Mar 2012

When to return to exercise after having a baby?


This article on postnatal exercise is written by Rebecca Bennett of Natus Physiotherapy. She currently offers Postnatal Return to Fitness sessions (see link below).

Early postnatal exercise has many positive effects on our bodies including: increasing confidence, toning weakened muscles like abdominals and pelvic floor, giving you more energy and releasing feel-good hormones. For a lot of new mums, after looking after baby and getting some sleep, returning to exercise is often high on the agenda, but when is it safe to re-start exercise? How often should you be exercising?

Often your doctor, midwife or health care professional may ask you to wait until your 6 weeks postnatal to resume exercise. This can be for a few reasons which include: you will have your 6 week check where they can ask how you are feeling and check your blood pressure, lochia (breakthrough postnatal bleeding) has often stopped by this point, you may have got into a good routine with baby so you can fit in exercise in a more structured way and numerous other reasons. However, The American College of Obstetricians and Gynecologists suggest gradually resuming exercising when you feel up to it, which may be before or well after the 6 week mark.

Here are some things to consider when or before resuming exercise:

·         You can start your pelvic floor exercises very soon after giving birth and even though they may feel very difficult to contract or have reduced sensation, persevere, they will help support your bladder when you are exercising and help with healing of any stitches.

·         Starting some gentle abdominal exercises as soon as you can is important to give tone to your stomach. At your 10 day health visitor visit, ask them to check for any ‘stomach gap’, formally known as divarication of recti, if the gap is more than 2 fingers widths wide at this check it means some postnatal exercise like sit-ups will be restricted and you should see a women’s health physiotherapist. Some examples of basic abdominal exercises that are safe for everyone include pelvic tilts and static abdominal contractions.

·         The type of delivery you have had may restrict how quickly you return to exercise, especially if you have had a c-section, allow your body to recovery for 6 weeks but you can still do pelvic floor exercises, gentle abdominal exercises and walking.

·         Try not to start a completely new exercise immediately postnatally, re-start something you have done in the past and gradually increase the intensity of the workout. Listen to your body, if you need to slow down or stop, do so. A good exercise early postnatally is a slow walk which can then be increased to a power-walk and then a jog over time.

·         If you would like to go swimming, make sure your breakthrough bleeding has stopped for at least one week, this reduces any infection risk, and in the early stages avoid breast stroke movements as this often puts a strain on your abdominals.

·         Always warm up the body before doing exercises with some gentle stretches, and always stop when you feel your body has had enough.

·         Have water handy when you are exercising and you may need to drink quite a bit more than usual if you are breast feeding. Sometimes breast feeding before exercise means your breasts are not quite so heavy. Do not forget a well fitting, supportive sports bra!

·         The hormone ‘Relaxin’ is released in your blood stream in early pregnancy and affects all of your ligaments by softening them in order to help your pelvis expand. Even though this hormone leaves your system very soon after birth, the effects of this hormone can stay in your system for months. This leaves your body  more susceptible to strains and sprains as your ligaments will be looser. Try and keep to flat, even ground and wear good quality, supportive trainers.

·         A postnatal exercise class run by a professional will provide safe guided exercises as well as advice and support. An exercise buddy can help keep you motivated.

In conclusion, when to return to exercise postnatally will depend on the individual, what sort of delivery they have had, how easily baby gets into a routine and how you are feeling physically and mentally. In general in the first few days postnatal commence pelvic floor exercises, gentle abdominal exercises and some stretches daily. After a few weeks, either when you feel ready or you have had your 6 week check you can re-start some gentle low impact exercises, listen to your body and then gradually increase as you feel able.

Rebecca Bennett (Natus Physiotherapy)

For details of Rebecca’s assessments and treatment sessions, please click here

Why would you do a refresher class if you've got a smaller age gap?

The popularity of my refresher classes is starting to take off. Hooray!!

When you start a new business it’s hard to know how best to help people and which class will be most popular.

It made sense to me to offer refresher classes to people on babycare thinking that it’d mostly be those with a larger age gap that would come along.

More recently though, the classes have been popular with smaller age gaps - 2 1/2 and below. These refresher classes are less about babycare as that is still top of mind (and in most cases your firstborn still feels like a baby). Instead the focus of the classes is more about the logistics of managing 2 - how would bath time work and what about bedtime as you can’t split yourself in 2 (although it’d be very handy sometimes if you could!)

Also I’ve had lots of questions about potty training - when is the right time to do it and when you start what are you really letting yourself in for?

Moving to a bed is also a hot topic as many want to free up the cot so as not to have to buy another, but again they want to know what issues might arise if they do this too early?

