When breastfeeding your baby, you need around 500 extra calories per day. This is more than when you were pregnant! This amount could be a little less or a little more depending on how much milk you are producing. For example, if you doing a combination of formula-feeding and breastfeeding your baby, you likely do not need the full 500 calories; Or, if you are breastfeeding your baby and also pumping additional milk, you may need more than 500 extra calories. Try to get the extra calories from high-quality food sources (See list below).
It is also important to remember than when producing milk, your body may want you to keep a couple of extra pounds on you in order maintain milk supply. Do not worry about a few extra pounds! It is also not unusual for some women to lose weight when breastfeeding. Everyone is different. Don’t compare yourself to anyone else! Focus on keeping a healthy weight for you and your baby!
List of important nutrients for breastfeeding, and where to find them.
Calcium: milk; cheese; yogurt; fish with edible bones; tofu processed with calcium sulfate; bok choy; broccoli; kale; collard, mustard, and turnip greens; breads made with milk.
Zinc: meat, poultry, seafood, eggs, seeds, legumes, yogurt, whole grains (bioavailability from this source is variable).
Magnesium: nuts, seeds, legumes, whole grains, green vegetables, scallops, and oysters (in general, this mineral is widely distributed in food rather than concentrated in a small number of foods).
Vitamin B6: bananas, poultry, meat, fish, potatoes, sweet potatoes, spinach, prunes, watermelon, some legumes, fortified cereals, and nuts.
Thiamin: pork, fish, whole grains, organ meats, legumes, corn, peas, seeds, nuts, fortified cereal grain (widely distributed in foods).
Folate: leafy vegetables, fruit, liver, green beans, fortified cereals, legumes, and whole-grain cereals.
One of the most common pieces of advice is to listen to your body. While this is not bad advice, it is lacking in that your body is doing something you have never experienced before! While there are no hard and fast rules, we hope this article will give you some good ideas about what changes you can expect to experience when working out during pregnancy, as well as what things are not normal and may warrant a call to your doctor.
You may notice a decrease in your ability to do activities you were able to do previously. Things may feel harder than they used to, especially strenuous activities. Feeling a little bit more short of breath is okay. This is normal. Your body is also growing a human and is working very hard! Give yourself some slack when picking your intensity.
You may notice yourself feeling hotter during a workout. Pregnancy brings elevated body temperatures, so this is normal. Make sure you wear loose-fitted clothing, avoid exercising in excessive heat or humidity, and stay-hydrated!
You may notice your balance may be off. This is normal. With weight gain and a shift in your body’s “center”, you may notice yourself having a harder time with balance or activities that rely heavily on balance. For this reason, allow yourself to hold onto something during these types of activities, or consider stopping them until after the baby arrives.
You may notice your heart beating faster. This may or may not be physically noticeable, but if you wear a device that measures heart rate, you may notice this. This is a completely normal occurrence during pregnancy and it will return to normal after the baby is born. That said, if you ever notice any chest pain or discomfort, this is not normal and should be evaluated by your doctor.
Some things that are NOT normal during exercise and should be evaluated immediately.
If you notice any vaginal bleeding or leaking of fluid during or after exercise.
If you have any pain in your abdomen, chest, or calves.
If you feel dizzy, short of breath, or have a headache.
If you notice any regular painful contractions.
Physical Activity and Exercise During Pregnancy and the Postpartum Period: ACOG Committee Opinion, Number 804. Obstet Gynecol. 2020;135(4):e178-e188.
Proper body mechanics refers to the application of body movement in a way that achieves maximum efficiency and reduces the risk of physical stress or injury. Ergonomics is about creating a workspace that promotes efficiency and comfort. Together, proper body mechanics and ergonomics are the keys to preventing overuse and strain with baby care.
Think about how many times you lift your baby each day—lifting improperly puts a strain on your back and can cause injury. Using the followings techniques for lifting and incorporating ergonomic techniques for your changing table and other baby equipment will keep you pain and injury-free.
Start practicing these techniques before your baby is born. Learning how to lift your baby correctly from the start will help make proper lifting techniques a habit.
Slow down and think about how you are going to lift properly.
