Improving the mother-infant relationship in the context of maternal eating disorder – a randomised controlled trial
Ed Juszczak and Rosamund Weatherall with Alan Stein, Anne Schmidt and Sandra Cooper (Oxford) and Rob Senior, Fiona Challacombe and Joanna Lee (London)
There is accumulating evidence that psychiatric disorders, including eating disorders, occurring in the postnatal period are associated with increased risks to child development and that a key way in which maternal psychiatric disorder affects children’s development is by disrupting parenting functions. There have been no published intervention studies aimed at helping mothers with eating disorders and their infants. Eating disorders are relatively common amongst women of childbearing age affecting approximately 4% of women. However, it has been recently reported that a relatively new intervention using video-feedback may be particularly useful in helping vulnerable mothers and infants although no studies to date have been aimed at mothers with psychiatric disorders. Critically, this intervention provides direct access to the details of mother-child interaction.
The study design was a two-arm, parallel group randomised controlled trial investigating whether an intervention for mothers with eating disorders, targeted specifically at mother-infant interaction would improve that interaction and particularly reduce mealtime conflict, compared to a counselling treatment. 80 mothers with an eating disorder (bulimic type), with infants aged 4 to 6 months were randomised to either a video-feedback interactional treatment or non-directive supportive counselling, delivered over thirteen sessions in their own homes; concurrently all mothers also received brief guided self-help cognitive behavioural therapy for their eating disorder.
The main outcome measures were the level of conflict during the principal meal of the day (rated by assessors blind to group assignment) and other aspects of the mother-infant interaction, infant autonomy and infant weight assessed at baseline and 12 months follow-up.
