Exercise has many benefits, is there a protocol for breastfeeding moms? Are there any risks associated with a mother exercising while she is still breastfeeding? As well, what is the recommended type of exercise? and how much time should be spent actively working out?
When can I start?
Before jumping on the work out bandwagon a mother needs to remember that exercising after birth must be self paced. There are many factors that can affect the turnaround time one may experience with their body postpartum. These factors can range from perineal trauma, hemorrhaging, medical/surgical complications which arose during pregnancy and the postpartum period, as well as her own personal preferences (Artal, & O'Toole, 2003).
That goes without saying that even a mother who had delivered vaginally, without any complications would need clearance from her physician before getting back into a gradual exercise routine. Which typically occurs at their six-week postpartum appointment. Making sure to speak with a health care provider and discuss your personal goals to create a timeline that works best for you and your healing process.
Where do I start?
Aerobic exercises should be the first choice of physical activity a postpartum mother chooses when returning to gym. Waiting about 12 weeks is the recommended time that a mother waits prior to returning to more intense exercises like weights or running. Although the above recommendations are for typical births, there are those who may have experienced a cesarean or similar complications during birth. These complications could leave scar tissue, which would need extra time for proper healing of the abdominal wall (Artal, & O'Toole, 2003).
It’s important that each mother remember that their workouts need to be gradual. Having a routine, and working your way back up to pre-pregnancy capabilities is of utmost importance when returning to exercise. If any activities or movements cause pain or seem difficult, they should be discontinued immediately.
Types of Postpartum Exercise
There are a couple of great exercises that can help strengthen a mothers core and muscle capacity. Artal & O'Toole (2003) list a number of safe exercises, they advised mothers to focus on aerobic exercises and the strengthening of muscles which were out of commission during the pregnancy, and weakened during delivery.
Pelvic floor exercises (AKA Kegels): Can be initiated earlier on in the healing process. About two weeks postnatal, a mother who didn't experience any ripping or an episiotomy can start to voluntarily contract their pelvic floor muscles. This motion is known as Kegels and are known to promote healing and increase blood flow to the pelvic floor region following the trauma of a delivery. Kegels can be performed multiple times a day to help reduce involuntary urinary and bowel incontinence.
Walking and running: Slowly working up from walking to running may take some time. A mother can start walking almost immediately after delivery. This holds true for a mother who had a cesarean or vaginal delivery. Walking has many benefits, one such benefit is its ability to decrease the likelihood of experiencing a postpartum blood clot. Additionally, it has been proven to have a positive impact on the mothers mood. These walk’s can be short and gradually built upon, to multiple short walks completed in one day. Prior to building up the endurance to run or intense exercise, it is recommended that a mother wait at least 12 weeks postpartum. Each session should be limited to 20-minute sessions, 3 times per week and can gradually be built up over time.
Weights-strength training: When focusing on specific regions of the body there are a number of muscle specific exercises you can try. When a mother is two weeks postpartum and after consulting with a health care provider, it is recommended to start with yoga which will help the mother regain her balance, flexibility and strength. Yoga has also been shown to aid in pelvic floor rehabilitation and reduces postpartum anxiety. Other Such exercises that can be introduced include; pilates, yoga, light weight-lifting and swimming which can be done at least two days per week in addition to the aerobic exercises mentioned above.
Types of exercise to avoid
Each person has their own personal circumstances that may interfere with their body's ability to exercise and they may need to be avoided until clearance is given by a doctor. Even more so, those mothers who delivered via cesarean, whose health care provider recommends that they not lift anything heavier than their newborn for the first two weeks postpartum. Things that should be avoided include the following;
Rigorous abdominal workouts: During the period of pregnancy and after birth, a mothers abdominal muscles are weakened and under-stimulated, they may not function at the same capacity as they did pre-pregnancy. Keeping this in mind, doing exercises involving the use of abdominal muscles, will need to be modified, and performed carefully until the mothers original strength is regained.
Excessive/Strenuous workouts: Performing intense physical activities can lead to further complications to the mother who is trying to heal. Additionally, it may delay the recovery of her joints and ligaments throughout the body.
Effects of exercise on breast milk
There are a number of psychological and biological benefits a mother may experience. A moderate level of exercise will have a positive effect on the emotional wellbeing of the breastfeeding mother. Other such benefits include, the positive impact exercise has on cardiovascular health, the ability to maintain weight, an improved lipid and insulin level, a reduced level of stress, fatigue, and alleviating depression symptoms. Lastly, moderate exercise increases levels of dyad bonding (Blumenthal et al., 2007; Demissie, et al., 2011).
