What do Breastfeeding Women Need and Want? - No One Told Me About This Part!

What do Breastfeeding women need and want? Let's take a closer look.

You’ve had your bundle of joy and you’re working out the kinks of having a new baby in your life and feeding them the best you can. From breastfeeding to return to exercise, there are many challenges that new moms must navigate.

There are a wide range of feeding options, from exclusively breastfeeding to formula/food feeding or a combination of the two. Studies have tried to get a better understanding of what women need in this stage of motherhood, particularly determining what impacts breastfeeding may have on exercise and activity. We know that breastfeeding causes a depression in estrogen which in turn can cause pelvic floor dysfunction like the involuntary leakage of urine with activities such as sneezing, coughing, laughing or exercise defined as stress urinary incontinence. This type of incontinence has been linked to a longer duration of breastfeeding, however its effects are not lasting (Snyder). Breastfeeding people may also have breast-related discomforts such as nipple pain, mastitis, and over/under supply. Any of these symptoms may limit one’s motivation to exercise. 

The benefits of exercise to our physical and mental health are well established.  By staying physically active, exercise can challenge your pelvic floor to gain strength, coordination and flexibility. Exercise also decreases the likelihood of postpartum depression, obesity and metabolic conditions while aiding in returning to one’s pre pregnancy weight (Edie et. al). Postpartum women, however, are having difficulty meeting the 150 hours per week of moderate activity/exercise recommended by the U.S. Department of Health and Human Services along with the American College of Obstetricians and Gynecologist (ACOG).  

What are truly some of the biggest obstacles? Let's ask the mothers themselves. 

Two studies looked at women within 1-12 months postpartum at any level of breastfeeding (exclusive or supplemented) to see what they struggled with.

• What Pelvic floor dysfunction (PFD) did breastfeeding women have and was it dependent on what kind of breastfeeding they did?
  • The most common responses were complaints of stress urinary incontinence and trouble with straining for bowel movements.
  • A higher Body Mass Index (BMI) was a predictor for complaints of pelvic floor dysfunction. (number of children, exclusivity of breastfeeding or age of child were found to have no predictive value to pelvic floor dysfunction.) Calculate your BMI here https://www.nhlbi.nih.gov/health/educational/lose_wt/BMI/bmicalc.htm
  • There was no correlation between the level of breastfeeding (exclusive or supplementing) and pelvic floor dysfunction.

• What do breastfeeding women need in an exercise program and how has their exercise level changed pre and post pregnancy?
  • Women want pelvic floor strengthening and general exercise with guidelines on what is safe to do.
  • Upper body exercise (strength and stretch) to accommodate for changes in breasts and feeding. 
  • The most significant barriers to exercise were (Edie et.al)
    • “Lack of time/social support” due to child care demands.
    • Tiredness/lack of sleep
    • Unpredictable routine due to responsibilities.
  • Activity levels decreased in intensity and frequency from pre pregnancy levels from 88.9% pre pregnancy to 79% currently. The more common type of exercise postpartum was walking, cycling and light exercise for at least 4 hours/week. (Snyder et. al)

Do any of these sound like you? The physical therapists at Femina Physical Therapy are knowledgeable in working with pregnant and postpartum mothers to address health needs. From helping you on your birthing plan and general health during pregnancy to working with postpartum symptoms like pelvic pain, incontinence, diastasis rectus abdominus concerns and return to exercise, you are supported! To make an appointment with our team, contact us soon to start your healing journey and start reaching your goals.

Resources:

https://journals.lww.com/jwphpt/fulltext/2021/04000/barriers_to_exercise_in_postpartum_women__a.6.aspx

Edie, Rebekah SPT1; Lacewell, Alexis SPT1; Streisel, Christine SPT1; Wheeler, Lauren SPT1; George, Ellie SPT1; Wrigley, Jordan MA, MSLS2; Pietrosimone, Laura PT, DPT, PhD1; Figuers, Carol PT, EdD1. Barriers to Exercise in Postpartum Women: A Mixed-Methods Systematic Review. Journal of Women's Health Physical Therapy 45(2):p 83-92, April/June 2021. | DOI: 10.1097/JWH.0000000000000201 

https://journals.lww.com/jwphpt/fulltext/2021/04000/_no_one_told_me_about_this_part___what.2.aspx

Snyder, Kailey PhD; Peterson, Julie PT, DPT; Bargstadt-Wilson, Kari PT, MPT. “No One Told Me About This Part”: What Breastfeeding Women Want and Need to Support Their Physical Health. Journal of Women's Health Physical Therapy 45(2):p 51-56, April/June 2021. | DOI: 10.1097/JWH.0000000000000195 

https://journals.lww.com/jwphpt/fulltext/2019/10000/perceptions_of_physical_activity_while.5.aspx

Snyder, Kailey PhD1; Hanson, Corrine PhD2; Hill, Jenni PhD3; Dinkel, Danae PhD4. Perceptions of Physical Activity While Breastfeeding Using the Self-determination Theory. Journal of Women's Health Physical Therapy 43(4):p 180-187, October/December 2019. | DOI: 10.1097/JWH.0000000000000146