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Postpartum Fitness... And Beyond

Carla Dobrovits
From New Beginnings, Vol. 31 No. 1, 2010, pp. 4-8

After the "bump" watch expires and the first photos have been bought and printed, the glossy magazines turn their cameras and attention to the next critical celebrity mom update: how long will it take her to lose her baby weight?

Rich and famous mommies have their personal trainer scheduled, their meals prepped and/or delivered, a nanny to watch the baby while they slave in the gym ... but what about the rest of us? How can ordinary, non-celebrity mothers get fit and (somewhat) back to their pre-baby bodies when they are nursing every hour, making meals and snacks about ten times a day, and have a toddler to amuse as well? What if a mother is working outside the home and doesn't want to spend any more time away from her precious baby than she has to? We need to get real.

Early Expectations

The celebrity mags have really warped our perception of what a postpartum body actually looks like and how long it takes to be back to regulation weight and fitness level. The old adage "It takes nine months to make a baby, it takes nine months for your body to get back to normal after baby" has been swapped for a turbo-charged schedule that nature never intended. "The expectation today seems to follow the six-week timetable. You get your postpartum medical clearance at six weeks, you can go back to work at six weeks, you should be back in shape in six weeks," notes Andrea, a mother of three. "Personally, I am just getting dressed and showered on a regular basis at that point -- fitness and weight loss are barely starting to enter my mind."

The American Council on Exercise notes in its guide for fitness professionals that "the priority for these first six weeks should be bonding with the baby and taking advantage of every opportunity to get necessary rest." While a few women may want to exercise in the six weeks after giving birth, the goal of such exercise should only be to help with relaxation, stress management, and emotional well-being. Additionally, this exercise should be resumed gradually and cause no associated pain or increase in postpartum-related bleeding. Standard medical advice is to wait at least four weeks after an uncomplicated vaginal delivery and at least six to eight weeks after a cesarean section.

The almost universal fitness recommendations for a woman in the first few weeks after giving birth are REST and KEGEL. If you have never performed Kegel exercises, go to www.mypelvichealth.org to learn how right now, whether you are pregnant, postpartum, or just breathing! Kegel exercises support the vital organs in your pelvic area and can even improve your sexual satisfaction. You can begin Kegels about 24 hours after delivery, and doing them will start healing your pelvic floor and strengthening your core. Work up to doing groups of Kegels several times a day. When you begin moving around more, you will want to do Kegels while lifting your baby and going up and down stairs, for instance. Making sure you maintain good posture (drawing your navel toward your backbone and lengthening your spine) while doing your daily activities, or even just when sitting, is an easy way to help your abdominals recover.

Personal trainer Wanda McCormick notes that you should check with your health care provider to determine whether the diastatis rectis (separation of the rectus abdominus muscle) that occurs during pregnancy is healing normally before you begin more formal and intense exercise. "One of the most common mistakes women make is to ... [try] to do hundreds of sit-ups and countless hours of aerobics. Your abdominal muscles have been stressed, stretched, and weakened. Postpartum exercise should be started slowly," she reminds new moms.

There are also some very simple exercises you can do for just a few minutes a day that will really make a difference to how your mommy middle and postpartum physique will look in the coming months. These are shown in most pregnancy/postpartum fitness books and include exercises such as the pelvic tilt, hip lifts, bridges, planks, side planks, squats, and opposite arm/leg lifts. You can find out how to do these simple exercises from a trainer, online, or in printed resources for pregnant/postpartum women. One short and simple, yet complete, book is Your Pregnancy Quick Guide to Fitness and Exercise by Glade B. Curtis and Judith Schuler.

Movin' and Groovin' and Nursin'

Breastfeeding and exercise go together very well indeed to contribute to postpartum fitness goals. First, nursing moms are burning more calories. Second, studies from several years ago that suggested babies reject exercise-tainted breastmilk have been debunked. It is true, however, that some babies don't like mom's salty taste after sweating. If this is your baby, try a shower or washing your breasts with soap and water before nursing after a hard workout.

Do keep in mind that you need to stay very well hydrated when breastfeeding, especially if you are working out. Invest in a good support bra, which will keep you comfy and let you exercise for longer. If you are doing high impact be more careful than usual as your joints and ligaments will continue to be more loose than normal. Finally, because your baby needs lots of time at the breast and/or has rather unpredictable nursing times, you may think it will be impossible to schedule workouts until your baby is years old and/or weaned. Not so, according to Denise Jelinek, M.S., ACSM, a personal trainer and wellness coach:

"Use 'stolen moments.' Five minutes of marching in place during commercials, or while folding laundry provide benefits. Five minutes six times a day equals 30 minutes."

