TWO FOR THE PRICE OF ONE The impact of body image during pregnancy and after birth

This report looks at the myriad of health and psychological effects that body image can have

on pregnant women and new mothers, and shows how preoccupation with body image problems

can be unconsciously transmitted down to their children.

Eating problems of all kinds are on the rise. The most visible and obvious is obesity which is straining

the resources of the NHS. The most hidden is the chaotic eating which doesn’t show but which

involves individuals who intermittently restrict and binge while obsessing about their bodies,

rarely feeling safe around food.

Many factors contribute to the current epidemic. Often overlooked is the role of inter-generational

transmissionof eating problems and the psychological meaning of eating and body difficulties.

This is especially powerfulbetween mothers and daughters but it extends to the whole family.

We see obesogenic familiesand families who are vulnerable to eating problems and we see families

in which food restraining, fad dieting and extreme exercise are the manifestation of disturbed

appetites and fear of food.

Psychologists, neuroscientists, infant researchers, and public health professionals agree that

conception to age 2 is a vitally important time in human development. It lays down patterns

for life. It is also a time when attention targeted to parents and babies reaps huge dividends for


Early attachment between mothers and babies creates the foundation for mental health, resilience

and flexibility in children. Mothers who are preoccupied with eating and body image problems can

inadvertently behave in ways that shape bonding and attachment patterns in damaging ways.

Midwives and Health visitors are crucial in the transmission of public health to mothers and

new babies.

They are vested with ensuring that the mental and physical health of mother and baby is optimised.

Midwives and health visitors receive little training on the effect of eating problems on mothers’

relationship with her infant, the feeding relationship and its impact on the baby’s developing body.

They also work with significant resource constraints and can be hard-pressed to find time to take

on new issues and challenges. Nevertheless, we cannot afford to overlook their potential contribution

to supporting women’s body image and healthy eating behaviours at this time.

Early intervention is the optimal chance to reach two populations in one go. Pregnancy and post-partum

is a time when mothers are most receptive to ‘getting things right’. Routinely talking to all mothers about

these issues will help them to identify causes of distress and unease, and legitimise asking for help. It gives

women the opportunity to optimise their own wellbeing and therefore also the wellbeing of their babies. .