1) - Pregnancy & Exercise
2) - Prenatal - Exercise Guidelines
3) - Why you should exercise with your child
4) - Q&A's for Pre/Postnatel Classes

- POSTNATAL EXERCISE GUIDELINES

When to see your doctor:
Six 6-week check up by your doctor (should be done before resuming or starting exercise).

Be aware of colour of lochia (normal blood flow after birth) which can run anywhere form 2-6 weeks. Stages are bright red, to pinkish brown and then creamy yellow.
If lochia changes colour to darker than it is a sign to slow down. Also if colour goes back to bright red, a heavy flow starts again or if clots show up - see your doctor.

Lochia has a distinct odour and this is normal but if the odour changes or if you have a temperature - see your doctor.

If at any time you experience severe abdominal or back pain - see your doctor.

If breasts get hard, hot, and bright red with or without a temperature - see your doctor.

If you experience extreme fatigue other than normal nightly feedings - see your doctor.

Exercise guidelines:
Postnatal breast feeding women should also consume an extra 500 calories a day

Proper bra support, sometimes 2 sports bars are worn together

Work at 1/3 of exercise intensity pre-pregnancy…
Supporting pelvis may not provide stability needed for high impact cardiovascular exercise or specific muscular strength or endurance exercises that stress the low back for six weeks or longer

Can take body up to a year to get “body back” - healing process body adaptation to stress put on the body

Joint laxity in sacroiliac joints can contribute to lower back pain when triggered by postures taken during activities such as breastfeeding and lifting baby or toddler.

If you are going to be working at higher intensities and are breastfeeding try to feed baby just before class or in middle of class. There has been some evidence of a lactic acid build up in breast milk, which gives it a bitter taste. Some babies find this difficult to accept. Highest levels of this lactic acid are usually 10 minutes after exercise and 30-90 minutes to return to resting levels.

Enjoy the exercise. Go at your own pace - listen to the levels and if tired and have to take it down a notch, sometimes that’s okay.

Moderation is the key - think of how body is healing and adjusting to life with a newborn and reconditioning that may have occurred during pregnancy.

Weight Loss:
Has not been shown to be significantly greater in women who breastfeed and exercise as compared to women who just breastfeed as long as they are eating to appetite.

Although such things as follows have been observed:

- Muscle mass weighs more than fat mass therefore, weight doesn’t appear to change, but body composition does.

- Breastfeeding moms will retain about 10 pounds of body fat.

- Caloric intake particularly of carbs may increase, and both breastfeeding and exercise utilize large amount of carbs.

Benefits of Postnatal exercise:
Certain exercises can help with particular conditions:
Abdominal separation (Diatasis Recti) can be corrected 6 months postnatal
Hemorrhoid pain relief and faster healing rate may be achieved
Sciatic pain relief
Relief of postural muscle pain by strengthening properly with baby
Managing and/or correcting incontinence (leaking pee)

Has had success in reducing rates of post-partum depression (the “blues”)

Can help alleviate some of the conditions mentioned above in Exercise Guidelines.

When one is happy and feeling good, goals are more easily met.

Meeting new people in the same position you are.

Helps with stress

It is a break away from home and other little children.

Exercising with your baby and having he or she next to you and the benefits the baby gets - stimulation and a positive feedback from your body.

To learn to accept body and the changes that have occurred.
Most of all take a break get someone to help you out and develop a support system among friends or family. Don’t be hard on yourself. Look what you have done giving birth to this amazing child - enjoy this experience with your baby and the rest will fall into place.

- Why you should exercise with your baby or children:

1. If breast feeding you get to eat an extra 500 calories a day and possibly more if you add exercise into your diet.
2. You’re a role model. It shows your child(ren) you are interested in being healthy and taking care of yourself.
3. Kids are more likely to continue exercising into and throughout adulthood when starting at a young age.
4. When kids are active they are more able to concentrate on different tasks when they are suppose to. (ex. in pre/school) Can help with ADD.
5. They are more likely to eat, sleep, and behave better because of exercise.
6. Today there is a lot of emphasis on academics. My child can say the abc’s, or count to 10 or talk all at early ages. There isn’t much mention anymore of my child can catch a ball or skip or ride their bike - this is a scary road we are going down. Both need to be incorporated and are equally important.
7. For mom it is a chance to get out and be able to exercise with your child(ren) and bond with him or her or them. Many classes to choose from in the snugly, to the stroller, bike, or a family fit class.
8. For new moms it is a safe way to get back into exercise as some exercise practices may not be safe in certain situations.
9. A great way to meet other moms and babies/kids
10. Exercise releases endorphins which make you feel better so you can cope easier especially with the “blues”.
11. Opens up communication lines with other moms from sharing stories or questions from breast feeding, weaning, sleeping habits, introducing foods, or aches and pains you are feeling or experiencing etc….

- Pregnancy and Exercise

Changes:
Uterus 4ml - 4000ml like tsp. to 4L-milk jug
40-50% increase in tidal volume amount of air she breathes inhale/exhale
Glow - due to increased blood volume 40-50%
An average of an extra 300 calories are required about an extra 150 in first and second trimesters and 300 in last trimester

Different methods of training zones important:
Resting Heart Rate, RHR, increases 10-15% or 15 - 20 beats per minute
Blood volume increases 40-50%
1st trimester - heart rate will be much higher than rate of perceived exertion, RHR, because there is not enough blood in each beat. So HR increases to meet blood flow demands so target heart rate, THR, zones important.
2nd trimester - Blood volume goes up therefore increasing stroke volume = more blood with each beat so RHR can stay the same so RPE is back to about normal = talk test or RPE
3rd trimester - Difficult to get HR up without over exerting themselves mostly because of increased weight gain so a high RPE is experienced.

