PostNatalExercise.co.uk

Pregnancy and Postnatal Exercise

We specialise in teaching fitness and exercise to women before, during and after pregnancy.

We provide networking opportunities and continuing education for qualified instructors.

Are you a new mother? Congratulations!

If you have you recently given birth and are just wondering how to begin safely exercising to help your body come back to its pre-pregnancy condition, then read the article below! Have you heard that exercise might affect your milk and this has worried you? If so read the authoritative article from the Journal of Human Lactation which confirms  that you can exercise without causing any problems to your milk supply - The Effect of Exercise on Lactation

Firstly, it is important to know that a group of hormones called ‘Relaxin’ are produced in early pregnancy to make the ligaments in the body elastic. Normally  ligaments are relatively inelastic, which is necessary to maintain joint stability. But during pregnancy relaxin is produced in various amounts to help the body accommodate the growing baby. Production of relaxin, in these quantities, ceases after birth.

The effect of the ligaments becoming more supple and pliable means, for instance, that back problems can be made worse by excessive twisting and if you return to high impact or inappropriate exercise you can put your body at unnecessary risk of injury. 

Why does the body produce relaxin?

The purpose of relaxin is to provide increased movement in the pelvis to accommodate the growing baby and to allow an easier birth. It also helps the abdominal muscles to stretch during pregnancy and the pelvic floor muscles to stretch during delivery.

Although relaxin is no longer manufactured in the postnatal period, the effects of the hormones on the ligaments are still evident.  Relaxin has an effect on every joint in the body (even the little finger) and the effect on the joints lingers on until about five months post birth. 

So what sort of things do I need to be aware of to avoid problems?

In her book ‘The Complete Guide to Postnatal Fitness’ Judy diFiore offers the following guidelines when undertaking any exercise. If you would like to order her book click here.

·         Gentle exercises can be commenced at home in the first few weeks after the birth.

·         Wait until you have had a satisfactory postnatal check-up before commencing more vigorous exercise. 

·         If you had a caesarian delivery it is advisable to wait eight to ten weeks. 

·         Wear a good supporting bra to protect the breasts when exercising. 

·         Wear appropriate footwear for the activity.

·         If you are breastfeeding, feed before exercising.

·         Drink plenty of fluids before, during and after exercise. 

·         Don’t exercise on an empty stomach.

·         Incorporate exercise into your daily activities as much as possible. 

·         Swap your exercise session for a rest if you are feeling particularly tired. 

·         The level of exercise must be comfortable and achievable. 

·         Recognize when your body has had enough. 

·         Stop immediately if pain is experienced or make adaptations if you feel uncomfortable.

How do I regain (re-train) my  pre-pregnancy posture

·         Start pelvic floor exercises and some gentle abdominal exercises as soon as you can (for example, some pelvic tilts, static abdominal contractions, head and shoulder raises) 

·         You may feel that the pelvic floor exercises don’t seem to do much, but they are really well worth doing, the more you do the stronger the muscles will get. 

·         Start any exercise gradually, allowing yourself to build up over a number of weeks. 

·         Always warm up the body before doing more exercises, have water handy to drink, especially if you are breastfeeding and always stop when you feel your body has had enough. 

·         Try and take the baby for a walk in the pram or carry papoose and ‘power’ walk till you feel warm and your breathing is a little faster than normal. 

·         Pull in your deep tummy muscles (called transversus muscles) whenever you think about them - when walking along, when driving and stopping at the traffic lights, whenever you feed your baby. 

·         Structured exercise may take many forms – swimming, walking, postnatal exercise class. But it is a good idea to leave anything that creates ‘impact’ on your body until you are at least five months postnatal. Impact can be defined as taking both feet off the floor at the same time.

·         If you can get to a specific postnatal exercise class you will meet other mothers with babies of the same age and you will probably find you have much in common. The class can be a really great way to meet others and develop new friendships at this time, especially if you can take your baby along too and afterwards go for a coffee in the cafe. 

·         Look on the Guild  webpage members for a qualified teacher or personal trainer near you. Most of these exercise teachers run classes specially for mothers and babies. 

·         If you cannot find a class near you, investigate a ‘ low impact’ class, arrive early and let the teacher know you have just had a baby.  He or she should encourage you not to jump, bounce or use jerky movements or work harder than you are really ready to do and build up your strength gradually. If you feel pressured into working too hard you can do damage so do not overdo it! 

·         Don’t work into any sort of pain. Pain is a warning signal that should never be ignored. Make adaptations or stop altogether. 

Abdominal Muscle Separation – Is this normal?

