Are you pregnant, or have you had a baby less than a year ago? Learn about exercise and during pregnancy, and how to safely ease back into exercise post-partum.
What should you eat while pregnant, and how much do you need to eat?
Learn exercise modifications for pregnancy.
Develop a nutrition plan post-partum.
Safely ease back into exercise.
Nutrition & Supplements During Pregnancy
If you are pregnant,this page is for you. All recommendations stem from well respected sources such as the 2002 DRI Panel Report of the Institute of Medicine, and the 2015 Dietary Guidelines for Americans from the USDA. But even so, you should always consult your doctor, OB/GYN or Midwife before instituting any of these suggestions. These recommendations assume that you are in perfect health and are having a singleton pregnancy (I do not discuss recommendations for twin, triplet, or higher order pregnancies). If you have gestational diabetes or other conditions or complications, you will need to adjust according to your doctor's recommendations.
Macronutrient and Caloric Needs
You should get at least 175 grams of carbohydrates, an extra 21 grams of protein more than the non-pregnant recommendation (typically results in intakes of 90 to 150 grams), and 20-30% of your calories from fats (which will be about 50-75 grams for most women) [IOM RDA]. In first trimester, you do not need added calories. You need an additional 340 calories/day in second trimester, and 450 calories/day in third trimester above your maintenance needs prepregnancy. For more information on caloric needs during pregnancy see Calories During Pregnancy.
Recommended Weight Gain
In 2009, the IOM revised their guidelines for suggested weight gain during pregnancy.Their new guidelines are (singleton pregnancy):
- Underweight women should gain 28-40 pounds at term.
- Normal weight women should gain 25-35 pounds at term.
- Overweight women should gain 15-25 pounds at term.
- Obese women should gain 11-20 pounds at term.
Controlling Weight Gain
The best way to meet these targets is to incorporate daily exercise during pregnancy, such as walking or swimming. I do not recommend counting calories unless you (or your doctor) feel your weight gain is out of control. For many women, making healthy choices (see healthy eating) and limiting junk food adequately controls weight gain during pregnancy.
Note: During third trimester many women gain water weight. If your ankles are swelling, you may have a significant amount of water weight. This can skew your weight gain so it looks higher than it would without the extra water. For this reason, some women may end up 10 pounds or so over their target easily. It is worth mentioning that if you gain an unusual amount of water weight you should see your OB/GYN or midwife to evaluate you for preeclampsia.
Supplements for Pregnancy
- Prenatal Vitamin
- Folic Acid - at least 800mcg if not taking it in your prenatal
- Vitamin D - 400-1000IU if you don't get it in your prenatal
- Calcium citrate - As needed to get calcium intake up to 1400mg per day.
- Iron - if your doctor says you are low or if you are a vegetarian.
- Omega 3 - 1g of combined EPA+DHA. This is lower than my regular recommendation since it can thin the blood.
- Protein Powders - look for one that is sweetened with sugar, sucralose or stevia only. Make sure there is no added creatine.
- Dietary Reference Intakes - Institute of Medicine. 2002.
- Weight gain during pregnancy - Reexamining the Guidelines. Institute of Medicine.
Exercise During Pregnancy
If you are pregnant this page is for you. All recommendations stem from well respected sources such as the Physical Activity Guidelines for Americans and the American Congress of OB/GYNs (PDF). But even so, you should always consult your doctor, OB/GYN or Midwife before instituting any of these suggestions. These recommendations assume that you are in perfect health and are having a singleton pregnancy (I do not discuss recommendations for twin, triplet, or higher order pregnancies). If you have gestational diabetes or other conditions or complications, you will need to adjust according to your doctor's recommendations.
Benefits to Exercising During Pregnancy
The recommended amount of physical activity for pregnant women is 30 minutes a day. However, even 10 minutes a day helps! So start with 10 if you don't feel like you can commit to 30.
Just like physical activity done while not pregnant, it can:
- Improve your mood.
- Increase your energy levels, and decrease fatigue.
- Help you sleep better.
- Help you maintain more of your muscle mass, and strength.
Additional benefits related to pregnancy are:
- May help prevent or treat gestational diabetes.
