Breastfeeding is challenging for many women: there’s the stress of needing to feed a tiny new human with your own body, concerns about baby’s weight gain, latching issues, complicated breast pumps, not to mention the pressure to breastfeed in the first place. But for those with a history of an eating disorder, breastfeeding can be even more fraught.

As someone with a history of anorexia, I was surprised to find that I had no trouble with the weight gain and body changes associated with pregnancy. My motivations and goals were clear (nourish my body well so that I can grow and birth a healthy baby!), and those around me praised and marveled at my expanding bump. But breastfeeding was much more complicated. My objectives were suddenly murkier, society’s expectations different, and there were a whole host of new stressors brought about by life with a newborn. In the weeks and months after my daughter’s birth, disordered thoughts and habits that had long ago disappeared began to resurface, shaping my breastfeeding experience in ways I hadn’t anticipated.

My experience isn’t unique: many women who have been affected by an eating disorder or disordered eating have struggled with the particular set of challenges that breastfeeding can present. Read on to learn more about the link between breastfeeding and eating disorders, risks and benefits to be aware of, and expert insights on how to navigate breastfeeding while in recovery.

Do eating disorders affect breastfeeding?

Because eating disorders have such a profound impact on the physical body, including hormone levels, it’s natural to wonder whether breastfeeding is even possible for those dealing with or in recovery from an eating disorder. According to the research, the answer is overwhelmingly yes. In fact, studies have shown that when it comes to whether or not a mother initially breastfeeds her infant, there’s no statistically significant difference between those with eating disorders and those without.

However, some research does suggest that eating disorders can impact both how long breastfeeding lasts and how it goes. Several studies have found that those with eating disorders are more likely to stop breastfeeding “early” (which is defined differently from study to study, but can range from two to six months postpartum). This seems to be particularly true for women with a history of anorexia or purging disorder, and for those considered to be underweight.

Research has also found that those with eating disorders may have a harder time with the experience of breastfeeding itself. One meta-analysis showed that women with an eating disorder history had more negative experiences and emotional problems during breastfeeding, while another study found that those with clinically significant eating disorder symptoms felt less confident in their ability to breastfeed.

It’s important to note that there’s relatively little research into this topic, and these findings don’t mean that if you’ve dealt with an eating disorder you are destined to struggle with breastfeeding or stop breastfeeding earlier than you want to. Rather, they simply highlight the fact that those who have been affected by eating disorders may face unique challenges along their breastfeeding journey—and with the right support, these challenges are surmountable.

Why breastfeeding can be challenging for those affected by eating disorders

Regardless of whether or not you’ve dealt with an eating disorder, there are a multitude of potential food- and body-related triggers that can come up after giving birth, and breastfeeding can be one of the biggest. “The postpartum period presents a number of potential challenges for women regardless of their lived experience with eating disorders, disordered eating, or body image concerns,” says Maddie Friedman, LCSW, therapist lead at Equip. “Breastfeeding is one of many options people may or may not choose to pursue that can pose additional physical and nutritional needs during the postpartum period.”

If you decide to breastfeed your baby, the journey can be complicated by a number of different challenges, including:

Difficulty eating enough

When my baby was inside my body, I had no trouble eating the amount of food recommended to me. It made intuitive sense: there’s another human inside me, so I need to eat more. Once the baby was outside, however, things changed. I logically understood that my body still needed a significant amount of calories to produce breast milk, but this reasoning wasn’t strong enough to override the eating disorder logic telling me, “The baby isn’t in your body anymore, so you don’t need to eat as much.” This line of thinking is all too common among women who have struggled with eating issues: in an Equip survey of women with a history of an eating disorder or disordered eating, 56% of respondents reported finding it at least somewhat challenging to give their bodies adequate nourishment to support lactation.

