Postpartum Nutrition

Postpartum Weight Struggles

“Just breast-feed—you’ll lose the baby weight!” Most, if not all RDs who have given birth have heard that. And our clients who are mothers have heard it too.

But many women don’t lose weight during breast-feeding. These women are in our offices asking for help not only with their health but also with their newfound identities as mothers—they hope to regain their sense of prebaby self in a new world that seems completely out of their control. Their identities have shifted with the new title of “Mom,” and they seek familiarity in the mirror when it doesn’t exist in so many other aspects of their lives.

We can tell our clients to “Appreciate the miracle your body just created!” and “Don’t stress—enjoy this time with your beautiful blessing.” A woman may look back 20 years from now and wish she had enjoyed this perspective, but in the moment, it’s just not helpful.

As RDs understand, many factors contribute to a person’s size and shape. Weight is affected by a dizzying combination of genetics, nutrition, activity, health status, and lifestyle factors, many of which may be out of clients’ control, especially during the postpartum period. It may be valuable for a client to understand all of the facets of weight gain, including the following, so she understands that struggling to lose weight isn’t a personal failure.

• Psychosocial: Stress over a new baby’s illness (particularly if it’s severe enough to require a neonatal ICU stay), lack of social support, returning to work, financial troubles, cultural marginalization, and other psychosocial factors have been implicated in postpartum weight retention. In addition, a Danish study involving 37,000 women found a significant correlation between anxiety and depression and postpartum weight retention, though causation hasn’t been established.

• Physical: Genetics impact weight gain during pregnancy as well as how quickly the weight comes off. Furthermore, by how much fat metabolism increases during lactation also varies due to genetic variances among women. Inadequate sleep, use of birth control or other prescription medications, close pregnancies, or postpartum thyroid dysfunction all can cause hormonal shifts resulting in increased weight retention. Finally, the thyroid increases in size during pregnancy to meet increased energy demands, so any diagnosed or subclinical thyroid condition present before pregnancy may be exacerbated in the postpartum period.

When counseling clients, we must provide realistic solutions, such as the following, to address these factors.

• Share tips for getting more rest. Babywearing (ie, keeping a baby in a wearable sling or other wearable, hands-free carrier) while doing household chores can enable new mothers to get chores out of the way when the baby is awake and use nap time to rest and relax. Provide meal preparation tips to help clients save valuable energy (and time) by making it easier to get a meal from the fridge or pantry to the table. Encouraging clients to establish a regular, early bedtime for themselves can be helpful in ensuring a better-rested new mom.

• Make exercise easy. Physical activity can improve both physical and emotional health, but must be fun, safe, and convenient, as getting to the gym during the postpartum period can be difficult. Clients with other, older children may appreciate activities that include them, such as tag, freeze dance, or an energetic game of Simon Says.

• Encourage a healthful, convenient diet. Despite their desire to lose weight, new mothers—and babies—benefit from regular meals and snacks, as mothers’ nutritional needs still are increased through the breast-feeding period. Encourage new moms to create a snack station, much like a diaper station, as a visual reminder to nourish themselves. Providing a list of nutrient-dense and shelf-stable foods, such as nuts, fresh fruit, and crunchy roasted garbanzo beans, can be very helpful. Some new moms experience intense anxiety concerning how their nutrition affects the quality of their milk, so it’s important to discuss how their body will prioritize perfect breast milk for their baby and impart that, as long as they don’t engage in extreme caloric restriction, their milk will be exactly what their baby needs.

The many changes to a woman’s body and mind during the transition to motherhood often result in stress and confusion. By counseling new mothers with a unique combination of science and compassion, RDs can help increase their confidence that they can remain healthy, ensure the health of their baby, and manage changes to their lifestyles (and bodies) as well as meet changes yet to come.

— Yaffi Lvova, RDN, is a proud mom of twins plus one. As the owner of Baby Bloom Nutrition and Toddler Test Kitchen, she writes and speaks with the goal of helping pregnant women and new parents smooth the transition into parenthood. You can find Yaffi on her weekly Facebook Live segment, Nap Time Nutrition; on Facebook at Baby Bloom Nutrition; and on Instagram at @toddler.test.kitchen.

2 Comment

  1. Thanks for sharing this article. I am a dietitian who did not partake in any extreme over indulgence during my pregnancy and managed to gain over 50lbs. I went to my annual physical at 6 months postpartum and the doctor started talking to me about how I needed to lose weight. As a new mom, and dietitian, I found this to be extremely offensive. I think there needs to be more awareness of how truly the first year and potentially longer while nursing, we should just let the body heal and let moms figure out this new identity. There should also be a new rule for providers, don’t ever tell a new mom she needs to lose weight when she is metabolically healthy and healing.

    1. Lela, thank you for sharing your personal and professional journey. As healthcare practitioners, we need to know the scientific factors behind these concerns, as well as how to be compassionate while caring for our clients’ health needs. Sometimes there is an underlying issue, like PPD or hypothyroid, but sometimes there is no problem at all, as you pointed out.

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