Exercise and Breastfeeding

After birth, most women find it helpful to take a period of rest with their new baby – this can extend for as long as you wish or are able. When they feel ready, some mothers may choose to continue their previous forms of exercise, or start something new. You may wonder whether they are able to introduce exercise alongside breastfeeding. For most people, the answer is yes. Standard exercise does not impact on milk supply or content.

In this article we discuss some of the common questions around breastfeeding and exercise, and consider instances where some more planning may be required, for instance for elite athletes.

Exercise whilst breastfeeding

Your body will change a lot during pregnancy and post-partum, whether you go on to breastfeed or not. This is due to the shifts in hormones and chemicals of pregnancy, and the fact that your body has grown and nurtured a new human being. You may feel an expectation (whether your own or others’) to return to exercise or start exercising after having a baby, to ‘get your old body back’. However, you may also discover the strength and adaptability of your ‘new’ body, especially as it goes on to nourish your baby, is a source of great pride as a new mother.

Exercise of some form or another may have been part of your life before and during pregnancy. You may feel eager to start exercising again soon after birth. In most cases it is recommended to give your body sufficient time to rest and recover post-partum. Whatever your pregnancy and birth were like, having a baby is a significant event for your body. Six to twelve weeks is often considered a reasonable time frame to allow this healing. Recent research suggests that higher impact exercise like running should ideally only resume after 3 months¹. Much of the recovery is internal and not always visible. This period of rest can also be incredibly valuable as you spend time with your new baby – learning about them, and learning from them the new skills of motherhood. Once your body has fully recovered from birth and the immediate post-partum-period, it is generally safe to resume, or start, exercising if you have chosen to breastfeed.

Some studies have shown that very strenuous exercise may lead to a slight lactic acid increase in milk² and a slight decrease in IgA levels³, with some mothers reporting that their baby was slightly fussier for a short period, but that there was no impact on milk supply or baby’s growth⁴. A 2020 study suggests that exercising while breastfeeding increases a compound in breastmilk that may reduce a baby’s lifelong risk of serious health issues such as diabetes, obesity and heart disease⁵.

Practical tips

Whether you have chosen to breastfeed or not does not need to affect your ability to start exercising again. For most women, exercising alongside breastfeeding is more often a matter of sorting out a few practicalities.

It is very normal for young babies and children to want to stay close to you. In the early weeks and months you may find that you have to be a bit more imaginative to fit in any exercise you want to do. Some mothers work out at home or do fitness classes online. Others try some of the fitness classes especially for mums and babies. For many, the most popular form of exercise is going for walks with their baby, either in a carrier (where baby can feel close to you, and you get a bit of an added work-out), or with a buggy/pushchair. If you do find that exercising requires to be away from your baby, you can read our article on separation here, which considers some of the practical tips.

You may find it useful to breastfeed before you exercise. This can be helpful as it may lessen the weight/feeling of fullness in your breasts, and may give you a little longer before your baby will want to nurse again.

Finding a well-fitting and supportive sports bra often helps to make exercising more comfortable and helps to ensure that your chest is not compressed. It is helpful to remove tighter fitting bras once you are finished exercising to reduce the risk of blocked ducts and/or mastitis. If you’re worried you may have a blocked duct or mastitis, you may find our article on that helpful.

You may find that your are thirstier when breastfeeding, so may wish to have more water to hand. However, remember that breastmilk supply is not linked to drinking enough water. If you are worried about your supply, see here.

You may find that eating enough to feel energised is important. Studies suggest that breastfeeding can burn around 500-700 calories per day⁶,. For some mothers this may lead to weight loss post-partum, but this is not always the case as many other factors can impact weight loss. Breastfeeding mothers may need to consume at least 1800 calories a day and can safely lose around 400-500g per week⁷,. Low carb diets are also considered safe while breastfeeding, as long as long as you also consume a good mix of fruit, vegetables and proteins.