Under the influence of relaxin the abdominal muscles undergo a tremendous amount of stretching in all directions. Sometimes the mid-line separates to allow more space for the growing uterus. This is known as diastasis recti – separation of the recti muscles and in quite common, occurring in 66% of women in the third trimester. It is not painful in itself, but can result in backache, and does not look too attractive!

What is the best exercise to regain tummy strength? 

Transversus Abdominal Exercise / Tummy retraction. Here is a sample exercise from Judy DiFiore's book "The Complete Guide to Postnatal Fitness" To order a copy click here.

Preparation: Kneel on your hands and knees with knees under hips, hands under shoulders and fingers facing forwards. Keep the back flat and the neck long.

Action: Breathe out and pull in the tummy muscles, lifting your abdomen up towards your spine. Keep the elbows slightly bent to prevent them locking. Hold for a count of six, continuing to breathe. Lower with control to the starting position, taking care not to let the back arch.

Repeat eight times.

This exercise can  also be carried out sitting or standing in everyday contexts.

·         When it comes to the abdominal work, stick to static transversus tightening, classic rectus abdominal work (with transversus tightening) and work on all fours until you are sure your rectus abdominal muscles have come back together.

·         Leave out oblique muscle exercises until you are sure your abdominal muscle separation has come back to ‘less than two fingers’. 

·         You can ask your midwife, physiotherapist or your postnatal exercise teacher to show you how to check on these muscles.

Remember, the best course is to attend classes given by qualified teachers such as those given by members of the Guild, YMCA, or Fitness Professionals. Ask if your teacher is qualified to teach postnatal exercise if you are not sure.

PostNatalExercise.co.uk

Pregnancy and Postnatal Exercise

We specialise in teaching fitness and exercise to women before, during and after pregnancy.

We provide networking opportunities and continuing education for qualified instructors.

INSTRUCTORS ON THE WEB

***On some computers viewing in low graphics version (click to left in black banner above) will display more comfortably.***

A list of members to contact for classes in your area is set out below. It is  updated regularly and sorry if there is no instructor shown in your area. Instructors are listed alphabetically under Area Covered. On most browsers Ctrl F will bring up a search box you can use to search the page.

Guild instructor member details are provided here to assist pregnant women and new mothers find a qualified pregnancy and postnatal instructor in their area. This information is also for instructor professional networking purposes of a non commercial or non profit-making nature.

Whilst the Guild makes every effort to ensure that members' specialist qualifications are adequate, genuine and up to date, the Guild accepts no responsibility for the accuracy of information provided on their website. Before engaging the services of a particular instructor or joining a class, we strongly suggest that you satisfy yourself as to relevant qualifications and adequacy of Continuing Professional Development.

Can you let the instructors know that you found her through the website. Instructors are advised not to give out their bank details, so do not ask for them.

Please note that the Guild are not insurance brokers or insurance experts. The Guild does expect and advise instructors  to have insurance and this is normally arranged by the instructor with a specialist broker. However, you should always check with your instructor that they carry insurance, and that it is current, relevant and appropriate to your needs.

You also have a responsibility to be open and honest about any physical problems you may have and to follow all safety instructions given by your instructor.

For any other details contact megwalker@pnex.freeserve.co.uk

PostNatalExercise.co.uk

Pregnancy and Postnatal Exercise

We specialise in teaching fitness and exercise to women before, during and after pregnancy.

We provide networking opportunities and continuing education for qualified instructors.

TRAINING INFORMATION 

The Guild does not offer training courses for new instructors.

If you have already undergone a course and are wondering if you can join the Guild, then please email us with your qualifications and experience and we will let you know.

The Guild does run specialist study days for members and these count towards the Guild's annual CPD requirement.

WANT TO KNOW MORE?

CONTACT   megwalker@pnex.freeserve.co.uk

PostNatalExercise.co.uk

Pregnancy and Postnatal Exercise

We specialise in teaching fitness and exercise to women before, during and after pregnancy.

We provide networking opportunities and continuing education for qualified instructors.

Weights, Bands and Circuits

This write up is designed to give you  a flavour of what the Guild study days are like and to encourage you  to book up for the coming ones! Click on future study days above if you are interested.

The tutors for this day were Gillian Fletcher and Judy DiFiore, and the programme incorporated the very first Guild AGM.

After initial chats and catching up with familiar faces not seen since the last study day - or earlier - we got down to business. Gillian kicked off the day with introductions, aims of the day, and then a session on the basic theory and principles of fitness training. Much of this session was revision, but it was good to be reminded of some of the fundamentals which can so easily be forgotten. Gillian had provided us with handouts with copies of the overheads which she used, complete with space to make notes alongside. This struck me as being such a simple thing to do, yet not usual practice. It was immensely useful and a very nice touch - so ‘thank you’ Gillian !