Protect your back when lifting your baby and baby equipment by bending the knees and keeping the back straight. Avoid bending from the waist or hips,
When lifting from the floor squat or kneel in front of your baby to lift.
Bring your baby as close to your body as possible before lifting. Avoid holding your baby out in front of your body, as that puts a strain on your back.
Exhale and contract the abdominal muscles as you lift.
When carrying both the baby and the carrier simultaneously, distribute the weight more evenly by carrying the baby in one arm and the carrier in the other.
Avoid the one-arm “grab and lift”—always use both arms to lift and hold.
When lifting your baby from the crib, position the baby as close as possible to your side of the crib by gently sliding your baby towards you.
Before lifting your baby from the crib, take a big breath and as you exhale, tighten your abdominal muscles as you slowly lift.
Creating an Ergonomic Workstation
Adjust baby changing table to a height that allows an upright position and prevents you from having to bend forward.
Tables should be positioned so that their tops are just below the level of the elbow.
Store your baby supplies such that you don’t have to reach overhead, or bend and twist to get to them. If possible, set up the changing table against a wall and install shelving above the table within easy reach.
Before you buy, make sure that baby cribs, carriers, and a changing table are easily adjustable to fit the person using them.
Our team of experts have talked to many women about their conversations with health care providers regarding exercise during pregnancy. We have found that in many cases, women and their health care team are not talking about exercise at all during this special time! Given how important it is to stay active while pregnant, and also how important it is to be safe, it is very important you talk to your doctor about any and all of your exercise plans. Your health care providers WANT to talk to you about exercise. They think it is important, but in the rush of their busy schedules and appointments, sometimes they forget.
Don’t hesitate to bring it up. Don’t hesitate to ask questions. The best way to ensure you get to talk to them about it is to bring it up yourself! And if they don’t feel like they can offer you specific ideas for exercising, ask them if they can direct you to someone who can!
And, you can use BumptUp to help you track your exercise routine and show it to them! They can give you feedback on what you are doing with the app.
Tinius, R. A., Lopez, J. D., Cade, W. T., Stein, R. I., Haire-Joshu, D., & Cahill, A. G. (2020). Patient and obstetric provider communication regarding weight gain management among socioeconomically disadvantaged African American women who are overweight/obese. Women Health, 60(2), 156-167. doi:10.1080/03630242.2019.1616044
Some pregnant women have jobs that require lifting things. Some of you may have older children that still require being held. Some of you may love lifting heavy weights at the gym. But, how much is too much? How much is safe?
The National Institute for Occupational Safety and Health created a model that can help determine the most weight that would be acceptable for the vast majority of pregnant women (90%) while at work; however, it can serve as a helpful guide for women who work from the home or do things at the gym as well. Keep in mind, there are some women who can do a little more and some who should do less. But we hope this will serve as a guide to help you make decisions about lifting things during your pregnancy!
To use the tool, start with the question in the first yellow box (“At work do you….”), then based on your answer, you will move through the figure.
Physical Activity and Exercise During Pregnancy and the Postpartum Period: ACOG Committee Opinion, Number 804. Obstet Gynecol. 2020;135(4):e178-e188.
Every pregnant woman has had the experience of someone offering (usually unsolicited) advice about their fitness routine. Although a lot of advice isn’t grounded in science and doesn’t reflect the vast amount of research findings showing the safety of prenatal exercise, it still can be disconcerting to hear.
Let’s break down some of the most common prenatal exercise misconceptions and provide you with medically-based responses that can ease your mind and enlighten the not so helpful advice giver!
Keep your exercise heart rate below 140 bpm.
This advice hasn’t been in use since 1994, when the American College of Obstetricians and Gynecologists dropped it from their guidelines. Research has shown that training heart rate isn’t the best way to monitor exertion during pregnancy because of the significant cardiovascular changes that occur. ACOG now advises that pregnant women keep their exercise intensity at a level that feels moderate to somewhat hard. A simple method for knowing you’re not working out so hard: keep your intensity at a level that feels challenging, but not so hard that you can’t carry on a conversation while exercising.
Running during pregnancy is not safe.