Mothers’ experiences:

“I’ve never been a “sporty” person or been much into fitness but when I got to mid-thirties, I thought I had better improve my health a wee bit so started doing a few things: three-five times a week I’d go swimming or to yoga or an hour’s walk. Since my baby arrived, I still haven’t been “sporty” or worried about fitness, I have just enjoyed getting out and getting moving for fresh air, a change of scene, and to help my body feel energised.”

“I really struggled with breastfeeding initially and it took its toll on my confidence and mental health in general. Returning to netball when my daughter was nine months old was personally the best thing I could have done for myself as a person and as a mum, and almost 17 months on our breastfeeding journey is still going strong!”  Christina, Divisional Netball Team

“After my beautiful baby arrived, I began breastfeeding him and I found I’d just fit little bits of exercise in around his needs/day/week, and my needs too. Sometimes for a nap I’d walk with him in the buggy or sling.”

“I’ve enjoyed getting back into yoga post-baby, especially in the sessions where they warm the room. It feels like giving my body a massage, and stretching out the arm/back/neck muscles that I didn’t realise had been bending new ways for breastfeeding and cuddling my bundle of joy.”

“When I was on maternity leave sometimes I’d meet a pal for an hour or 90 mins of gentle cycling while chatting, so I could get some movement and other human contact while my other half cuddled/hung out with the baby.”

“I haven’t bought any special bras for exercise since my bub arrived, I have actually found breastfeeding bras much more comfy than my regular ‘pre-baby’ bras. ” Bonnie, keen cyclist, Edinburgh

Elite athletes

In recent years, there has been an increase in understanding and support for elite athletes who are pregnant, breastfeeding (and bottle-feeding) or caring for a young child. UK Sport, the body that supports high-level athletes, teams, and sports, has published pregnancy guidance for the Olympic and Paralympic high-performance community. (You can access that here: https://www.uksport.gov.uk/resources/governing-body-and-athlete-guidance)

Elite athletes will ideally have access to additional skilled support from coaches and physicians. However, some of the following considerations for training and competing at elite level, while continuing a breastfeeding relationship, may also be helpful:

Professional and elite athletes may feel pressure to return to strenuous training regimes. Understanding and arming yourself with information about the normal needs of young babies to be with their mother and to feed regularly and responsively may help to structure your own plans and the expectations of your team or funding body.

Breastfeeding has a hormonal impact on the body, for example through the release of ‘relaxin’, which may impact on joints and ligaments. However, there are very many examples of elite athletes that have trained and performed while breastfeeding. Working with physiotherapists that understand the hormonal impacts and can adapt training may be helpful.

As well as the physiological impacts, breastfeeding can play an important role in the formation of the psychological bond between mother and baby. In this article from the official website of the Olympic Games, Dame Sarah Story and Serena Williams discuss how important their breastfeeding relationship felt as part of their experience as elite athlete mothers.

One of the practical challenges for elite athletes may be the need to be away from their baby for longer periods for training and competition. How you solve this is often a mix of ingenuity and adaptability. It’s also worth remembering that the intense needs of small babies are not long-term. Many sportswomen reflect that their priorities changed when they had their baby and they found that they did not want to be separated. Mothers should be supported in that decision. Equally, if you are keen to get back to training and competing there are often ways of including your baby in that.

Where you do need to be away for their baby for a longer period, e.g. to compete, there are often practical ways to support breastfeeding. Many elite sportswomen, e.g. ultra-runners needing to be away from their babies for over 24 hours, have someone bring their baby to check points so that they can feed the baby (and sometimes express/pump milk) while refuelling themselves. Others may also express/pump milk to leave with a caregiver for their baby whilst away. Further information and about expressing and storing breastmilk can be found here.

There are many examples of elite athletes that have breastfed alongside the resumption of their high-level training and performance. Two of the UK’s elite athletes, Naomi Folkard (Team GB, Archery) and Jasmin Paris (elite long-distance fell runner) have kindly shared with LLLGB their reflections on breastfeeding while continuing to train and compete:

Naomi Folkard

“My sport is archery, a closed skill sport which requires standing and walking 70m to the target and back to collect the arrows. Before my pregnancy I enjoyed running as part of my conditioning, as well as gym and rotator cuff work, which I continued with through to the eight months mark.