The thing about a smaller gap between kids is the fact that you’re still very busy with your first - they still need you to do most things for them. (Although on the plus-side they are still usually having a nap or 2 in the day) Therefore you don’t have lots of time to be reading books on what to do through each of the stages and you haven’t had friends go through it yet to help you out.

My 2 hour class is an opportunity to get a practical heads-up on all the things you might be thinking of with your firstborn so that you don’t make things harder for yourself. It’s also an opportunity to think of the practicalities of coping with 2 and how to manage it so that the transition is as smooth as possible.

My first birth experience (7.5 years ago!)and the early weeks with my son


I remember feeling really excited when I was pregnant with my first baby. After my 20 week scan, I felt more confident that things would be OK, and whilst I didn’t know if I was going to have a boy or a girl, I started to think about the things I’d need for the nursery and gearing myself up for the birth.

I found it quite hard knowing what to buy for my baby. There was so much ‘stuff’ out there. The Bugaboo had just come out and at the time everyone thought it looked odd. It was featured in magazines being pushed by the then new mummy Gwyneth Paltrow and was new competition for the popular 3-wheelers. I remember feeling completely confused about what to get. At the time I wasn’t thinking – does it fit in my hallway, can I push it with one hand so I can hold my mobile with the other to speak to my friends/husband. I remember the lady in the shop demonstrating how to fold it down and back up again, but I wasn’t thinking just how many times I’d be doing this and how I really should be paying attention to how small it folded and how much it weighed.

Similarly I didn’t know much about the other things that I needed – yes friends had babies and I loved cuddling them and smiling at them, but in terms of babygrows vs. bodysuits and swaddle robes vs. sleeping bags in addition to everything else, I was pretty clueless.

I had a wonderful birth which I’m sure was down in part to luck, and in part to learning the different birth positions, breathing properly and staying active. I laboured at home for most of the day – getting into the bath as soon as I felt my first contractions, and then using the tens machine and the birth ball until it felt like things were getting more intense. My husband was amazing – I was lucky that I spoke to him before about how I’d like him to help me – not asking me too many questions but just being on-hand if I needed him. When we got to the hospital (over what felt like a hundred speed bumps = not good when you’re contracting!), I remember with amazement when the midwife told me I was 8cms and would I like her to run the water? I was soon in the birth pool, feeling cocooned, and then after a couple of hours, my gorgeous boy was born with the longest eyelashes I’d ever seen. That moment of instant love was completely unforgettable.

I got home early the next day and it was then that I’d realised having a baby was much more than just the birth. I remember looking at our gorgeous boy and wondering what do we do now? I guess I was focusing so much on the birth, that the reality of a baby almost didn’t feel real until that point. I was used to just popping out to get things for 10mins and I wasn’t prepared for how much harder it was to leave the house with my son.

Similarly I was just so shocked by how a little person could cause so much work. I hadn’t really thought through just how long I’d be feeding, and how it could take over my day and night! I was shocked just how simple things you take for granted can change straightaway! I was used to eating when I was hungry and sleeping when I was tired - my son had other ideas!

I’d wished in hindsight that I’d thought more about those early weeks with my son and prepared myself for what it would be like and how I might go about doing things.

When my second son arrived, I felt I had learnt the short cuts and practicalities the hard way. I was so much more prepared this time round and those early weeks were so amazing. Less rushing around and instead concentrating on my beautiful boys.

I started to share my learnings with friends when they became pregnant, and it was them who suggested I set up The Baby Care Company to help other mums and dads-to-be feel more prepared.

The Babycare Company offers a straightforward service based on equipping you with the knowledge and skills you need to thrive as a new mum. Partly, this is about giving you essential information - the things I wished I'd known when I was a young mum. But it's more than this. It's about providing small classes and a supportive environment to give the confidence and encouragement through what is a truly life changing experience.

Mine is a never ending quest to make mums feel happy and confident in those early weeks.

Flying with your baby - some helpful hints

Here’s an interview I did for Ready Steady Mums on flying with your baby for the first time..

Going on holiday with your new baby is fun, relaxing and joyful... No?

I recently met with Eilish Saba, mother of 2, Oxford University graduate in Physiology, expert in caring for babies and toddlers and founder of 
The Baby Care Company. We were talking about holidays, and in particular, the challenges of taking a flight with your baby.

Many of our Ready Steady Mums members really look forward to the precious time they have to go on holiday as a family. But how can you make sure it's more fun than fuss? Here is some of Eilish's expert guidance on taking a flight with your new baby.

Q: What should we consider when planning our journey by plane?