I for one was ready for the coffee break that followed - it was 11.30, four hours since breakfast !

After our break, we re-located to one of the physiology labs for Judy to instruct us through a ‘postnatal circuit’. Unfortunately, the room was not large enough for us all to partake in the full circuit session, although we all warmed-up, so we sorted out amongst ourselves who would exercise and who would take notes.

I was one of the lucky ones able to complete the whole session, and I thoroughly enjoyed what followed.

Judy led us through a warm-up, mobility, and prep stretch, and then gave us a taster of two different types of circuit: the command circuit, and the multi-station circuit. Each type of circuit can further be categorised into aerobic, mse, or combined. The predominant characteristic of the command circuit is that every participant performs the same exercises under instruction together, and the individual exercises can be aerobic or mse in nature. This type of circuit has the advantage that the instructor has full control at all times over what is going on, giving opportunity to correct bad technique, give encouragement, etc., to all participants.

Multi-station circuits in contrast, can result in some of this control being lost. It is much harder to observe everybody as they exercise if there are 5 or 6 groups of 2 or 3 participants, all doing different things in different areas of the room. It becomes even more important to effectively demonstrate and teach the moves prior to the circuit start, so that everybody knows what they are supposed to be doing.

Judy very efficiently and professionally instructed us through a section of each type of circuit. For some of the mse exercises she introduced the use of bands and hand-held weights. This was followed by a cool down, short floor exercise session, and stretch and relaxation. Everything about the session was enjoyable, from Judy’s use of music and exercises, to her excellent delivery.

Lunch followed the practical session, but it was only a short break as we had to fit in the AGM. Gillian thought that it was the shortest AGM on record, but I’ve been to a shorter one - Swindon NCT branch AGM one year was 6 minutes long (guess who was secretary?) . This piece of business was short and sweet, just reporting on achievements to date (lots), thanking Meg and her family for all their hard work (phew!), and voting all post holders back into their posts - fortunately there were no resignations.

After the AGM we were fortunate to have a short presentation by Julie Hanson Moore, regarding her new video ‘Changing Shape with Carol Smilie’. The back sleeve of the video acknowledges the Guild and it is hoped that we may pick up some contacts as a result !

A feedback session on the circuits followed, and it seemed that everyone had enjoyed the experience as much as I had - even those watching. We had a brainstorming session about the muscle groups to target when designing a circuit, and then broke into pairs to work on exercises for a specific muscle group. Pam and I got the bum choice - actually I jest, I was thankful we had gluteals and not erector spineae ! This involved re-locating again to the lab to give us more room to demonstrate the exercises which we came up with.

The final session, presented by Judy, was about the content and structure of a postnatal circuit session. She gave us lots of tips and pointers to help in designing an effective circuit for this specialist client group. I have listed below the main points and considerations.

• about 12 participants is about the right number for manageability
• keep to the standard order of warm-up pulseraiser and mobility; prep stretch; followed by the circuit, and then pulse lowerer, standing stretches, floor mse, and finally cool down incorporating stretches and relaxation, and remobiliser.
• if weights are used, start slowly with 1lb weights, increasing later if required similarly with bands use bands with a beginners rating to begin with correct joint alignment is essential - especially watch wrist alignment when using bands emphasise slow, controlled movements at all times using full range of movement through each joint - avoid locking-out
• take care in bending and lifting when using equipment
• for mse exercises base the no. reps on the hardest exercise, and allow for muscle recovery by giving transitional exercises in between
• demonstrate and emphasise good technique at all times - allow plenty of time for participants to get into position before beginning

• movements need to be learnt first as a group
• teach correct starting positions
• allow time for safe transitions
• pay attention to technical detail - stand back out of the circuit to observe as much as possible
• slow, controlled and effective performance
• give alternatives and adapatations where possible (do this at the beginning)

In summary, I came away from the day with the knowledge and ideas I need to confidently plan a postnatal circuit session - which I am planning on doing. Judy showed us that we shouldn’t be afraid of using weights and other equipment with postnatal women, although it was generally felt that the circuit format would be more appropriate for a follow-on course, provided we remembered certain safety considerations, and pitched the intensity correctly.

In addition to the information I gained, the day provided me with the opportunity to chat to other postnatal instructors and to remind myself that I am not alone ! My only criticism was one which was not the fault of the tutors, but please, please, can we have the heating on next time ?

To all you out there who were unable to attend, especially those who had planned to but who were ill on the day, my commiserations - I’m afraid you missed a good one !