With the support of a dietitian, I was able to fight back against the eating disorder voice and provide my body with enough energy to feed myself and my daughter. However, Friedman points out, it’s important not to adopt a line of thinking that views eating as conditional on breastfeeding: “We want to be careful to balance an understanding of increased nutritional need without a strict justification that this is ‘only’ because of breastfeeding, and try to maintain psychological flexibility around food intake fluctuating during different days and life moments to promote recovery,” she says.

“Bounce back” culture

Because of the seemingly inescapable reach of diet culture, many women experience extreme pressures to “lose the baby weight” as soon as they’ve given birth. I felt this pressure acutely, and was paralyzed by the mixed messages I was receiving: on the one hand, I was supposed to eat enough to support lactation, but on the other, I was supposed to return to my pre-pregnancy body as quickly as possible.

It doesn’t help that a lot of the research and educational materials on breastfeeding amplify diet culture messages by pointing out that breastfeeding may help with weight loss. Numerous studies have been conducted to evaluate the effectiveness of breastfeeding for weight loss, with one study even concluding that mothers should be encouraged to breastfeed exclusively “as a means of overweight and obesity prevention.”

This mindset is concerning. So concerning, in fact, that several eating disorder experts published a letter in the International Journal of Eating Disorders raising an alarm about the potential for breastfeeding and pumping to be used as maladaptive weight control behaviors. In the letter, they note that in their clinical practice, they’ve observed a number of postpartum women with a history of or current eating disorders using breastfeeding, pumping, or both to influence body shape and weight.

Pressure from healthcare providers

Regardless of eating disorder history, many women experience pressure to breastfeed from all sides: from doctors, social media, well-meaning friends and family. There’s endless discourse online about whether or not and how long new mothers “should” breastfeed, and many women feel intense pressure to meet these expectations. For those with a history of an eating disorder, this pressure can be a risk factor for slipping back into disordered habits.

According to one study, pressure to breastfeed was linked to increased eating disorder symptoms in postpartum women. This effect was particularly pronounced when the pressure came from women’s healthcare providers.

Other postpartum stressors

The challenges of breastfeeding can be compounded by other challenges of the postpartum period: body image concerns, grappling with a new identity, postpartum depression or anxiety, stress about baby’s growth chart, and more, all compounded by an extreme lack of sleep.

“Even at its most successful, breastfeeding requires folx who are often already scattered and sleep deprived to consume more food more often to make up for nutritional deficits caused by feeding,” says Friedman. “Rapid hormonal and body changes may also cause discomfort with body image as well as a sense of loss of control.” Indeed, according to research, the psychological stressors of new motherhood and postpartum body image concerns have been shown to exacerbate eating disorder symptoms and postpartum mood disorders, which can, in turn, affect mother-baby attachment, including breastfeeding.

Benefits of breastfeeding for those in recovery

While the choice to breastfeed can present difficulties for many women with an eating disorder history, it can also have the opposite effect, strengthening recovery. Which direction it goes may depend on how long you’ve been recovered, what kind of support you have, your baby’s nursing style, and an infinite number of other factors—it can also change from day to day.

Breastfeeding has the potential to help those in eating disorder recovery in a number of different ways, including:

Appreciation for your body

“For many people with lived experience of eating disorders, being able to carry a pregnancy to term and use their body to feed their baby can be incredibly healing and empowering,” says Friedman. “Where their body once felt like a battleground, this experience of giving and sustaining life can alter one’s perspective of what their body is capable of and generate a sense of gratitude for its ability to heal past previous challenges.”

In the moments when breastfeeding was going well for me, I experienced this deeply. Seeing my daughter’s weight move up the growth charts and knowing that it was my body helping her do that filled me with a gratitude for my body that I’d never felt before.

Helpful hormones

The hormone oxytocin plays an important role in breastfeeding, stimulating milk letdown. This is notable because oxytocin has also been linked to a sense of calm that can be helpful in mitigating eating disorder-related stress. In fact, some research has called for more studies into the potential role of oxytocin in eating disorder treatment.