Exercise and its effects:
1st trimester not good to start. You are in most vulnerable state if never exercised and 3rd = fatigue
2nd trimester is best and safest
Fatigue don’t overdue it
Temperature increases don’t overheat
Hormone relaxin comes into play careful not to overstretch
Balance dizziness

Insulin resistance is increased so maternal diet is important - If too much sugar insulin can’t deal with it so adequate diet is important along with exercise see gestational diabetes sheet.

A suppression of the release of glycogen from liver, so it is important pregnant women eat little bits more often, especially in active women. If wait too long there is a rapid drop in blood sugar.

Hormones:

Hcg morning sickness when this drops and placenta take over usually sickness goes away
Progesterone causes most symptoms
Relaxin relaxing of the joints

Appetite:

Extra 300kcal per day
Increase eat smaller more frequent meals - because heartburn, esophagus pressure, eat 1- 1.5 hours before exercise or on flip side, if dizzy snack during if need to.
Pica-craving non-food stuff (chalk, dirt, paint…) something lacking in diet? Maternal vitamins being taken?

Types of exercise:

Postural:
Lots of stretching some strengthening to help support enlarging breasts
Strengthening for upper back/shoulders due to kyphosis rounding in upper back/shoulders
Abs to help support low back lordosis excesses curvature in low back
Gluteus, quads, calves weight bearing muscle groups help in delivery as well as ab/adductors
Sciatic relief exercises due to pressure in sacroiliac joint insertion of femur into pelvis muscles fighting frontal protrusion pinches nerve
Kegels to strengthen pelvic floor muscles
Deep inner core muscles for support

HOW EXERCISE CAN HELP

Relieves postural imbalances
Helps with hemorrhoids - which exercises are good which bad
Abdominal separation (Diastasis Recti) how to exercise to prevent further separation and what exercises to avoid
Kegels to perineum to allow blood flow to area if hemorrhoids and hopefully help to prevent incontinence
Healthy weight gain
Mood swings by increasing energy /self esteem with changing body
Constipation - exercise will help blood flow to gastrointestinal tract to increase mobility and reduce constipation. Healthy diet in fibre also helps.
Ankle swelling - aerobic exercise helps improve circulation
Leg cramps - warm up and stretching and increase in milk /decrease in pop helps
Sleeplessness exercise and relaxation breathing helps to sleep better

When exercising do the following:

Wear proper supportive bra maybe two sports bras are required
Avoid quick changes of position or when turning at the waist to avoid round ligament pain if still getting it bend towards it or change positions
Urinate just before exercise or take bathroom break don’t decrease fluids
Wait till second trimester to exercise if experiencing morning sickness
Kegels to help avoid urinary incontinence if still getting use light pad avoid high impact
Shortness of breath - decrease exercise and avoid lots of directional changes. (Because of cardiovascular/respiratory changes hr, blood volume, oxygen uptake etc.)

Effects on baby:

Hr goes up and not down meaning that adaptations to regular MODERATE exercise are taking place-allowing fetus to circulate more blood thereby increasing oxygen availability. EXCESSIVE exercise can do opposite. Very few studies have shown depressed APGAR scores to mothers who exercised. There is no evidence that exercise causes a significant negative effect on baby.

- Q and A for Pre/Postnatal Classes

Q.Is it safe to exercise during my pregnancy?
A. Yes! “Women and their care providers should consider the risks of NOT participating in exercise activities during pregnancy, including loss of muscular and cardiovascular fitness, excessive maternal weight gain, higher risk of gestational diabetes or pregnancy induced hypertension, development of varicose veins and deep vein thrombosis, a higher incidence of physical complaints such as dyspnea or low back pain, and poor psychological adjustment to the physical changes of pregnancy.”
The Society of Obstetricians and Gynecologists of Canada (SOGC)

Q. If I am pregnant, do I need medical clearance to join your classes?
A.Yes! We care about you and your baby; your healthcare provider (physician or midwife) must sign a Par-Med-X for Pregnancy Form prior to your participating in class. See the link on this page for a copy of this form. Sorry we cannot make any exceptions to this rule.

Q. How soon can I get back into fitness?
A. For vaginal births, usually when you feel ready and you have verbally spoken to your doctor about returning to exercise. Fatigue is a good guide as for most women about 4-6 weeks. Your lochia (postpartum bleeding) should be either finished, very slowed down and/or turned brownish in colour.

For Casearean Births, women should be at least 6 weeks postpartum and have verbal medical clearance from their doctors.

Q. Why are some classes for pre-mobile babies only?
A. Safety. We wouldn't want your mobile baby or tot to get trampled or hurt on a piece of equipment. Good options for mobile babes and tots are: Stroller Fitness, Parent and Toddler classes.
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Q. What if I miss a class?
A. That’s the great part – you can do a make-up class at any of the on-going classes. We do ask that you try to make them up in a timely fashion. The time line for making up classes is anytime between current sessions and the next set of sessions.

Q. Can I register part way through a session?
A. Yes. We will pro-rate your fees accordingly.

Q. Can I try a class before registering or do a drop in?
A. If you are not sure about registering, feel free to drop-in and try a class at the drop in rate. If you decide you like it and register immediately after class that fee will be applied to your registration fee. Please note, we do not accept drop-ins for Prenatal Fit or Yoga Inspired Prenatal Relaxation.
If you get a friend to join enjoy 1 class for free.

Q. What should I wear?
A. Proper athletic attire (good runners, workout pants or shorts, sports t or sports bra and t-shirt). Sometimes you may feel more comfortable wearing two bras or investing in a well-fitting supportive sports bra.