

Joanna Hess PT, DPT, PRC, WCS
- Intensity: Most studies evaluate moderate exercise intensity, roughly measured as the ability to talk, but not sing during the activity. Depending on the mother’s fitness level, the activity varies from walking to jogging. Vigorous activity is cautioned mainly because of the lactic acid buildup that is associated with poorer baby nursing.
- Duration and frequency: 45 minutes, 5 days/week for cardiovascular. 30 minutes, 3-4 day/s week for resistance training (6).
- Fatigue. At 6 weeks postpartum, the majority of mothers do not yet have their normal level of energy (9) making additional activity difficult and almost incomprehensible to include into long days. Physical activity is only one part of wellness in the postpartum period.
- Fussy baby. Full breasts contribute to uncomfortable and leaky exercise. If possible, feed your baby before heading off to exercise. Clean off the sweat after exercise, wait for 30 minutes if your baby seems fussy after exercise.
- Good fitting bra. The balance of support for comfort and managing compression to protect milk ducts is the goal for your sports bra. Take off your bra when feeding to allow for complete emptying of the breasts and maintaining supply.
- Hydration. Although hydration is more important for mother thirst than milk supply, increase fluid intake during and after exercise by about 1 liter (5). Attend to the thirst signal.
- Baby and mother health. Although studies show that physical exercise does not detrimentally affect infant growth nor maternal health, consult with your healthcare practitioner if baby or mother aren’t following expected patterns.
REFERENCES
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2 da Silva MD, Oliveira Assis AM, Pinheiro SM, de Oliveira LP, da Cruz TR. Breastfeeding and maternal weight changes during 24 months post‐partum: a cohort study. Maternal & child nutrition. 2015 Oct;11(4):780-91.
3 Daley AJ, Thomas A, Cooper H, Fitzpatrick H, McDonald C, Moore H, Rooney R, Deeks JJ. Maternal exercise and growth in breastfed infants: a meta-analysis of randomized controlled trials. Pediatrics. 2012 Jul 1;130(1):108-14.
4 Elliott SA, Pereira LC, Guigard E, McCargar LJ, Prado CC, Bell RC. Association between breastfeeding, maternal weight loss and body composition at 3 months postpartum. The FASEB Journal. 2016 Apr;30(1_supplement):45-.
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8 Mortensen K, Kam R. Exercise and breastfeeding. Breastfeeding Review. 2012 Nov;20(3):39.
9 Mottola MF. Exercise in the postpartum period: practical applications. Current sports medicine reports. 2002 Dec 1;1(6):362-8.
10 Nascimento SL, Pudwell J, Surita FG, Adamo KB, Smith GN. The effect of physical exercise strategies on weight loss in postpartum women: a systematic review and meta-analysis. International Journal of Obesity. 2014 May;38(5):626.
11 Straub H, Simon C, Plunkett BA, Endres L, Adam EK, Mckinney C, Hobel CJ, Thorp JM, Raju T, Shalowitz M. Evidence for a complex relationship among weight retention, cortisol and breastfeeding in postpartum women. Maternal and child health journal. 2016 Jul 1;20(7):1375-83.
12 Thein-Nissenbaum J. The postpartum triathlete. Physical Therapy in Sport. 2016 Sep 1;21:95-106.
13 Wright KS, Quinn TJ, Carey GB. Infant acceptance of breast milk after maternal exercise. Pediatrics. 2002 Apr 1;109(4):585-9.