Many pregnant women can comfortably continue or even start a running program during pregnancy. The caveat is to pay close attention to how your body feels, drop your pace or the length of the run if you start to feel it’s becoming too difficult. It’s also a good idea to invest in a new pair of running shoes, as pregnancy can make your feet swell and even lengthen as a result of hormonal changes. Makes sure your shoes fit properly and think about swapping out the liners for a more cushioning gel liner. As your pregnancy progresses, you may notice that your round ligaments (they support your uterus) can become painful with weight-bearing exercise. Try wearing a pregnancy support belt while running to ease the tension on your round ligaments and keep your runs comfortable. Compression socks and shorts can also help with swelling and pain.
It’s dangerous to lift weights during pregnancy.
There’s no research that has shown that strength training during a healthy pregnancy is dangerous. Of course, you’ll need to modify your routine as pregnancy progresses (such as avoiding laying flat on your back during a lift after the first trimester) and reduce your weight level or resistance if a lift becomes uncomfortable or causes pain. Never hold your breath and bearing down as you lift —always exhale with the lift and inhale as you return to start position. Maintaining or even building strength during pregnancy will prepare your body for all the lifting required once your baby arrives, and helps avoid injury.
Avoid all abdominal exercises while pregnant.
As your belly grows during pregnancy, it becomes more difficult to perform a traditional “sit-up” type exercises. In reality, sit-ups aren’t very effective for strengthening abdominal muscles when pregnant. The key to effective prenatal ab exercises is to focus on exercises that work your transverse abdominal muscle, which plays a big role in abdominal support. Also, after your first trimester, avoid lying flat on your back for more than 5 minutes while doing ab exercises. The weight of your growing baby can reduce blood flow and cause you to feel lightheaded or dizzy if you are flat on your back. Instead, modify the exercise by using a wedge or pillows to raise your upper body. If you are laying on your back and get dizzy, immediately roll to your left side. This helps to take the weight of the uterus and baby off the major blood vessels in your tummy.
Keeping your abs strong will help provide support for your back and reduce low-back pain and help speed your postpartum recovery.
Don’t start an exercise routine during pregnancy.
If you haven’t been exercising pre-pregnancy, then starting once you are pregnant is a great way to gain the benefits prenatal fitness provides for you and your baby. Apps such as this one are a great way to have a “virtual trainer” to help you make sure that your exercise program is safe and effective. Daily walks are also a great place to start. Always check with your healthcare provider before starting any fitness routine, and if you have any concerns, follow up with your provider about them.
The healthy habits you start during your pregnancy will pay off during and after your baby is born, and hopefully encourage you and your family to make fitness part of your lifestyle.
You may have heard other pregnant women talk about using a doula and wondered what is involved with doula support. If you’re considering looking into hiring a doula, we’ve put together some tips that can help you make the best choice for your pregnancy, labor, and delivery.
A doula is a trained childbirth professional who offers pregnant woman assistance before, during, and after delivery. The support can range from emotional (offering encouragement) to physical (providing pain relief techniques during labor). A doula typically starts working with a pregnant client in her third trimester, allowing time for them to form a relationship and feel comfortable with each other and discuss birthing options and preferences.
Doulas are skilled at using a variety of techniques during labor that can help reduce anxiety, fear, and pain. The key role of a doula is to offer comfort, support, and help advocate for the birth experience her client desires. There’s even research that has shown that women who used a doula during labor and delivery bonded more effectively with their baby. Most doulas also provide antepartum support with breastfeeding and infant bonding—as well as helping new moms feel more confident about their mothering abilities.
If you’re thinking about hiring a doula, here are a few questions that you should ask to make sure you find a doula that will be a good fit:
Where did you receive your doula training?
Are you a certified doula?
What services do you provide?
How long have you worked as a doula, and can you provide references?
What are your fees, and what do they include?
What is your philosophy regarding childbirth?
Are you available for my due date?
Will you be on call 24/7 for my birth?
Will you meet with me postpartum, and what is covered during those visits?
For more information, check out the Doulas of North America website link below.
Whether your cesarean section was planned or a result of a birthing complication, it’s important to remember that you’ve had a major abdominal surgery that requires eight to ten weeks or more for recovery.
Although you may not feel like doing much the first few days post-surgery, specific exercises should be started right away to help speed recovery after anesthesia, and stimulate muscle function, and promote circulation.
