How can we help a woman with an eating disorder to exclusively breastfeed without causing excessive mental stress?

If you're asking this question as a friend or family member of someone with an eating disorder, I would say that many times it can be as simple as showing yourself to be approachable, available, or directly asking how you can help, without judgment.

As professionals, we must individualize and focus care on the person in front of us, keeping in mind their wishes, their needs, and their circumstances.

Breastfeeding can be more harmful than beneficial if sufficient intake is not ensured, as it can activate and reinforce the symptoms of eating disorders.

Sometimes, if a woman is experiencing an energy deficit, exclusive breastfeeding, with all its benefits, can be more harmful than helpful if sufficient intake isn't ensured, as it can trigger and exacerbate the symptoms of the eating disorder. It's crucial to avoid falling back into an energy deficit . Explain to the woman that it's normal to feel hungrier and to honor that feeling. Episodes of extreme hunger or hyperphagia have been described, which is perfectly normal. It will be important to always respond to both physical and mental hunger.

Finally, it's worth noting that, as healthcare professionals, emphasizing the caloric expenditure of breastfeeding is anything but valuable. Studies already suggest that in women with eating disorders, breastfeeding can be a dysfunctional weight control mechanism—in other words, a compensatory behavior.