Journal of Human Sport and Exercise

The physical effects of exercise in lactating women: A review

Katya Meyers, Mee Young Hong

Abstract

This review was conducted to better understand the physical effects of exercise in lactating, postpartum women—specifically on weight loss, changes in body composition, and bone mineral density. Prior research indicates that despite high motivation, many women struggle to lose the weight gained during the gestation period. There has been limited research on physical activity in the lactating women largely due to concerns about reduced milk supply and infant health. Female competitive athletes, in particular, seek to understand postpartum physical changes and factors affecting their return to pre pregnancy fitness. A review of the literature was conducted by searching PubMed and Medline for human studies related to weight loss, body composition, and/or bone mineral density in exercising, lactating postpartum females. Of 179 studies identified, 36 full-text articles were screened, and 12 met the inclusion criteria. Exercise with caloric restriction was associated with weight loss in lactating females. Exercise was positively correlated with decelerated trabecular bone loss and improved body composition due to preservation of fat free mass. Mothers should be encouraged to exercise during the postpartum period, as benefits to both mother and child outweigh the risks. However, medical professionals should counsel on reasonable expectations, particularly regarding weight loss.

Keywords

Breastfeeding; Exercise; Weight loss; Body composition; Bone mineral density

References

Bertz, F., Winkvist, A., & Brekke, H. K. (2015). Sustainable weight loss among overweight and obese lactating women is achieved with an energy-reduced diet in line with dietary recommendations: results from the LEVA randomized controlled trial. Journal of the Academy of Nutrition and Dietetics, 115(1), 78-86. https://doi.org/10.1016/j.jand.2014.05.017

Boardley, D. J., Sargent, R. G., Coker, A. L., Hussey, J. R., & Sharpe, P. A. (1995). The relationship between diet, activity, and other factors, and postpartum weight change by race. Obstetrics & Gynecology, 86(5), 834-838. https://doi.org/10.1016/0029-7844(95)00283-w

Colleran, H. L., Wideman, L., & Lovelady, C. A. (2012). Effects of energy restriction and exercise on bone mineral density during lactation. Med Sci Sports Exerc, 44(8), 1570-1579. https://doi.org/10.1249/mss.0b013e318251d43e

Del Ciampo, L. A., & Del Ciampo, I. R. L. (2018). Breastfeeding and the Benefits of Lactation for Women's Health. Revista Brasileira de Ginecologia e Obstetrícia/RBGO Gynecology and Obstetrics, 40(06), 354-359. https://doi.org/10.1055/s-0038-1657766

Dewey, K. G. (1998). Effects of maternal caloric restriction and exercise during lactation. The Journal of nutrition, 128(2), 386S-389S. https://doi.org/10.1093/jn/128.2.386s

Dewey, K. G. (2004). Impact of breastfeeding on maternal nutritional status. In Protecting Infants Through Human Milk (pp. 91-100). Springer, Boston, MA. https://doi.org/10.1007/978-1-4757-4242-8_9

Durham, H. A., Lovelady, C. A., Brouwer, R. J., Krause, K. M., & Østbye, T. (2011). Comparison of dietary intake of overweight postpartum mothers practicing breastfeeding or formula feeding. Journal of the American Dietetic Association, 111(1), 67-74. https://doi.org/10.1016/j.jada.2010.10.001

Gore, S. A., Brown, D. M., & West, D. S. (2003). The role of postpartum weight retention in obesity among women: a review of the evidence. Annals of Behavioral Medicine, 26(2), 149-159. https://doi.org/10.1207/s15324796abm2602_07

Grattan, D. R. (2001). The actions of prolactin in the brain during pregnancy and lactation. In Progress in brain research (Vol. 133, pp. 153-171). Elsevier. https://doi.org/10.1016/s0079-6123(01)33012-1

Hale, R. W., Kosasa, T., Krieger, J., & Pepper, S. (1983). A marathon: the immediate effect on female runners' luteinizing hormone, follicle-stimulating hormone, prolactin, testosterone, and cortisol levels. American journal of obstetrics and gynecology, 146(5), 550-554. https://doi.org/10.1016/0002-9378(83)90801-3

Hayslip, C. C., Klein, T. A., Wray, H. L., & Duncan, W. E. (1989). The effects of lactation on bone mineral content in healthy postpartum women. Obstetrics and Gynecology, 73(4), 588-592.