- Help with labor by maintaining strength in the core and pelvic floor (you will have an easier time pushing) and improving cardiovascular endurance.
- Decreases back pain caused by your shifting center of gravity
- Increases mobility by loosening up muscles which may seem stiff especially toward the end of third trimester.
- Helps you gain weight in the recommended range by burning more calories.
- Helps increase circulation and may reduce swelling and water retention.
How does pregnancy affect the body?
Hormones produced when you are pregnant (especially after first trimester) relax your ligaments which support your joints. This means you have more movement in your joints, and you are at a greater risk of injury. Additionally, your center of gravity shifts toward your front putting pressure on your pelvis and lower back. As you get further along in your pregnancy, you may have back pain, and notice that your balance is not as good.
Important considerations for pregnancy
Types of exercise you should definitely avoid
- Avoid activities where there is a high risk of falling down, taking into consideration your poor balance, as you may hurt your baby. Examples are: gymnastics, water skiing, horseback riding,and downhill skiing.
- Avoid contact sports such as hockey, basketball and soccer.
- Avoid activities done lying on the back after the first trimester, such as bench press.
- Avoid anything other than low intensity activity if the weather is very hot and humid.
- Avoid exercises that compress the spine after first trimester. For example, use dumbbells instead of barbells for squats and overhead presses.
- Avoid jumping, or things that involve quick changes in direction in third trimester, or sooner if you notice your joints starting to become lax.
- Stop direct abdominal work after first trimester.
Things to make sure you do
- Drink lots of water to keep hydrated.
- If you are out of shape, start slowly. Begin with 5 or 10 minutes of exercise a day, adding 5 minutes each week until you reach 30 minutes a day.
- Wear comfortable clothing that will help you to remain cool.
- Be sure to not undereat.
What are the warning signs that I should stop exercising?
Stop exercising and call your health care provider if you have any of these symptoms:
- Vaginal bleeding
- Dizziness or feeling faint
- Increased shortness of breath
- Chest pain
- Muscle weakness
- Calf pain or swelling
- Uterine contractions
- Decreased fetal movement
- Fluid leaking from the vagina
Recommended cardio activities are:
- Swimming - the buoyancy will relieve pressure on joints.
- Cycling - the recumbent bike is nice when standing becomes difficult in third trimester.
- Low impact aerobics (without steps so there is no balance issues)
- Running IF you already ran before pregnancy.
- Elliptical trainer
Muscle Strengthening Exercises
Past the first trimester, your yoga routine will have to be modified to avoid backbends, twisting at the waist, handstands, headstands, balancing on one leg (use a chair), and exercises which involve lying on the back. For all trimesters, avoid hot yoga. Be sure to tell your yoga instructor you are pregnant, and how far along you are. If available, take a prenatal yoga class instead of a regular class. For further guidelines on adjusting your yoga routine, see the following links:
- Bodyweight squats. If later in pregnancy, use a chair or have a partner hold your hands for balance. These strengthen the pelvic floor, the core, and the hips and will help with birthing. Do up to 3 sets of 10.
- Pelvic Tilts. Stand with shoulders and back against a wall. Pull your belly button toward your spine, hold for 5 seconds and release. Repeat up to 10 times.
- Yoga cat and dog stretch - do 10 times
If you've already been weightlifting you should be able to keep up with your current routine for at least the first trimester. Past the first trimester, you should:
- Avoid exercises which involve lying on your back.
- Use dumbbells instead of barbells to avoid risks such as spinal compression, falling over due to loss of balance, and dropping the barbell on your belly.
- Discontinue direct abdominal work.
- Sit down while doing overhead presses, and use lighter weight for them.
- Reduce your weights drastically when joint laxity starts to set in (usually the beginning of third trimester).
- Don't do exercises for which your growing belly prevents proper form.
- Use dumbbells for squats and lighten the weight.
- Don't do exercises, such as lunges, which require a great deal of balance when you notice your balance suffering (usually third trimester).
Nutrition & Supplement Recommendations for Postpartum
If you had a baby less than one year ago, and are breastfeeding and/or pumping, this page is for you.
