Health - Get fit for two

DR. SHEELA NAMBIAR M.D


How you can get back into shape after the baby arrives.



After nine months of growing larger and enduring the assortment of complex changes experienced by your body, you are probably looking forward to getting back into some semblance of ‘shape’. Much to your surprise, your body refuses to cooperate. The baby is delivered, so why aren’t things back to ‘normal’, you lament after just a few sit-ups to flatten your tummy, twists to whittle your waist and some calorie-counting (although you’ve been told repeatedly to continue to ‘eat for two’ by the elders!) and feeling wretched as a result.

Many women seem to be in a tearing hurry to get back into their skinniest jeans influenced perhaps by the media hype about J.Lo looking fabulous two weeks after having twins. We forget sometimes that not everyone can indulge in a fleet of personal trainers, nutritionists, baby sitters and so forth to make ‘getting into shape’ the prime priority in life.

Truth be said, it is not the easiest task for a new mom to contemplate her figure. On the one hand she has to suffer sleepless nights, endless feeding routines, be a responsible mother, eat sensibly to feed her baby, be loving and compassionate and all of those things that are apparently ‘naturally maternal’. On the other, she needs to get into shape and reclaim her identity which now seems to be somehow entwined with the little wailing imp who is taking over her life.

If you were able to maintain activity levels during pregnancy, you will find it far easier to return to normal levels of weight and exercise compared to women who, for whatever reason, had to reduce or stop exercising altogether.

You have probably gained about 15-20 pounds during the nine months of your pregnancy (sometimes more, especially among the urban women). This weight gain is partly the weight of the growing uterus, the baby, surrounding liquid and placenta. The remaining fat accumulation, which is predominantly over the hips, thighs and breasts, was evolutionarily required as a store of energy for the nutrition of the baby after delivery.

More and more women are having babies in their late 30s and 40s. Reclaiming your figure at this stage is even harder with the slowing metabolism, but not impossible. The key is moderation and a realistic approach to fat loss, strength and muscle gain over a period of 6-12 months.

How much do you need to eat after the baby?

Eating for two is not entirely what it is made out to be. A breast feeding mother needs to increase her calorie intake (from the regular calorie intake required for her height and weight) by only 500 cals/day to compensate for breast feeding. This would amount to an apple, an extra cup of skimmed milk and a fistful of roasted nuts a day.

Increasing water intake is important to stay well hydrated. There is absolutely no justification though for the ghee-soaked rotis, sweets, the never-ending intake of milk (that too the full fat variety), the incessant snacking on fried foods or other indulgences.

Do you really need to exercise?

You are also probably dealing with an onslaught of well meaning, and sometimes unsolicited, advice regarding exercise post-delivery. It is commonly believed that the weight gained in pregnancy will disappear of its own accord with no effort on your part. This is not essentially true. It has taken you nine months to gain all that fat and will probably take you another six to lose it provided you endeavour to.

Losing weight may be the prime objective, but the strengthening parts of your body that have been subjected to undue stress with the growing pregnancy — like the back and abdominal wall for instance — will go a long way to a fitter you. It will also address to a great extent, the back ache, neck and shoulder pain you develop following delivery and the posture assumed during breast feeding and carrying the baby.

Concerns

There have been some concerns about exercise producing lactic acid build-up and affecting breast feeding. Very strenuous exercise can result in an accumulation of lactic acid in the working muscles. Moderate physical activity will not lead to lactic acid build-up. This, however, has not been found to deteriorate the quality of breast milk. However, a breast feeding mom should wait at least half an hour following a vigorous exercise routine before feeding her baby.Watch out for bleeding. If you experience heavy bleeding or an increase over your normal bleeding while exercising, stop and consult your physician. Rest is an important component of fitness. Trying to exercise when totally sleep deprived is not advisable, your body will not respond and may in fact be more prone to injury.

Before starting abdominal exercises do a ‘rec check’ to see if you have developed what is called ‘Divarication of the Rectus muscle’, which happens during pregnancy when the rectus is over-stretched and separated. Your Obgyn can ascertain if you have this condition. If you have only a slight separation, using an abdominal belt, and performing the exercises with utmost caution and perfect form will actually aid in bringing these muscles together. A larger divarication with associated herniation of the bowel will, however, need to be addressed by a professional.

