As a postpartum doula, one way I help support families once they bring home their new baby is by giving information regarding newborn care, infant sleep, or feedings. When I tell my clients that I am a runner, I often have questions from new mothers about getting back to exercise, specifically from those who were athletes before and during their pregnancy, and want to get back to it again once they are feeling up to it. I am not a medical provider, and I was not a runner until well after my children were born, however I have done some research regarding this frequently asked question, and wanted to share here on the blog!
I ran into a podcast on this subject in Running Rogue (episode 43). Karen Rooff, a perinatal fitness specialist who helps women carefully return to a fitness routine postpartum, reminds the listeners of the most important piece of advice before beginning any exercise after pregnancy: check in with your OB. Whether you had a cesarean section or vaginal delivery, both require time for healing. Your OB will check for signs of prolapse, which can also occur after exercise is resumed, so it is something to watch for. Rooff also adds if you have a jogging stroller, it needs to be one that fits your body, so that you don’t have another factor that further changes your stride as you adapt back to running.
In Running for Real (episode 70), Tina Muir interviewed Dr. Emily Krass, a Sports Medicine and Orthopedics Specialist at The Stanford Children’s Health Center. They talked specifically about running again with regard to the pelvis, hip, and back area of the body. Sadly, there is a lack of good research involving returning to sports and running post-pregnancy. Krass reminded listeners that the body does not automatically bounce back into its prior position after birth, and rushing back into it can be harmful. While certain exercises do increase bone density, just after pregnancy there is a temporary loss in bone density, and increasing volume and impact too quickly can lead to injury, such as stress fractures. The pelvis has less tone and strength as well, and can take time to return to its former structure. Strength training, as well as pelvic floor strengthening, can be a key component into getting back to former levels. Additionally, if breastfeeding, milk supply can be affected by a chronic energy deficit due to not taking in enough calories. This in turn can also cause more bone breakdown, if there is an energy mismatch, not just with calorie intake, but with sleep deprivation and emotional energy expenditure.
On the topic of breastfeeding during the postpartum period, I turned to two wonderful lactation consultants in our area. Nicola Singletary, PhD, MAT, IBCLC, owner of Harmony Lactation, recommends that 500 additional calories per day are needed for exclusive breastfeeding (this can come from food intake and stored fat). Singletary says a breastfeeding mother who exercises strenuously, or has minimal fat stores, has to eat enough calories to avoid 2lb or more per week weight loss. Secondly, she notes that lactic acid is released during exercise, which has been blamed for breastfeeding refusal because it changes the flavor of breastmilk (although this has not been conclusively reported to affect breastfeeding). Babies may also prefer not to feed after a workout due to saltiness on the breast, so rinsing can help. Holly Healy, FNP, IBCLC, at Little Oaks Pediatrics in Raleigh, also recommends a good sports bra, proper hydration before and after a run, and timing exercise just after feeding your baby or pumping. Healy also recommends proper stretching after a run, not only for the legs, but the shoulders, wrists, chest, and back, which can be helpful since a mother’s posture is compromised at times during breastfeeding.
The overall message: listen to your body and start back slowly. Our society can at times send the wrong message to women about how quickly we return to normal after having a baby, whether at work or at play! If you just had a baby, you have a new body, and a new normal. Give yourself some time, and follow the advice of your doctor and other postpartum professionals, so that you can take the best care of yourself and your baby as you ease back into running!