.

Lisadai, everyone who has posted so far has told you to see you Doc, and your OBGYN. I think everyone is in agreement that that is the only way you can ensure the health of your future child.

I would recommend taking vitamins right away.  Especially, because your body is likely malnurished.  Purchasing a good prenatal vitamin should cover much of what you need.  But, I would also take extra calcium.  Do you have labs from previous appointments?  I would request a copy of those labs to see where you are. 

Definitely see your doctor.  In the mean time though, ramp up your protein intake.  I'm sure you know that you need to eat more then you have been.  This baby should be a much needed kick in the pants to be healthy.

Well I only found out yesterday and went straight to GP this afternoon. Like I said I really want to do right by this baby, losing two daughters has been quite enough heartache and left a big enough void. I am a bit nervous that the ED will prevent me from doing the best by the baby as it is such an aweful thing, but the GP said he is confident that I will slowely increase my portion size and calories to do right by the baby, it was nice to hear him being confident in my abaility.  7 weeks ago everyone told me (family and friends) that I would never come off anti depressants, diazipam and temazipam, but as soon as we started trying to conceive I was off them and fighting hard to stabalise my mood - have not had a single tablet since which I am proud of.

Ok, I have doubled my calorie intake over the last two days and am now up to around 1,000 including lunch, dinner and one snack.  I know it still isnt enough, but when you think just two days ago I was at 500 max I thin it is progress ...

I have the phone number for my obstetric consultant and will be ringing tomorrow for an open and honest chat, but I know he wont discuss diet with me ... I find you guys helpful though.

Does anyone know of a certain meal I should try and eat - high vitamines etc. ?

Thanks, Lisa

Because I cannot say this any better.
http://www.something-fishy.org/dangers/pregna ncy.php

... because of both the physical and emotional health of women with Eating Disorders, those who become pregnant are at an increased risk of of some of the following complications: Risks to the baby can be delayed fetal-growth, low birth-weight babies, birth defects, fetal abnormality such as a cleft palate or cleft lip, jaundice, respiratory distress of the baby immediately after birth, higher death possibility to the baby in the last trimester of pregnancy or within 1 month after birth (perinatal mortality), and low Apgar scores -- The Apgar score is a reading of the baby's skin color, heart rate, movement, breathing and reflexes, each rated from 0 - poor, to 2 - good. The reading is taken 1 and 5 minutes after birth.

Other risks to mom and the baby include miscarriage, Gestational Diabetes, Preeclampsia (toxemia), low amniotic fluid, placental separation, complications during labor (such as a breech birth), incompetent cervix and/or spontaneous abortion, and increased risk to Mom of damage to the kidneys and heart...

It is brilliant you are fighting this. Really, it is. As it is you want to recover for your child. But you have to be healthy. To support their growth, and to support yourself. 1000 calories is not enough. Only upwards of 2500 will be - more, in fact, as you will need even more than this for the baby too.

I want you to go back to your GP and ask about being monitored. Inpatient. Even if he says he is confident, there is too much risk here.

Lisa,

Congrat's!! I will keep you & your baby in my prayers :). I didn't have as low of numbers as you have for intake but I am pretty sure I can't ever have kids bc of my amenorrhea. Anyhow, I am really happy for you and I hope you can conquer your fears and issues and focus on the next few months :). Remember this is only temporary... any weight gained is good weight and you can deal with the "fat" issues later... right now the only thing that matters is the little gal/guy in ya ;) and their needs.

G'luck with everything!!

_mel

Well I am 5 weeks pregnant now and have taken a few small steps forward. I have not gained weight yet, but have not lost any either which I see as positive. I must admit the list of all I could be doing to damage my baby upset me a little, but i am keeping things in perspective, slowely increasing my calories and resting lots. The doctor is hapy with this for now, I am seeing him again in two weeks. I am determined this baby will do well and thrive, I am staying positive despite my two previous losses.

Lisa

Lisa,

I am really glad to hear you are staying positive. Sometimes it can be hard, and since you are off all meds it's probably harder for you... but stick it out girl!! You can persevere and you are strong enough to handle anything!!

Just keep you baby plastered in your mind. Remind yourself that you will not fail. Every day make a small goal (start with 15 cals extra or something simple) and up it as you go along. When selecting your cals, select the best nutrient-rich cals.

If it helps whenever I eat meat or veggies even when going overboard on cals I just don't feel the same guilt. It's so un-processed and so natural that I feel like the cals don't count almost. During pregnancy iron deficits are ramped. Try going for steak if you can... loaded with iron and cals but it's just not bad ya know? Especially when I buy carpaccio or carne asada... it's thin and the meat is fatless. :)

I will continue to pray for you & wish you all the very best!!

Thank you for your positive encouraging words :-)   Yes after a horrendous six months being controlled with antidepressants and sedatives for my grief, I am really proud to be off them all and I am coping with grieving and nurturing a new baby. I have to be proud of myself and stay positive and cant let myself stress over eating too much (GP said this). I am getting a good ranage on steamed fish, veg and fruit and am trying to have the odd mars to get some calories down lol! My body still cant tollerate a big meal but my portion size is building up. I have to do it for the baby, god I want it to all go well.

I will dig myself out of this.

Love Lisa

Lisa,

If it means anything - I'm super proud of you. I would have an equally hard time... even though I'm probably not able to have kids the thought of gaining scares me. I commend you for your efforts. Have you talked to your doc about protein shakes? Those have a ton of vitamins and cals and are generally small. Also there is high cal "nuggets". They are about the size of 1/3 my fist and contain 450 cals. Body builders use them when they cannot eat anymore but need more cals. It seriously might take away some of the "guilt" as your belly will still be somewhat empty :).

I can send you the link if you want.

-Mel