Ruth Barrett

USE BACK BUTTON ON YOUR BROWSER TO RETURN!

PostNatalExercise.co.uk

Pregnancy and Postnatal Exercise

We specialise in teaching fitness and exercise to women before, during and after pregnancy.

We provide networking opportunities and continuing education for qualified instructors.

The Complete Guide to Postnatal Fitness by Judy diFiore

This is the authoritative book on postnatal exercise and should be on every exercise teachers shelf. Mothers may be better off with The Pregnancy Exercise Book, see below, but if you want to go in depth into the subject then Judy's book is the best there is. If you want to read a review then click here

Deborah Mackin’s Video

 'GETTING BACK'

This video gets the thumbs up from our reviewer! Its helpful, informative and Deborah has a reassuring and down to earth manner. There are sections on posture, workouts and eating and weight loss. Use the video in conjunction with attending classes run by a qualified teacher and you will benefit. To read a more detailed review just click on the picture!

'THE PREGNANCY EXERCISE BOOK' by

JUDY DIFIORE

(Published 2000; Newleaf; ISBN 0 7171 2997 7)

This is  a stunningly illustrated and presented book. It is ring bound and on stiff card so that you can prop it up and read it while you work to your music! Thoroughly recommended. To read a detailed review just click on  here!

Carol Smillie's Video

'CHANGING SHAPE'

This video has a refreshingly different flavour with an excellent down-to-earth approach – you are encouraged to take as much exercise as you can as part of your everyday life! Take your baby out in the pram and go for a good quality walk – hints and tips are given for good technique. Mothers and teachers will find this a motivating video.  To read the detailed review click here!

Lindsey Jackson's Video

'PILATES IN PREGNANCY'

For a different approach to exercise post pregnancy this is an interesting and well constructed video. Our reviewer prefers exercise to music but if you are already into Pilates, or simply want to give Pilates a try, then this video is for you. .It takes you through the basics, and then gives you exercises to use both during your pregnancy and afterwards.Thoroughly recommended if you want to use Pilates exercises.To read the detailed review click here!

Karyne Steben's Video 'The Perfect Postnatal Workout'

This is a refreshing postnatal exercise video with a pleasant and low-key ambiance. The music is very soothing and the demonstrations are clear and the exercises mainly simple. Unusual. Nice to see the baby taking part! To read the detailed review click here

'The Fitness Leader's Handbook'

This offers good value at £13.99 according to our reviewer. Its a good textbook for anybody involved in teaching or planning exercise programmes. To read the detailed review click here!

Anne Selby's 

'Pilates for Pregnancy'

Our reviewer was not very impressed by this book, because it is a very low key exercise programme without a good understanding of pregnancy changes. To read the detailed review click here!

Sally Lewis's

'Back in Shape'

One to avoid. Our reviewer felt this this book gave some advice verging on the dangerous. You would have to be Jane Fonda (or the 2003 equivalent) to cope with the exercise level in this plan! To read the detailed review click here!

Judy Sadgrove's

'Your Health After Birth'

This book's better. The format and presentation is very accessible with clear explanations and plenty of photographs. To read the detailed review click here!

James F Clapp III. M.D.

'Exercising Through Your Pregnancy'

A really interesting and authoritative book. Dr  Clapp has obviously done a lot of research and dispels a number of myths about ante and postnatal exercising. He is obviously an enthusiast. However, our reviewer was not entirely convinced that all his advice was appropriate for all mothers. This book is highly recommended for exercise teachers, in fact, probably essential reading. However, possibly too technical for the average Mum. To read the detailed review, click here!.

5 Steps to Fat Loss by Joanna Hall

Price £11.95 Also used copies available on Amazon for £0.90!  

Whilst this is neither a new video or a specialist pregnancy or postnatal exercise video, it is sufficiently good to be recommended here. The teaching techniques that Joanna Hall demonstrates and her ideas for good body alignment, especially in the aerobic component are useful and worthy of a good quality postnatal exercise routine. She gives teaching points almost constantly and her motivational work is helpful. To read the detailed review. click here

PostNatalExercise.co.uk

Pregnancy and Postnatal Exercise

We specialise in teaching fitness and exercise to women before, during and after pregnancy.

We provide networking opportunities and continuing education for qualified instructors.

The following article on ‘The Effect of Exercise During Lactation on short- and Long-term Immune Status’ by Laurie Nommsen-Rivers MS, RD IBCLC was originally published in the Journal of Human Lactation and was submitted by Elizabeth Mayo, who is an Infant Feeding Advisor with Cheltenham Hospital and NCT Breastfeeding Counsellor. It helps to answer a commonly asked question. Does exercise adversely affect breastfeeding?