Connection

Eating disorders thrive in secrecy and can be extremely isolating. Many people who struggle with eating disorders feel disconnected from others in their life, both physically and emotionally. Breastfeeding is one of the most intimate forms of connection a human can have with another human, and this sense of connection can be deeply healing for those who have struggled with eating disorders. For me—someone who had been in recovery for years but still felt some of the lingering isolation of my eating disorder—the unbridled physical and emotional connection I experienced when nursing my daughter was nothing short of revelatory.

A new perspective on eating

An infant nursing is one of the most primal acts we witness as human beings: the babies are driven by pure intuition and instinct for survival, they know exactly what to do and they do it without any other concerns or clutter in their mind. Newborns know they need to eat to survive, and so they eat, and they enjoy it, and that’s the end of the story. Watching this happen can be eye-opening for those affected by eating disorders.

“I’ve heard folx with active eating disorders reflect on observing babies eating with reckless abandon and without any self-perception or body image worries,” says Friedman. “Breastfeeding and taking a more agnostic approach to feeding can feel very contrary to one’s past experiences with eating and can promote a more objective approach.”

How to navigate breastfeeding while in recovery

If you’ve dealt with or are dealing with an eating disorder, it’s first important to be thoughtful about whether or not to breastfeed. Breastfeeding has benefits, but—despite messaging to the contrary—you can still be a good parent and give your baby all the nutrients and love it needs without breastfeeding at all. It’s a personal decision and one that should be made thoughtfully and without being swayed by external pressures. “I would always defer to someone’s preferences, goals, and concerns when it comes to whether or not to breastfeed,” says Friedman.

However, if you do choose to breastfeed, there are some strategies you can use to help keep your recovery strong and support your breastfeeding journey.

Stay in the present moment

During the postpartum period, it can be easy to spiral into worries, fears, or your never-ending to-do list, and this stress can increase risk of turning to disordered behaviors. To combat this, do your best to stay present—and try using your baby as a tool for achieving that. “Babies are so helpful for increasing present moment awareness, so I would recommend tapping into that whenever possible,” says Friedman. “Feet on the ground, deep breaths, and connecting with loved ones for support.”

Be mindful of your thoughts

If you’ve struggled with an eating disorder, you’re likely familiar with how good eating disorder thoughts are at taking over your whole mind—it’s for this reason that we often say that eating disorders hijack a person’s brain. One way to combat this is by taking time to notice and observe your thoughts objectively, rather than identifying with them. “I think it’s important to remember that thoughts are stories and not facts. They come and they go if we let them pass,” Friedman says.

Get support

As you navigate all the ups and downs of taking care of and nourishing a new baby, remember that you don’t need to go it alone. Lean on loved ones to give you help and let you take breaks, and don’t be afraid to turn to professionals for extra support. As Friedman says, “the postpartum period can be so challenging and transformative, and I think carving out space for regular therapy and self-care is critical.”

When I found myself struggling to eat the amount of food I knew my body needed, I called up the eating disorder dietitian I’d worked with many years earlier. She was able to coach me over the phone and provide a loose meal plan that I could use to get back on track with my eating.

Put your mental health first

If, along the way, breastfeeding begins to take a toll on your well-being, remember that you can stop at any time, and it isn’t a sign of failure. What’s most important for a baby is that it has a parent who is mentally and physically healthy. “Birthing parents’ mental health is of utmost importance, and if breastfeeding is not feeling like a good choice for them, I would support them through alternative considerations,” says Friedman.

Eating disorders can present breastfeeding challenges, and breastfeeding has the potential to trigger eating disorder behaviors—but neither of these outcomes are inevitable. If you’ve dealt with an eating disorder in the past, or are currently struggling with disordered behaviors, you can still breastfeed successfully while protecting (or working toward) recovery. What’s important is that you embark on your breastfeeding journey thoughtfully, and enlist support when you need it.

Reach out to our team to talk through your concerns and get the resources you need to support you and your baby.