Check with your healthcare provider before doing any of these exercises to make sure it’s safe for you to get started.
Cough five times each hour to help clear your lungs following anesthesia. You should support your tender abdomen by holding a small pillow or rolled towel against your tummy over the incision as you cough. If you are in the hospital, you can ask the nurse for an incentive spirometer. This is a special tool designed to help with breathing after a surgery. The nurse will show you how to use it.
Log roll to get in and out of bed. Log rolling is a technique that helps to decrease pressure on your belly. Start your back with your knees bent and feet flat on the bed. As you roll to one side, use your top arm to help roll and grab the side of the bed (or at least put the hand on the bed for balance support). Once on your side, knees still bend, use your top hand to help push you up as you gently swing your legs over the side of the bed with your body moving as a single unit or a “log”. Once you are up far enough, you can use your bottom hand to help push you up. Breath the entire time. If you need help with this technique, as the nurse to teach you or request a visit from a physical therapist in the hospital.
Lie or sit in a comfortable position and slowly pull your belly in towards your spine. Use your breathing by exhaling as you draw inward and inhaling as you relax. Work up to a set of five to ten repetitions every hour.
Lie on your back with the knees bent and arms out to the sides. Imagine that your tummy is the face of a clock, and gently press down at 12 o’clock, then to the side at 9 o’clock, down to 6 o’clock and then to the other side at 3 o’clock—reverse direction and repeat. Try and work towards a smooth movement of circles in each direction.
Once your anesthesia has worn off try walking a few steps with support. You can ask for a physical therapist to come see you in the hospital if you think you may need help or if you think you may need a walker for balance. Make sure you have someone holding you as you move as you may feel dizzy or unstable. You’ll prevent fluid retention and speed the return of bowel and bladder function by getting up and walking a few minutes every hour.
Strength training is a beneficial component of a prenatal fitness program. It can help your body compensate for all the physical changes of pregnancy and provide the strength needed for baby lifting postpartum. The changes in your body weight and posture during pregnancy can create stress on joints, but strong muscles can help prevent the development of pain and injury.
If you’re new to strength training, start with a low weight or resistance band routine that focuses on major muscle groups. You’ll be way ahead of the game by starting a strength training program during pregnancy, and better able to safely do all the lifting required once you have your baby.
Whether you’re new to strength training or have included it in your fitness program before your pregnancy, take a look at the tips listed below to help keep your routine safe and effective. It’s essential to listen to your body and incorporate modification (such as a reduced weight/resistance, repetitions, and sets, or lift positioning) if exercises become uncomfortable.
Before starting any fitness routine, check with your healthcare provider to make sure exercise is safe during your pregnancy.
You can continue your pre-pregnancy weight-training program once you become pregnant, but carefully monitor how you feel during and after training, and modify or eliminate exercises that cause pain or increased muscle soreness.
If you’re starting a strength-training program during pregnancy, begin with weight level or resistance that allows for one set of 10-12 repetitions without excessive strain. The weight amount and number of sets can be increased as the repetitions become easier.
Avoid maximal lifts. The force needed to perform maximal lifts makes this type of exercise unsafe during pregnancy.
Don’t hold your breath and bear down while doing your lifts. Always exhaling as you lift and inhale when returning to start position.
You can use strength training machines, free weights, resistance bands, or bodyweight in your routine. Use what’s readily available and within your budget.
Modification of weight training exercises (such as dropping down in weight level and repetitions and sets, or adjusting positioning) may be needed as the pregnancy progresses.
If a particular exercise causes pain or discomfort even after you’ve tried using modifications, it should be discontinued. If pain persists, stop your strength training routine and consult with your healthcare provider.
Avoid doing any strength training exercises while lying flat on your back (supine) after the first trimester. When you’re lying flat on your back, a large blood vessel that spans your abdomen can be compressed by the weight of your growing baby and can cause you to feel lightheaded and dizzy. Modify supine positions by using a wedge or pillows to raise your upper body so you’re not flat on the floor.