With the exception of rest, which is what I did the first week, I began the recovery immediately, by introducing a little walking, wearing baby in a sling, pelvic floor exercises, shoulder exercises and a little yoga. My whole pelvic and abdominal region felt like jelly for at least a couple of weeks, so I was very careful to consider what exercise I should do and gradually built up the quantity.

When I started shooting again at two weeks post-partum, I was able to take my baby with me so if she wanted a feed I would be able to stop what I was doing and have a cuddle with her on the sofa in the lounge.

By eight weeks I was able to give baby a feed, put her down (sometimes asleep and, probably more often, not asleep) and go training, leaving her with her dad; at this point I found it really difficult emotionally to leave her.

In my preparation for the arrival of my baby and care afterwards, I spoke to a few other mum athletes about how they managed the birth, breastfeeding and training. I also read books and articles on the internet.

I gave my baby bottles of expressed milk at five days because I found breastfeeding incredibly painful. I was extremely fortunate that the midwife I saw after that made me an appointment with a lactation consultant who sorted us out so quickly; she showed me the rugby ball hold and after that baby and I made a great team.

When I’m away at competitions my baby has a bottle of expressed milk. Sometimes she gets frustrated with the first couple of feeds when we’re back together because the milk flow of the breast isn’t as quick as the bottle. I just de-latch and try to calm her down.

While I’m away I have to care for my breast health by expressing at a similar schedule to what I do at home. It’s important to me to keep the milk production up and to prevent blocked ducts. I’ve flown to the Far East twice while doing this. I ensure I express immediately before the flight to minimise the number of times I have to express in the plane toilets!

When I was competing in the early months, I found timing feeding/expressing quite tricky. Competitions can take all day and the breaks are not always well-timed or long enough, nor are there always facilities available. If you are competing and breastfeeding, you may find it worthwhile to ask the organisers in advance about facilities.

I found while travelling to events abroad that it’s really difficult to keep the pump parts all clean. So now I make sure there’s a towel in the bag to catch the drips at least, even if there’s not enough time to dry it off properly. I give everything a really good clean when I’m back home.

They say sleep when your baby sleeps, but during the day I tended to train when baby slept! However, I’d definitely go to bed at night at the same time as baby, which would be about 9pm.

I had to increase my supply and do lots of pumping ahead of the Tokyo Olympics, as athletes were not allowed to take their infants due to the pandemic. It took me a while to realise just how many calories this was using on top of my training. Although my appetite was huge, I wasn’t eating enough, so the imbalance of calories along with my lack of sleep meant I was constantly exhausted.

It wasn’t until a month or two after Tokyo that I decided to get fit again for jogging, for a number of reasons: motivation, time, mental health, pelvic floor, changing bra size and uncomfortable breasts, especially when full. Sport shops do not stock my bra size which I find incredibly frustrating, but I did find a really good extra supportive bra in my size. I followed my female health physio’s advice by doing a few weeks of work on my pelvic floor; I was already doing pelvic floor exercises stationary and in squat positions, but she advised me to do them while doing some toe taps, half high knees, side steps etc. Once I was confident of no leakage, I did a couple of light jogs while pushing baby in a little tricycle, which she loved. I’d make sure I gave baby a good feed beforehand so my breasts would be most comfortable.”

Jasmin Paris

“I’m a fell runner (I also do mountain and ultra trail running). I had my first baby in November 2017 and my second in July 2020. I breastfed them both, for 15 months and 22 months respectively. During this time, I ran a number of races, including the Spine (2019) and Barkley Marathons (2022), and won the British Fell Running Championships (2018).

With Rowan I started running gently around 3-4 weeks post-partum; with Bryn I left it until five-six weeks, as I’d had some pelvic pain during pregnancy so I waited for that to settle down. I took it very easy at first, and didn’t start any structured training until around three months. My general approach during both pregnancies and afterwards was to listen to my body and do what felt comfortable.

I found that I needed to eat something before training once I was breastfeeding (prior to that I’d often run fasted first thing in the morning), so I guess that was another example of listening to what my body was telling me. Eating enough (to prevent RED-S, relative energy deficiency in sport) is particularly important if training hard whilst breastfeeding. So are Vitamin D supplementation, calcium and sufficient dietary iron.