A low to moderate level of exercise has shown no impact on the quantity of milk, the baby's growth, or milk quality or composition. Although strenuous exercise has been seen to increase levels of Lactic acid IgA, lactoferrin, urea and lysozyme content of a mother’s milk (Carey, et al., 1997 ; Lovelady, et al., 2003; Gregory et al, 1997).
The increase in lactic acid levels after an intense workout can last up to 2 hours. There are no known harmful effects for a baby. As well, the breast acceptance post workout will be similar if not exact to a regular session. This was even seen with mothers who had completed an intense workout. If a mother were to see a diversion of the breast post workout, it may not have to do with the taste of the breast milk but to the salty sweat sitting on the mothers skin. If this is a concern for an active mother, she should try to express or pump 3-5 mL from each breast prior to the work out. Alternatively, she could wait two hours after the workout so that the Lactic acid concentrate subsides. Alternatively, she could tone down the workouts to avoid this concern (Wallace, et al., 1992; Wright, & Quinn, et al., 2002).
A mother should wait until the baby is six weeks old prior to exercise if you delivered vaginally. Although slightly longer for cesarean births and with the go ahead of the health care provider. Start slow and listen to your body, and keep yourself hydrated (La Leche League International, 2022).
How will exercise impact my body
Those who are able to exclusively breastfeed for at least the first 3 month postpartum, could see a 2.7 percent decrease in their weight at 12 months in comparison to non-exclusive breastfeeding mothers or those using formula (Jarlenski, et al., 2014). This study found that those who breastfeed had returned to the pre-pregnancy weight 6% faster than their counterparts. This drastic weight loss was seen because of the increase in energy expenditures and hormonal changes a mother needs to nurse a child.
Am I Pushing too hard?
Listen to your body and don't push yourself too hard. If you're a mother who experiences feelings of pain, dizziness, nausea, or issues breathing, you should take some extra precautions while working out. There are a couple of complications that would warrant a mother to call a healthcare provider. Such complications include severe pain, heavy bleeding/flow/hemorrhage, swollen or painful leg, a fever or changes to a cesarean incision site, which may require immediate medical attention.
By Deena Zacks.
REFERENCES:
Artal, R., & O'Toole, M. (2003). Guidelines of the American College of Obstetricians and Gynecologists for exercise during pregnancy and the postpartum period. British journal of sports medicine, 37(1), 6-12.
Blumenthal JA, et al. Exercise and pharmacotherapy in the treatment of major depressive
disorder. Psychosom Med. 2007 Sep-Oct;69(7):587-96. Epub 2007 Sep 10.
Bonyata, K. (2018). Exercise and breastfeeding • kellymom.com. KellyMom.com. Retrieved
August 3, 2022, from https://kellymom.com/bf/can-i-breastfeed/lifestyle/mom-exercise/
Carey, G. B., & Quinn, T. J. (2001). Exercise and lactation: are they compatible?. Canadian journal of applied physiology, 26(1), 55-74.
Carey, G. B., Quinn, T. J., & Goodwin, S. E. (1997). Breast milk composition after exercise of different intensities. Journal of human lactation : official journal of International Lactation Consultant Association, 13(2), 115–120.
https://doi.org/10.1177/089033449701300211
Demissie, Z., Siega-Riz, A. M., Evenson, K. R., Herring, A. H., Dole, N., & Gaynes, B. N. (2011). Associations between physical activity and postpartum depressive symptoms. Journal of Women's Health, 20(7), 1025-1034.
Gregory, R. L., Wallace, J. P., Gfell, L. E., Marks, J. E., & King, B. A. (1997).
Effect of exercise on milk immunoglobulin A. Medicine and science in sports and exercise, 29(12), 1596-1601.
La Leche League International. (2022). Exercise. Retrieved August 3, 2022, from
https://www.llli.org/breastfeeding-info/exercise/
Lovelady CA, Hunter CP, Geigerman C. Effect of Exercise on Immunologic Factors in Breast
Milk. Pediatrics 2003 February;111(2):e148-e152
Jarlenski, M. P., Bennett, W. L., Bleich, S. N., Barry, C. L., & Stuart, E. A. (2014). Effects of
breastfeeding on postpartum weight loss among U.S. women. Preventive medicine, 69,
146–150. https://doi.org/10.1016/j.ypmed.2014.09.018
Wallace, J. P., Inbar, G., & Ernsthausen, K. (1992). Infant acceptance of postexercise breast milk.
Pediatrics, 89(6), 1245-1247.
Wright, K. S., Quinn, T. J., & Carey, G. B. (2002). Infant acceptance of breast milk after maternal
exercise. Pediatrics, 109(4), 585-589.
*Not medical advice. This post is made for educational purposes only.
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