Caloric intake should increase by approximately 300 kcal/day during pregnancy. This value is derived from an estimate of 80,000 kcal needed to support a full-term pregnancy and accounts not only for increased maternal and fetal metabolism but for fetal and placental growth. Dividing the gross energy cost by the mean pregnancy duration (250 days after the first month) yields the 300 kcal/day estimate for the entire pregnancy.1,2 However, energy requirements are generally the same as non-pregnant women in the first trimester and then increase in the second trimester, estimated at 340 kcal and 452 kcal per day in the second and third trimesters, respectively. Furthermore, energy requirements vary significantly depending on a woman’s age, BMI, and activity level. Caloric intake should therefore be individualized based on these factors.
Concerning protein, the recommended dietary allowance is 71 grams per day, but realistically, 1.1 g/kg body weight is more accurate. Carbohydrates should comprise 45-64% of daily calories and this includes approximately 6-9 servings of whole grain daily. Total fat intake should comprise 20-35% of daily calories, similar to non-pregnant women.
Nutrition Postpartum when breastfeeding
When breastfeeding your baby, kilocalorie needs are 500 kcals for the first six months and 400 kcals for the second six months (Academy of Nutrition and Dietetics, n.d.). This amount could be a little less or a little more depending on how much milk you are producing. For example, if you doing a combination of formula-feeding and breastfeeding your baby, you likely do not need the full 500 calories; Or, if you are breastfeeding your baby and also pumping additional milk, you may need more than 500 extra calories. Try to get the extra calories from high-quality food sources (See list below).
It is also important to remember than when producing milk, your body may want you to keep a couple of extra pounds on you in order maintain milk supply. Do not worry about a few extra pounds! It is also not unusual for some women to lose weight when breastfeeding. Everyone is different. Don’t compare yourself to anyone else! Focus on keeping a healthy weight for you and your baby!
List of important nutrients for breastfeeding, and where to find them.
Calcium: milk; cheese; yogurt; fish with edible bones; tofu processed with calcium sulfate; bok choy; broccoli; kale; collard, mustard, and turnip greens; breads made with milk.
Zinc: meat, poultry, seafood, eggs, seeds, legumes, yogurt, whole grains (bioavailability from this source is variable).
Magnesium: nuts, seeds, legumes, whole grains, green vegetables, scallops, and oysters (in general, this mineral is widely distributed in food rather than concentrated in a small number of foods).
Vitamin B6: bananas, poultry, meat, fish, potatoes, sweet potatoes, spinach, prunes, watermelon, some legumes, fortified cereals, and nuts.
Thiamin: pork, fish, whole grains, organ meats, legumes, corn, peas, seeds, nuts, fortified cereal grain (widely distributed in foods).
Folate: leafy vegetables, fruit, liver, green beans, fortified cereals, legumes, and whole-grain cereals.
Women who breastfeed require approximately 500 additional kcal/day beyond what is recommended for non-pregnant women.68 The estimate is derived from the mean volume of breast milk produced per day (mean 780 mL, range 450-1200 mL) and the energy content of milk (67 kcal/100 mL).69 During pregnancy, most women store an extra 2 to 5 kg (19,000 to 48,000 kcal) in tissue, mainly as fat, in physiologic preparation for lactation. If women do not consume the extra calories, then body stores are used to maintain lactation. It is not unusual for lactating women to lose 0.5-1.0 kg/month after the first postpartum month.70
There are even less evidence-based recommendations for nutrient intake during breastfeeding compared to pregnancy. Lactation is considered successful when the breast-fed infant is gaining an appropriate amount of weight. The recommended daily allowance for protein during lactation is an additional 25 g/day.
Maternal factors such as stress, anxiety, and smoking can decrease milk production, but the quantitative and caloric value of breast milk does not change with dieting and exercise.76–83 Moreover, a woman’s weight, BMI, body fat percentage, and weight gain during pregnancy do not influence milk production.84–86
Reviewed and edited by Heather Emerson-Payne, RD, PhD, 2023.
References
Academy of Nutrition and Dietetics. Nutrition Care Manual. Comparative Standards, Breastfeeding/Lactation. https://www-nutritioncaremanual-org.wku.idm.oclc.org/topic.cfm?ncm_category_id=1&lv1=272980&lv2=144973&lv3=269509&ncm_toc_id=269509&ncm_heading=Normal%20Nutrition. Accessed July 12, 2023.