Wanda McCormick concurs: "Some people don't exercise because they figure if they can't give themselves an hour or so why bother. Research has shown that smaller increments of exercise can give the same benefit (if not more) than an hour of weight training and slow time-consuming cardio. If you make the time you have count, you can do three bouts of ten minutes each during the day and benefit more because you are kicking your metabolism into gear throughout the day."

It is great to have professional confirmation that even between nursings, and in only small time increments, you can make real progress on the road to fitness.

Find Your Fitness Fun

The last thing you need as a new mom is another item on your "todo" list -- especially an item that makes you cringe, procrastinate, or figure ways to wriggle out of it every day! Fitness needs to be FUN in the real world. Having a drill sergeant screaming at you makes for entertaining reality TV, but is probably not your motivational method of choice. Below are some real-world-tested exercise options for moms. Read them and pick the one you want to try, but don't feel bad if it ends up not being for you. Ditch it and try something else. Or maybe you loved doing it for weeks and now you are bored. Mix it up with another choice. The important thing is to keep yourself moving and a healthy and fit body will come in time.

Walking

The great thing about walking after having a baby is that you can start doing it pretty much whenever you feel like it (just no power walking for the first six weeks or until your health care provider gives you the okay). You can walk with your baby in a carrier on your chest or in a stroller. Keep your shoulders back and head up and focus on standing straight and tall when walking. Go at a comfortable pace, starting with shorter distances and taking breaks when needed. If your baby has older siblings, walking is a great exercise option since everyone can do it together. Put baby in a pouch or sling on your chest (a back carrier with a hip-belt is great once baby can sit up on his/her own), push the toddler in a stroller, and let bigger children ride a bike or scooter or walk with you. Don't be afraid to walk alone though. It is okay to need some quiet solitude occasionally and a good walk (with or without some music) can rejuvenate you to get back to the work of mothering. Many a mom has been known to "tank up" her baby with a good nursing before heading out for a brisk walk or leisurely stroll, heading back revitalized.

Running

Even moms who went into pregnancy very fit will probably start with walking as they resume their exercise routines, but they can progress quickly into more strenuous workouts like running. Running is a great fitness activity you might want to try if walking starts to seem a bit too easy or if you want to get more intense exercise in a shorter amount of time. All you really need are a good pair of shoes and a supportive bra (some runners who are lactating swear by wearing two sports bras to stay comfortable).

You can easily get started by inserting "running breaks" into your walks. Just start jogging/running (whatever feels comfortable) after about five minutes of walking and keep doing it for one minute, then walk again until you are feeling comfortable, then run again for another minute.

You can fit in a quick run after nursing your baby or bring him with you in a jogging stroller. There are even tandem jogging strollers to fit two babies or a baby and a toddler. Some babies love the fast movement while mom is running. Some really don't like it. Try to borrow a jogging stroller and try it out before buying one. If your baby does not like the movement, maybe investing in a treadmill makes more sense for you. Treadmills are great if you live where winter weather makes it tough to get out, and you can usually get a great deal on a second-hand one at garage sales. The treadmill can be a great "bribe" to exercise while catching up on your favorite TV show or you can run during the half-hour newscast you like to watch. Many babies are happy watching mom run -- just make sure they are contained and safe in something like a bouncy chair so they cannot crawl or toddle over to you and the fast-moving treadmill.

Mommy and Me and Exercise Make Three!

For the mommy who wants it all -- baby, exercise, and interaction with other moms -- there are many classes that can offer the whole package to motivate you to work out. Many gyms and some hospitals offer postpartum exercise classes where baby stays with mom. These classes typically are taught with the baby in a front carrier for the cardio section and either in a front carrier or on the floor for the strength-training section. The social atmosphere is fun for mom and as the baby gets bigger and heavier, the workout gets more intense and mom gets stronger. Another option is a program like Stroller Strides®, where women bring their babies along in strollers and are led through a series of full-body exercises using the stroller as a prop. These programs are offered in many locations (you can find one near you at www.strollerstrides.com), both outdoors and indoors (in locations like malls). To be really cost effective, you can organize your own stroller-exercise group and follow the workouts in either Super Fit Mama by Tracey Mallett or Lean Mommy by Lisa Druxman.

Home Grown Exercise

For those days (or weeks) when you find it just too hard to leave the house, there are plenty of exercise options. Fitness videos/DVDs are very popular, and there are excellent pregnancy/postpartum ones available. You can buy or rent them or even borrow them from the library. Bridget, a mother of four boys, would do her exercise with baby in a front carrier and, now that her boys are between the ages of four and 16, still uses exercise videos on a regular basis. "I like that the children see mom exercising to stay healthy. Having the tapes in the house takes away all the excuses I could come up with not to exercise."