What kind of an exercise routine do I follow?

Thirty to 40 minutes of any form of cardiovascular exercise (walking, cycling, cross training) per day, may be partaken in for weight loss. Increase the intensity of the exercise gradually to about 70 per cent so you burn a minimum of about 250-300 calories/ session.

If you exercised before and during pregnancy, continue to do so varying intensity of exercise depending on your energy levels. Find something you like and stay with it. It may take up to six-seven months for the weight to decrease. But it will, with perseverance and sensible eating.

Strengthening exercises need to address specific muscles that have been and are being strained/stretched during pregnancy and after.

The upper back and shoulders are particularly vulnerable to stress with constant breast feeding and the postural changes that occur during and after delivery.

In addition to these (which are only a basic listing of exercises that may be put into practice), there are several that can be combined to break the monotony of exercise.

It is also advisable to change the routine every six weeks to challenge the muscles and prevent boredom. Not all the exercises need to be implemented at the same time. Start with about six-eight repetitions per exercise and work up to three-four sets of 12 to 15 reps each.

Strength training can be done on alternating days if all the body parts are addressed in a single routine or, every day (for a shorter period of time) if different body parts are worked.

Yoga is particularly helpful at this time in your life. Combining the above with yoga and relaxation on the days when you are simply incapable of pushing yourself through a heart pounding cardio session will create a well-rounded fitness routine. Including the Sun-Salutation, asanas like the ‘camel’, ‘boat’, downward-dog’ and ‘seated forward bend’ may be extremely helpful in improving flexibility of the body aside from aiding relaxation.

The crucial question then arises: “When do I start?” After a normal delivery — as soon as possible. Many active women return to exercise within two weeks of their babies’ birth without detrimental effects. After a caesarean — six weeks, unless you develop scar dehiscence, infection or have been advised against it by your Obgyn for any other medical reason.

Even abdominal exercises can be started six weeks post-caesarean. Begin with isometric exercises for the Transversalis muscles (which travel around the waist like a corset), followed by breathing exercises using the abdominal wall to attain control over these muscles.

Finding the time

With a newborn, innumerable household chores, not to mention a career if you have one, it may seem impractical if not impossible to find the time. How do you allocate 30-40 minutes of time that you don’t have? One solution is to try incorporating exercise at intervals.

Stealing a few minutes at various times during the day to do your crunches, squats, kegels or back extensions (and not necessarily as one uninterrupted session) may work for some women. Even your cardio may be done as three, 10-minute sessions provided you can motivate yourself to the required intensity each time.

Nap time for baby, for instance, may be another good time to get in a workout provided you are well rested (is that at all possible, you ask?). If not it may be more important to catch a nap yourself instead of gruelling through an exercise routine.

Include baby in your strengthening workout as the child grows older. Hold on to him (close to your centre of gravity) while you do a ‘Mommy and Me’ routine with squats, pelvic bridging, bent over rowing and even crunches. Exercising with your baby is not only more demanding but also more enjoyable.

A father’s role in your getting into shape cannot be over-emphasised. Taking some of the child rearing/caring load off you and giving you the time and space to indulge in exercise may be one of the best gifts he can offer. He may then find you more sanguine and charming besides beginning to look fabulous!

Benefits


Having got on this roller coaster ride of new motherhood, some women find themselves too tired to exercise. But exercise can be invigorating and uplifting, physically and emotionally. The endorphins released during exercise benefit post partum mood swings. Post-partum blues can sometimes be incapacitating.

A systematic exercise routine regulates and even treats these mood upheavals to help you deal with the sense of overwhelming responsibility you feel now that you are a mother. Regular exercise also helps you sleep better, get stronger to handle the growing child, eat healthier and of course, lose that extra flab.

It is also a great way to socialise, if you join a class for instance, and most importantly, the time spent solely for yourself is great for your morale making you a more confident mother capable of handling any crisis with your baby.


The writer is a practising Obgyn, a Fitness and Lifestyle Consultant NAFC (U.S.A) and Director, TFL Fitness Studio, Chennai. E-mail: drsheela@tflinc.net