Eilish: Your little one will need their own passport. The application process is the same as for an adult passport but they last for 5 years. Getting the photo right when your baby isn’t sleeping or crying can prove a bit of a challenge so give yourself plenty of time.

When booking your flights, give the airline your baby’s details. A child under 2 will be on your knee unless you buy them a separate ticket. For longer journeys ask to book a bassinet which is a small fold down cot, for your baby to sleep in. As numbers are limited, book them as early as you can, and confirm you have one reserved just before you travel.

Q: What should we expect when going through security?

Eilish: You’ll be expected to take your baby out of the buggy, and fold up the buggy to put it through the X-ray machine.

There are still quite strict measures on taking liquids through security but check the latest guidelines before you travel as they change all the time. It’s usually possible to bring breast or formula milk in 100ml quantities. You may be asked to taste your baby’s milk or food to be allowed to take it through.

Just in case, bring an empty sterilised bottle in hand luggage as a spare so in an emergency you can buy pre-mixed formula on the other side of the security gates.

Q: How can we manage the stress of boarding the plane?

Eilish: Some airlines allow parents with small children to board first. But if not, try to relax, hold back and get on the plane after the rush has died down. Older babies can get restless if they board too early and it’s very difficult to get out of your seat whilst others are boarding, so it can sometimes be worth waiting to board.

It’s a good idea to bring your buggy with you on your journey through the airport. Most airlines let you keep them with you until you board the plane and don’t charge for it as extra luggage. You’ll usually get your buggy back when you get off the plane or it’ll be prioritised ahead of the suitcases on the carousel. A sling is also a good accessory to bring to keep your hands free once you get rid of the buggy.

Q: What can we do the make the flight itself easier?

Eilish: Once you’re in your seat, it’s very awkward to move around, and some babies can get frustrated and upset while you wait to take off. Take off and landing can also be hard as babies can be affected by the change in pressure. Try to plan to feed your baby at this time, or use a dummy, to help with equalising. If you’re breastfeeding, it’s worth bringing a blanket for extra privacy and also to ask for a window seat. If you’re formula feeding, pre-mixed formula is easier to use on flights, or measure out your powder beforehand.

Once you are in the air things may calm down and good preparation will help you stay in control.

Compartmentalise your bag so you don’t have to root around for things if you need them in a hurry. Have some wipes, nappies and nappy bags out separately so you don’t have to bring your whole bag to the toilets as there isn’t much room in there. Disposable changing mats are handy as the changing tables can get quite yucky after a longer flight. Oh, and check which toilets have fold down changing tables, to save you queuing at the wrong one!

Dress your baby in layers – so you can add or remove them easily with sudden temperature changes.

Babies often sleep on flights, but if yours doesn’t, taking the baby in the sling and walking up and down the aisle can help settle or entertain a baby. It’s advisable to move around on longer flights anyhow to help prevent DVT.

The cabin crew are usually really helpful when you have a baby on board, so don’t be afraid to ask if you need something.

Q: Do you have a check-list for "what to pack in hand luggage"?

Eilish: As a new parent you’ll be used to bringing the kitchen sink around with you! But here are the essentials.
  • Pre-mixed formula milk if not breast feeding.
  • Disposable changing mats
  • Nappies (lots), wipes, nappy bags
  • Pre-sterilised bottles (more than you think you’ll need just in case you’re delayed)
  • Some pre-boiled water (this can help sooth baby if there is turbulence and on take-off and landing)
  • Bibs
  • Muslins
  • More than one change of clothes for the baby
  • Change of clothes for you (just in case of sick or poo mess!)
  • Blanket (the temperature on the aircraft can change quite a lot)
  • Disinfectant hand gel
  • Plastic carrier bags (for soiled clothes or nappies)
  • Dummy (if your baby uses one this can help on take off and landing)
  • Tissues
  • Sling
  • Toys to entertain (book, cuddly toy, rattle, stickers)
Q: And what else do we need in our luggage?

Eilish: If you’re planning to hire a car at your destination, make sure you either bring a car seat with you, or hire one in advance. The quality and cleanliness of the hired seats can vary as can the position they rest in the car so bring your own if you’re concerned.

Annoyingly, buggies can be thrown around quite a lot by the baggage handlers, so either take a cheaper travel buggy with you, or make sure yours is packed up carefully. You can usually buy a separate buggy cover which might be a good investment to keep your buggy protected.

Q: Brilliant, we're set for a happy flight! Where can we get more of your tips Eilish?

Eilish: For more helpful tips on caring for your baby please follow us on Twitter:
You can email me or call me on 0207 228 1041 with any questions.

Good luck on your first flight together!

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