Real bodies: You're just like your mum

Heart disease, depression, anorexia - a mother can unwittingly pass them all to her child, says a new report. HESTER LACEY investigates

It is extraordinarily hard being a mother who is likely to pass on an illness to her child. Modern research has made clearer how disease can pass from generation to generation, and there can be few situations more heartbreaking than knowing that your child may suffer because of an accident of genetics. Recent research has now suggested that, apart from hereditary illnesses, maternal stress - hard to quantify and difficult to avoid for many women - can also play a part in health problems for offspring in later life.

The fact that breast cancer can be passed on within families is well- documented. Melissa's family has a history of the disease - her mother died of it, as did her grandmother. Melissa, who is 28, has a daughter aged four and finds the notion that she may involuntarily contribute to her daughter's ill-health a cruel burden to deal with.

"When I was pregnant, I hoped very much for a son," she recalls. "I know that breast cancer is hereditary and I feel as though I'm living with a timebomb myself. I so much didn't want to pass that on to Libby. When she was born, I immediately adored her and I just hate the idea that she might one day be ill because of something that's come through me."

Melissa's own mother died when she was 14. "I remember her being so ill and fighting so hard," she says. "At the time I didn't really take in the fact that this would affect me in later life. I was very young and you think you're immortal when you're a teenager. I am so grateful to my mother for my life, it's impossible to feel any resentment about the fact that you are carrying genes that may do you harm because of course it's not anyone's fault. But you can't help wishing that things were different. I feel it not so much for myself but for Libby - it's hard not to feel guilty that she may have inherited something genetically dangerous, even though it's no one's fault."

At the moment, although she is free from the disease, Melissa is contemplating requesting a double mastectomy to forestall any possible appearance of the cancer. "It's a horrible decision to have to make," she says. "I hate the thought that Libby, who is so young and perfect at the moment, might one day have to think along the same lines and have an operation that is disfiguring and dreadfully upsetting."

Libby, of course, is far too young to understand her mother's worries, but, says Melissa, she can't help feeling guilty. "I've discussed this so often with my husband and he tells me it's just an accident of nature. I know that he's right but at the same time it is terrible to carry such an awful potential legacy." And, she says, while she would like another baby, she is now almost phobic about the thought of having another daughter. "I'd love another child, but only if it was a boy. I can't bear the thought of feeling this way about another child."

New research is now suggesting that it is not only genetic inheritance that can be passed on from mother to child. Professor Peter Nathanielsz of the College of Veterinary Medicine at Cornell University, New York, claims that stress and poor diet in pregnant women can adversely affect their unborn babies. "We now have very impressive evidence that the effects of stress and diet start way before birth," he says. His theory is that killer diseases which develop later in life can be traced back to the mother's hormones - triggered by stress levels - on the developing foetus, or to maternal dietary deficiencies that then affect the unborn baby's development.

Stress during pregnancy, he suggests, can lead to heart attacks in later life for the child because the foetus is exposed to high levels of the stress hormone cortisol, which raises blood pressure, while poor nutrition in the womb affects the child's later ability to metabolise food and could show up as heart disease or strokes when the child is older. Prof Nathanielsz says he is keen for his research to be used to help mothers rather than worry them, and says that the most important preventative factor is to allow women the conditions for a successful pregnancy, including plenty of rest - a state which plenty of working pregnant women might find rather tricky to achieve.

Mothers may affect their children in even less obvious ways too. It was once thought that autism was triggered by a cold and distant mother, but this theory has long been discredited. However, it is possible that a mother's own attitudes to food may be reflected in her daughter's eating disorders.

"My mother is very slim and can eat what she wants," says one recovering anorexic. "She would tease me about my weight - it was a joke to her that I was plump - and say I should go on a diet. I'm sure she didn't mean any harm, but I went on quite a strict diet when I was 15, and at first she congratulated me and encouraged me. She would buy me lots of new clothes, and I felt really proud of myself."

Sadly, the diet went too far. "When I got really skinny she began to get worried and told me to stop. She started trying to tempt me with my favourite foods and cook for me, and I hated her for it because I felt as though she was undermining everything I'd achieved and that she had approved of. I ended up having to be treated for anorexia. She never acknowledged that she had contributed to it at first, even though she must have realised."

Parents of children with eating disorders often get a very bad press, says Grace Coia, a Glasgow- based hypno- and psychotherapist who runs an eating disorders clinic, and this is often undeserved. But sometimes they may unwittingly contribute to the problem. "There is a pressure on mums to produce slim daughters and it's seen as a fault if they have square, stocky daughters - mothers know how judged their daughters will be if they aren't slim," she says. "One young woman was severely anorexic and couldn't be left in the house on her own so her mother took her out with her - unfortunately she was going to a WeightWatchers meeting. Also mothers may have hangups about food. I have girls who say `No one eats normally in my family, mum is permanently on a diet'."

From hereditary illness to psychological damage, mothers these days have far more information on what they should be worrying about than ever before. At the annual conference of the Royal College of Psychiatrists a few years ago, for example, a paper was presented which suggested that depression in women was limited to the period of their reproductive lives.

"It seems as though when you have a baby everything is a disaster waiting to happen," says Melissa. "For every piece of good news on the research front it seems that there is something else that mothers are doing wrong in some way. But we are really hoping that before Libby grows up there will be some breakthrough in the treatment of breast cancer and she won't have to worry about her own daughter the way I worry about her."