New approach helps new moms with eating disorders

Special training using video feedback can help mothers with eating disorders interact in a healthier way with their infants during mealtimes, a new study shows.

Past research has demonstrated that mothers with eating disorders are more likely to have major mealtime conflicts with their children, Dr. Alan Stein of the University of Oxford in the UK and colleagues note. Mothers with eating disorders are less likely to allow their child to “experiment” with food or to feed him or herself in an age-appropriate way; they also have more difficulty interpreting and responding to a child’s non-verbal cues.

To date, no approaches have been tested to improve mealtime relations between moms with eating disorders and their children, Stein’s group points out. To investigate, they assigned 77 mother-child pairs to 13 sessions of standard counseling or to a video feedback counseling program. All of the women had been diagnosed with bulimia nervosa or a similar eating disorder.

In the video feedback program mealtimes were videotaped and then the counselor would review it with the mother, pointing out infant cues and using other techniques to improve the mother’s observational skills.

The sessions began when the infants were four to six months old. At about 12 months of age, when the sessions were completed, the mother-child pairs were observed during a standard mealtime for signs of conflict.

“Marked or severe conflict” occurred in 23.7% of the mother-child pairs in the video feedback group, compared to 53.8% of those who underwent standard counseling. Mothers who received the video feedback training were 73% less likely to have such serious episodes of conflict during mealtimes.

Babies in the video feedback group were more independent at mealtimes, while their moms interacted with them in a more supportive fashion.

Women in both groups had improvements in eating disorder symptoms depressive symptoms, and infants in both groups had similar weight gain.

The 73% reduction in conflict seen with video feedback is “striking,” Stein and his team report, and shows that this training “may play a role in halting the intergenerational transmission of this form of psychiatric disturbance.”

“Video-feedback treatment focuses the mother away from her eating preoccupations onto the infant,” they continue. “It helps her to notice and interpret her infant’s behavior and highlights where she can encourage her infant.”

The researchers conclude that the video feedback technique offers promise for helping mothers with other types of postnatal psychiatric disorders as well.

SOURCE: American Journal of Psychiatry, May 2006.

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