Considerations in managing bulimia nervosa in the postpartum

In the postpartum, the principles of treating patients with bulimia nervosa are the same as at any other time. Mothers with bulimia nervosa are:

• at increased risk of relapse because of the combination of stress, sleep deprivation and reduced motivation because the infant is no longer in utero
• more likely to develop postnatal depression.

Parent–infant interactions tend to involve more control and conflict, and parents can project their distorted body image onto their children. Children of mothers with bulimia nervosa tend to underweight for their age. Ongoing monitoring and management into the perinatal period is essential for both parent and infant.

For advice on psychotropic use while breastfeeding, see here.