After recovering from childbirth, many new mothers are motivated to “get back in shape” through dieting and/or exercise. However, some women worry that regular exercise is not compatible with lactation. Some of this concern may stem from a well-publicized study showing a decline in the concentration of immune factors in breast milk within the first 30 minutes of a bout of maximal exercise (1).  While the results of 2 previously published randomised trials show that breast milk volume and calorie content, in addition to the lipid, protein and lactose concentrations, are not affected by either an intense, short-term (11 days) aerobic exercise program (2) or a more moderate, sustained (10 weeks) regimen (3), neither of these 2 studies measured the effects of exercise on immune factors in breast milk. The anti-infective properties of human milk confer powerful immunity to the breastfed infant. It is understandable that mothers would not want to jeopardize this important benefit of breastfeeding. 

Exercise scientists have described the relationship between exercise intensity and immune status as an “inverted J”. In other words, it has generally been observed that as the amount of exercise increases, immune function is enhanced, up to exhaustive levels of exercise (such as running a marathon), which suppresses immune function. Based on the inverted J hypothesis, Lovelady and co-authors theorized that even though Gregory at al found a short-term decline in milk SigA following a test session of exercising to exhaustion (VO2 max test) (1), more realistic levels of exercise would not affect the immune status of lactating mothers or cause a decrease in the levels of immune factors in their breast milk. 

To test this hypothesis, Lovelady et al recruited exercising and sedentary mothers of exclusively breastfed 12  plus or minus  2-weeks-old infants to participate in a cross-sectional study of exercise and immune status. A sub-sample of the exercising group also participated in a randomized crossover study of the short-term effects of moderate exercise on immune status. In the first study, the immune status and breast milk composition of 29 lactating women who exercised at least 30 min/d for a minimum of 3 d/wk were compared to that of 24 lactating women who were sedentary (exercised less than 1 d/wk). On the day of laboratory measurements, subjects expressed 30 ml of breast milk during the first morning feed. Study subjects then came into the lab to have a fasting morning blood sample drawn while at rest, followed by a treadmill test. 

Although the exercise group showed significantly better cardio respiratory fitness, confirming their regular exercise status, no differences between the exercising and sedentary groups were found in any of the immune factors measured. 

Maternal immune status – whether expressed as percentage of absolute counts of Blood T cells, cytotoxic cells, helper T cells, B cells and natural killer cells; leukocytes; lymphocytes; monocytes; neutrophils; haemoglobins or hematocrit – was not significantly different between the groups. Furthermore, breast milk concentrations of secretory IgA, lactoferrin and lysozyme were not significantly different between the exercise and sedentary groups. These results suggest that moderate, regular exercise does not cause long-term alternations in maternal immune status or milk composition. 

In the second study, a sub-sample of the regular exercisers (n=17) returned to the lab on 2 separate occasions to have their breast milk sampled before and 10 and 60 minutes after either a 30-minute test session of exercise or rest. The order of the sessions (exercise or rest) was randomly determined for each mother. Unlike the Gregory study, mothers were not exercised to exhaustion. Instead, mothers walked or jogged on the treadmill at a pace that elicited an intensity of approximately 75% of predicted maximum heart rate. 

Researchers found no significant difference in breast milk SigA, lactoferrin or lysozyme concentrations between rest and exercise sessions at any of the time points studied (1, 10 and 60 minutes postsession).  The only significant comparison was in breast milk lysozyme, which declined significantly over time (from 1 to 10 to 60 minutes post-session), but the degree of decline was similar during both rest and exercise, perhaps reflecting changes in milk composition related to a great degree of breast emptying with each subsequent milk sample. 

The combined evidence from these studies provides support for the compatibility of exercise during lactation. Moderate levels of exercise do not appear to have a short- or long-term detrimental effect on the levels of the major immune factors in breast milk. Thus, lactating mothers can be assured that by exercising regularly and continuing to breastfeed, they are providing both themselves and their babies with health benefits. 

This  article was originally printed in the Journal of Human Lactation  20(4), 2004

PostNatalExercise.co.uk

Pregnancy and Postnatal Exercise

We specialise in teaching fitness and exercise to women before, during and after pregnancy.

We provide networking opportunities and continuing education for qualified instructors.

To download one of the copies of Scoops just click on the link. If using a modem check file size first to avoid long download times. Hope you find some interesting reading! They are archived back to Scoops 8. If you want to keep up to date then join the Guild! 

PNEX teachers, if you want to read the full text of Moira Clarke's well researched article on Group Resistance Training in Pregnancy in PDF format then click here.

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