Hui, L. L., Kwok, M. K., Nelson, E. A. S., Lee, S. L., Leung, G. M., & Schooling, C. M. (2019). Breastfeeding in Infancy and Lipid Profile in Adolescence. Pediatrics, 143(5), e20183075. https://doi.org/10.1542/peds.2018-3075

Kovacs, C. S. (2005). Calcium and bone metabolism during pregnancy and lactation. Journal of mammary gland biology and neoplasia, 10(2), 105-118. https://doi.org/10.1007/s10911-005-5394-0

Larson‐ Meyer, D. E. (2002). Effect of postpartum exercise on mothers and their offspring: a review of the literature. Obesity research, 10(8), 841-853. https://doi.org/10.1038/oby.2002.114

Little, K. D. (1998). Self-selected recreational exercise has no impact on early postpartum lactation-induced bone loss. Medicine and science in sports and exercise, 30(6), 831-836. https://doi.org/10.1097/00005768-199806000-00009

Lovelady, C. (2011). Balancing exercise and food intake with lactation to promote post-partum weight loss. Proceedings of the Nutrition Society, 70(2), 181-184. https://doi.org/10.1017/s002966511100005x

Lovelady, C. A., Bopp, M. J., Colleran, H. L., Mackie, H. K., & Wideman, L. (2009). Effect of exercise training on loss of bone mineral density during lactation. Med Sci Sports Exerc, 41(10), 1902-1907. https://doi.org/10.1249/mss.0b013e3181a5a68b

Lovelady, C. A., Nommsen-Rivers, L. A., McCRORY, M. A., & Dewey, K. G. (1995). Effects of exercise on plasma lipids and metabolism of lactating women. Medicine and science in sports and exercise, 27(1), 22-28. https://doi.org/10.1249/00005768-199501000-00005

Lovelady, C., Lonnerdal, B., & Dewey, K. G. (1990). Lactation performance of exercising women. The American Journal of clinical nutrition, 52(1), 103-109. https://doi.org/10.1093/ajcn/52.1.103

McCrory, M. A., Nommsen-Rivers, L. A., Molé, P. A., Lönnerdal, B., & Dewey, K. G. (1999). Randomized trial of the short-term effects of dieting compared with dieting plus aerobic exercise on lactation performance. The American journal of clinical nutrition, 69(5), 959-967. https://doi.org/10.1093/ajcn/69.5.959

Ölin, A., & Rössner, S. (1996). Factors related to body weight changes during and after pregnancy: the Stockholm Pregnancy and Weight Development Study. Obesity research, 4(3), 271-276. https://doi.org/10.1002/j.1550-8528.1996.tb00545.x

Pickering, L. K., Morrow, A. L., Ruiz-Palacios, G. M., & Schanler, R. J. (Eds.). (2013). Protecting infants through human milk: Advancing the scientific evidence (Vol. 554). Springer Science & Business Media. https://doi.org/10.1007/978-1-4757-4242-8

Sampselle, C. M., Seng, J., Yeo, S., Killion, C., & Oakley, D. (1999). Physical activity and postpartum well‐ being. Journal of Obstetric, Gynecologic, & Neonatal Nursing, 28(1), 41-49. https://doi.org/10.1111/j.1552-6909.1999.tb01963.x

Shangold, M. M., Gatz, M. L., & Thysen, B. (1981). Acute effects of exercise on plasma concentrations of prolactin and testosterone in recreational women runners. Fertility and sterility, 35(6), 699-702. https://doi.org/10.1016/s0015-0282(16)45568-8

Shapses, S. A., & Riedt, C. S. (2006). Bone, body weight, and weight reduction: what are the concerns?. The Journal of nutrition, 136(6), 1453-1456. https://doi.org/10.1093/jn/136.6.1453

Sundgot-Borgen, J., Sundgot-Borgen, C., Myklebust, G., Sølvberg, N., & Torstveit, M. K. (2019). Elite athletes get pregnant, have healthy babies and return to sport early postpartum. BMJ Open Sport & Exercise Medicine, 5(1). https://doi.org/10.1136/bmjsem-2019-000652

Vernon, M. M., Young-Hyman, D., & Looney, S. W. (2010). Maternal stress, physical activity, and body mass index during new mothers' first year postpartum. Women & Health, 50(6), 544-562. https://doi.org/10.1080/03630242.2010.516692

Walker, L. O., & Freeland‐ Graves, J. (1998). Lifestyle factors related to postpartum weight gain and body image in bottle‐ and breastfeeding women. Journal of Obstetric, Gynecologic, & Neonatal Nursing, 27(2), 151-160. https://doi.org/10.1111/j.1552-6909.1998.tb02605.x

Wiltheiss, G. A., Lovelady, C. A., West, D. G., Brouwer, R. J., Krause, K. M., & Østbye, T. (2013). Diet quality and weight change among overweight and obese postpartum women enrolled in a behavioral intervention program. Journal of the Academy of Nutrition and Dietetics, 113(1), 54- 62. https://doi.org/10.1016/j.jand.2012.08.012

Zourladani, A., Zafrakas, M., Chatzigiannis, B., Papasozomenou, P., Vavilis, D., & Matziari, C. (2015). The effect of physical exercise on postpartum fitness, hormone and lipid levels: a randomized controlled trial in primiparous, lactating women. Archives of gynecology and obstetrics, 291(3), 525-530. https://doi.org/10.1007/s00404-014-3418-y




DOI: https://doi.org/10.14198/jhse.2021.164.01





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