If you are a "techie" mom, you can do a search for Web sites with workouts that will play on the computer to guide you (sometimes for a fee). You can even download a workout routine to your iPod or iPhone. For a "low tech" workout, how about dancing along to your favorite music with your children? Do you have any hula hoops or jump ropes to take out for everyone to take a turn and try? How about pumping up the volume while you challenge yourself to load the laundry, mop the floor, and take out the garbage with the baby in the backpack? If baby is napping, keep it quiet with a few soothing yoga poses to stretch and relax your muscles gently. Or do a few minutes of good old fashioned push-ups, sit-ups, and jumping jacks and, while you're at it, don't forget those Kegels. Remember that these bits of exercise will add up and contribute to your health and well-being and that of your children too, when you include them.

Gym-Dandy Exercise

Gyms/fitness centers are great if you can afford them and you can get to them. They usually offer many different kinds of classes to keep your interest, such as yoga, Pilates, step-aerobics, and ab. workouts. If there is a pool you can swim for an excellent non-impact workout. You can try different machines like elliptical trainers, rowing machines, exercise bicycles, and stair machines. You can work out with weights, either on different machines or with free weights. Some gyms have indoor tracks or basketball or tennis courts, or even rock-climbing walls. These can make for fun family fitness outings. Maybe dad can play in the pool with the children while you are taking a class and then you can join them for a dip and some play time. Community fitness centers usually are a less expensive option, but can still have a variety of classes, exercise machines, and other amenities.

Making a Good Investment

We invest in healthy food for our families; it may be time for you to invest in your fitness. One way to do this would be to hire a personal trainer to get you started out on a good fitness regime, or to help improve your progress, or maybe just to keep you motivated. Trainer Denise Jelinek notes:

"The benefit of a personal trainer is that they can provide feedback and correct form to ensure a program is followed correctly and performed in the most beneficial manner. This also gives the postpartum mom greater confidence in her ability to maintain the program on her own. I sometimes simply work with people to give them the program and confidence in performing the program on their own and 'set them free.'"

Have you always wanted to try a specialty program, such as a military-style "boot camp"? Or a "fitness fad" such as belly dancing or boxing classes? Ask for a series of classes for your birthday. Home exercise equipment can also be an excellent investment, and not just large ticket items like treadmills. There are many home workouts that are extremely effective and use items such as exercise bands, stability balls, hand weights, or medicine balls. You might be more willing to exercise more frequently if you have several of these options on hand to keep workouts fresh, adding fun and variety to your fitness routine.

Keep Your Eyes on the Prize

While finding fun fitness options goes a long way to helping you meet your fitness goals, sometimes more motivation is needed. Little "rewards" can go a long way toward helping you exercise on those days when you just don’t feel like it. Can you save the current issue of your favorite magazine to read after you have worked out three times during the week? How about pampering yourself with a long bubble bath on Saturday night if you get in your long run that morning? A new pair of jeans (which might even be in a smaller size!) could be splurged on if you meet your workout goals for a month. Only YOU know what will motivate you to move!

Once you reach a certain base level of fitness, you might need a bigger challenge to strive for. Many women have found that entering and then having to train for a race (such as a local 5K or 10K run or walk) keeps them progressing and on track with their workouts. Some of these races allow jogging strollers so your baby can ride along and share in the excitement. Others even have shorter "fun runs" for different age groups so children can participate.

Finally, a fitness buddy can be invaluable. Many moms with young children really enjoy adult company and conversation and get too little of it during the day. Women can meet this need at the same time they commit to working out together. Neither friend wants to be the one who bails on an early morning appointment. There is strength in numbers! Get together with other women who want to make fitness as much a priority as you do and you will feed off each other's encouragement and energy.

Postpartum fitness ...and beyond is achievable. Time, patience, planning, and perseverance all play a part. Start slowly and then design a fitness plan that works for YOU, not the one touted by the starlet du jour, and you will reap the benefits of greater health for yourself and more energy for your children for years to come.

Resources

Anthony, L. Pre- and Post-Natal Fitness: A Guide for Fitness Professional from the American Council on Exercise. American Council on Exercise, 2002.
Curtis, G.B. and Schuler, J. Your Pregnancy Quick Guide to Fitness and Exercise: What you need to know about staying in shape during your pregnancy. Da Capo Press, 2004.
Druxman, T. Lean Mommy: Bond with Your Baby and Get Fit with the Stroller Strides® Program. Center Street: Hatchett Book Group USA, 2007.
Mallett, T. Super Fit Mama: Stay Fit during Pregnancy and Get Your Body Back after Baby. Da Capo Press, 2009.

Research

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Dewey, K. Effects of maternal caloric restriction and exercise during lactation. J Nutr 1998 Feb;128(2 Suppl):386S–389S.
Drinkwater, B. and Chesnut, C. Bone density changes during pregnancy and lactation in active women: a longitudinal study. Bone and Mineral 1991; 14:153–60.
Fly, A. et al. Major mineral concentrations in human milk do not change after maximal exercise testing. Am J Clin Nutr. 1998 Aug;68(2):345–9.
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