Macronutrient and Caloric Needs for Lactation
You should get at least 210 grams of carbohydrates, an extra 26 grams of protein more than the non-pregnant, non-lactating recommendation (typically results in intakes of 90 to 150 grams), and 20-30% of your calories from fats (which will be about 50-75 grams for most women) [IOM RDA].
If you are lactating, your caloric needs go up by approximately 500 per day in the first 6 months postpartum, and 400 per day between months 6 and 12 (assuming that there is complementary intake of solids).
Deciding on a Caloric Deficit While Lactating
The minimum recommended calories for all females PLUS 500 calories is 1700. This is the absolute minimum you will need if you provide all of your babies nutrition through breastmilk. This is for a sedentary, small female. Most women will need more than this. You do not want to take a big deficit while breastfeeding, 300 calories is sufficient for a deficit for most women. If you take too high of a deficit, you may decrease milk production.
The amount of calories you will want to intake will be the greater number of 1700, and your estimated maintenance minus 300 calories. Many active women need upwards of 2500 calories per day. An adequate caloric intake is essential for milk production.
You should expect to lose weight rapidly at the beginning, as you will lose not only the baby weight, but amniotic fluid, placental weight, any retained water, etc. The first 20 pounds should fall off quickly.
If you need to estimate your maintenance calories, use the caloric needs calculator.
Maintaining Milk Supply While Losing Fat
The best way to build and protect your milk supply is to not start dieting too soon. I recommend waiting a full 3 months to start dieting. This will allow your body to adjust to the increased needs of your older baby. Additionally, it will decrease your stress levels, allowing you to focus your efforts and energy on your new baby.
You may feel ravenous when you start your breastfeeding journey. This is normal, and protective. Fill yourself with healthful choices, and you will be fine. If you are having trouble finding time to eat, get lots of easy to prepare foods that are still fairly healthy - for example, cold cut sandwiches, cheese, crackers, etc. Also important is water intake. Try to drink water before you nurse your baby or before you pump.
A baby who needs more milk because you are undereating, behaves in the same way as a baby who is undergoing a growth spurt. If your baby demands to eat with greater frequency, is more fussy, and gets mad waiting for let-down to occur, try increasing your caloric intake. If your milk supply has decreased due to insufficient caloric intake, you may need to increase your calories above maintenance for several days to bring it back. Once it comes back, you may lower your calories slowly.
The first 6-8 weeks
For the first 6 weeks postpartum, you should rest as much as possible. Don't worry about exercise, you have lots of time to lose fat. Too much activity in the first six weeks postpartum may prolong bleeding, and delay recovery. Activities other than walking may be detrimental to your abdominals which should be going back together.
Getting back into your routine (6+ weeks postpartum)
Do NOT resume physical activity other than walking until your doctor or midwife gives you the go-ahead. This usually happens at the 6 week postpartum visit. Once you get the go-ahead to exercise, you should check if you have abdominal separation, also called diastasis recti, as this will affect your workouts.
Easing your way into regular exercise
With your new bundle around, trying to commit to workouts can be tough. Taking care of your new baby will eat up most of your time, and you will be sleep deprived. However, taking care of yourself is equally important. Exercise will help re-energize you. Get in whatever exercise you can. The first step to maintaining an awesome exercise program is getting into the habit of working out. If you can only find 10 minutes a day, start there, and add 5 minutes each week until you reach 30 minutes.
Workouts for beginners, or those who have been away from fitness
Some workouts which are great for the first 2 or 3 months back at exercising are:
- Couch to 5K
- Plyometric Cardio
- Jillian Michaels - 30 Day Shred
- Jackie Warner - Power Circuit Training (swap the ab workout for crunch free xtreme abs)
- Jackie Warner's Crunch-Free Xtreme Abs
Workouts for women who maintained fitness throughout pregnancy
The best workout will be one that can be done in 30 minutes but still provides a challenge. I recommend one of the following:
Workout 1 - Jackie Warner's Xtreme Timesaver Training combined with her Crunch-Free Xtreme Abs (Exercise on Monday, Wednesday and Friday, alternating between the two workouts)
Workout 2 - Dumbbell only timesaver split combined with Zumba Exhilarate 20 minute rush workout (Exercise on Monday, Wednesday and Friday, alternating between the 2 workouts)