Exercise and lactation

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Physical activity at any stage of the life cycle is associated with a decreased prevalence of cardiovascular disease, colon cancer, type 2 diabetes, and overweight, and it decreases mortality rates from all causes. Specifically in lactation, regular activity improves cardiovascular fitness, plasma lipid levels, and insulin response [14]. Regular activity also has the potential to benefit psychosocial well-being in lactation, such as improving self-esteem and reducing depression and anxiety. Other potential benefits include promotion of body weight regulation and optimizing bone health. Engagement in regular activity by the mother may also encourage the same in her offspring, promoting a healthy lifestyle and body weight management for the entire family.

Women can actively engage in moderate exercise during lactation without affecting milk production, milk composition, or infant growth [15, 16]. Lovelady et al. demonstrated that overweight sedentary lactating women randomized to a regimen of reduced energy intake (-500 kcal/day) and aerobic exercise (45 min/4 days each week) had babies that grew similarly to those of women who were not on an energy restricted diet and exercised once or never per week [15]. Aerobic exercise in this study consisted of walking, jogging, and dancing at 65-80% of maximum heart rate. The duration of exercise was initially 15 min, increased by at least 2 min each day until the women were exercising for 45 min at the target heart rate. There is some evidence that exercise in the absence of energy restriction will not promote weight loss postpartum, and diet restriction alone results in a greater percentage of lean body mass loss compared to exercise in combination with energy restriction [16, 17].

The American College of Obstetricians and Gynecologists has developed guidelines for exercising in pregnancy and the postpartum period [18]. For the postpartum period, these guidelines include resuming physical activity gradually, and only when a woman's body has healed substantially from pregnancy and delivery (usually 4-6 weeks postpartum). They encourage that women obtain clearance from their primary care physician to resume physical activity. In addition, Larsen-Meyer recommends that women avoid becoming excessively fatigued, remain well hydrated, and watch for abnormal bleeding or pain [14].

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