My main concerns were about being away from my baby, especially in the early days when they were feeding frequently. We did try to get both of them to take a bottle of expressed milk, but they were quite resistant to that, preferring it straight from the source.

It helped to have a routine. With both children we got into the habit of me going running between 6-8am whilst on maternity leave (typically 60-90 minutes once they were a few months old), before my husband went to work. This time worked well as the baby would either be asleep, or awake in a good mood, having fed throughout the night/early morning (for the same reason, my breasts would not be too full, and I wouldn’t be worried about baby being hungry).

 

I just ran in my standard sports bra. It was a bit tricky for immediate post run feeding, but I just hitched it up to allow access. My babies never seemed to mind me being a bit sweaty, and never refused milk even after a hard training session (which reportedly can occasionally change the flavour of the milk).

I guess as an elite athlete, the biggest challenge is probably travel to races – I tended to take my baby with me. For example, my husband and I ran the Lowe Alpine Mountain Marathon two-day event when my daughter was six months old, and my mum carried her in to the midway camp for her to spend the night with us in the tent (she was only just starting to try solid foods and she was still mostly breastfed at the time). Another example was Els2900 when my daughter came to the two high mountain refuges at the start and end of the race, to limit the time we’d be apart (again thanks to my mum).

For more of Jasmin’s experiences please see her blog here: jasminfellrunner.blogspot.com

Summary

You may wish to return to, or start, exercising post-partum. If you feel physically ready to do so, then breastfeeding is not a barrier. Any practical arrangements can usually be managed, in line with the normal needs of your baby in the early weeks and months. You can get additional support about this through your local La Leche League Leader and group (see here for our group finder).

Elite athletes who are breastfeeding may have additional considerations, but continuing to train and compete while breastfeeding is achievable alongside the right support for their physical recovery and some planning for events.

Thank you very much to Naomi Folkard and Jasmin Paris for their inputs to this article and for helping to show how mothers can successfully combine elite level athleticism with breastfeeding.

Written by Rhiannon Butterfield, LLL Cambridge July 2022

1.https://absolute.physio/wp-content/uploads/2019/09/returning-to-running-postnatal-guidelines.pdf
2.Wallace JP, Rabin J. The concentration of lactic acid in breast milk following maximal exercise. Int J Sports Med. 1991 Jun;12(3):328-31.
3.Gregory RL, Wallace JP, Gfell LE, Marks J, King BA. Effect of exercise on milk immunoglobulin Med Sci Sports Exerc. 1997 Dec;29(12):1596-601.
4.Cary GB, Quinn TJ. Exercise and lactation: are they compatible? (Review) Can J Appl Physiol. 2001 Feb;26(1):55-75.
5.Harris, J.E., Pinckard, K.M., Wright, K.R. et al. (2020). ‘Exercise-induced 3’-sialyllactose in breast milk is a critical mediator to improve metabolic health and cardiac function in mouse offspring’. Nature Metabolism, 2, 678-687. https://doi.org/10.1038/s42255-020-0223-8
6.Guidelines for perinatal care. 7th American Academy of Pediatrics and the American College of Obstetricians and Gynecologists; Washington, DC: 2012
7.Wiessinger, D., West, D., Pitman, T., & La Leche League International. (2010). The Womanly Art of Breastfeeding (8th ed.). New York: Ballantine Books.

References and further information:

LLLGB articles:
Working and breastfeeding
Workday practicalities
If you leave your baby
When you can’t be with your baby
Expressing your milk
Storing your milk
Breastfeeding and diet

Other articles
www.llli.org/breastfeeding-info/exercise/
www.lllusa.org/running-and-breastfeeding/
www.kellymom.com/bf/can-i-breastfeed/lifestyle/mom-exercise/
www.breastfeedingnetwork.org.uk/dame-sarah-storey/

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Cary GB, Quinn TJ. Exercise and lactation: are they compatible? (Review) Can J Appl Physiol. 2001 Feb;26(1):55-75.
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