Lean mommy: How to get a post-baby body

In "Lean Mommy: Bond with Your Baby and Get Fit with the Stroller Strides(R) Program," Lisa Druxman and Martica Heaner share their smart and simple techniques to get back into shape after giving birth — exercises that are easy to do with a baby, using power walks, the stroller, and exercise tubing. Here's an excerpt:

You came out of pregnancy with a different body. Plus, the physical demands of motherhood take a real physical and mental toll. This chapter explains your new needs and how to emerge fitter and stronger than ever.

During pregnancy, your body was a mixing pot of vastly changing hormones. Virtually every part of you was affected. There were profound changes in your cardiovascular system-including increases in the amount of blood that your heart pumped out and increases in your heart rate. A faster breathing rate helped you take in more oxygen and exhale the extra carbon dioxide that resulted from breathing for two. The amount of blood in your body increased and your body adapted to regulate its core temperature to keep baby in a favorable environment. Hormones like estrogen and progesterone increased. Your thyroid gland enlarged and your metabolism sped up, too.

As your baby grew, your anatomy changed. Your ligaments and cartilage loosened because of the hormone relaxin. Your ribs, pelvis, and other joints expanded to accommodate your growing girth. Postural distortions and subsequent back pain may have occurred. Your balance may have been affected-and it may still be a little off as your body shifts back to being baby- less. Your feet, ankles, and knee alignment also may have altered to adapt to these postural changes.

Many of the hormonal adaptations that occur during pregnancy persist for months afterward. This period-from delivery to the point when the reproductive organs return to a nonpregnant state-is known as the postpartum period. The extra flexibility in your body may linger for up to three months, or even longer if you are breastfeeding. Extra mobility often means less stability. Some of these anatomical changes could last a lifetime if you do not take deliberate action to address them.

The new you is more fragile than you may think. You can't just jump back into the same old exercise routine (if you had one). And you shouldn't dive into a quick- fi x diet. You have special needs now-unique physical, physiological, nutritional, and even emotional considerations that need to be factored into your new- mom life.

Being pregnant and delivering a baby are normal physiological states. But that doesn't mean that they don't wreak havoc on your body! Of course, with time, your body (mostly) reverts back to normal. But it's important to optimize the recovery process. And if you thought that pregnancy was tough on your body, you'll find out that the tasks of motherhood take their own unique tolls, too! But understanding the potential weaknesses in your postpartum body and doing what you can to strengthen them can help you alleviate or even avoid aches and pains. Here are common problems that new moms face-and how Lean Mommy will help you.

Having twenty- five, thirty- five, or more pounds of baby weight in your belly created a shift in the way you held yourself. Your center of gravity moves forward as the baby grows and this often leads to an increased arch in your lower back, a rounded upper back, a forward tilt of your hip bones, and a slight jutting forward of your neck and head. Each woman's body adjusts differently, but everyone's body accommodates for the pregnancy. Worse, your muscles may strengthen to support this new way of holding yourself, and if you don't rebalance them, this distorted posture may stick with you for life.

What you can do about it:Targeting the weaker, overstretched muscles and stretching the tight, over- activated muscles can establish better muscle balance. Your body has become used to this alignment-both when the baby weight in your belly pulled you forward, and now when you hold him or her close or during everyday mommy duties like bending over while picking baby up, or getting the stroller in and out of the car. So, you may find yourself stuck in a constant forward slump all day. The Lean Mommy plan redresses this movement imbalance by integrating pulling motions to strengthen the muscles in the back to help you stand and move straighter and taller. Stretches for the tight pushing muscles in the chest also help keep you feeling upright rather than hunched. See pages 159-160, "Chest Stretch," and pages 132-133, "Tubing Row," for example.

It's no surprise that the posture distortion can strain your back. Even when you shed some weight, your back can still feel fatigued or painful because being a mom requires constant leaning forward and carrying extra weight. Bending over can be stressful for the spine because the discs between each spinal vertebra get compressed. When you're sleep- deprived, exhausted, and overwhelmed, you can forget to use the best posture to lift, carry, and hold your little one (and all his paraphernalia).

The number one complaint of new moms is their tummy-a combination of lingering body fat, stretched- out skin, and poor muscle tone. Even if you didn't love your stomach before, in retrospect it looked much better than you ever realized! You wonder if it can ever feel fl at or firm again. Some women eat more and become less active in the postpartum period and actually gain weight after they have the baby! Women who are more active while pregnant are more likely to slim down after giving birth. But women who are active in the immediate postpartum period are also likely to drop a few dress sizes. Even though you should wait about six weeks before engaging in vigorous activity, there are things you can do immediately to incorporate exercise back into your life. Even if you've waited longer, it's never too late to start being active and reap the rewards. Although I'm not a proponent of worrying about your weight, it is important to get back down to a healthy weight because not doing so may contribute to staying overweight or even becoming obese in the future.

What you can do about it:
Your stomach will naturally recede as you lose your baby weight. The inches and pounds will come off from staying active and making smart eating choices. But doing the right amount of physical activity and performing specific tummy- tightening moves correctly will ensure that you slim down and firm up in a way that's easy, safe for your joints, and more likely to be permanent. See pages 101-104, for example.

When you were pregnant, the added weight and internal shifting of your organs magnified the pressure on your bladder, resulting in an increased urge to pee. If you had a vaginal delivery, you may have suffered trauma to the pelvic floor muscles, which can contribute to further incontinence. Either way you can end up with a permanently weakened bladder mechanism and pelvic floor muscles. You might experience just occasional leakage when you exert yourself (such as picking up the stroller, sneezing, or coughing). Or you may be silently suffering with a constant urge to urinate (even when there is nothing there), or a loss of control (you don't make it to the toilet in time). It's imperative to take corrective measures now because whether you experience incontinence later in life is associated with the level and length of time you experience incontinence after each birth.

What you can do about it:
Muscle fibers in the pelvic floor have an amazing recuperative ability. But you need to give them the proper stimulus. Most women can return to normal by performing pelvic floor exercises, as shown in the Lean Mommy plan. See pages 62-65.

After your second trimester you may have noticed a gap at the midsection of your belly. This condition, known as diastasis recti, is a separation of connective tissue in your outermost abdominal muscle, the rectus abdominis. Because your ab muscles split and widen, the muscles provide less stability. There are varying degrees of separation and the problem can persist or even worsen if you're not careful.

What you can do about it:
You'll need to learn how to do corrective exercises to help the muscle fibers rejoin. The Lean Mommy plan helps you identify if you have this condition and shows ab exercises that will help. See pages 57-58.

I call it "the hunchback of motherhood": muscles that raise the shoulders tighten while muscles that hold them down weaken. Many mommy motions encourage this shoulder slump: bearing the weight of milk- heavy breasts, nursing baby, holding baby close, and carrying diaper bags, car seats, and strollers. If the back muscle that runs from your neck to your shoulders and upper back, the trapezius, spasms from being continually tight, you may feel neck strain or pain that can extend through your shoulders, back, and even arms.

what you can do about it: Practice holding yourself in an upright posture, strengthening the back muscles while stretching the chest muscles. Learning to recognize-and stop yourself-when you slump is key. So, instead of bending over to breastfeed, you should bring baby up to your breast. The Lean Mommy plan includes exercises to help you hold yourself erect and to train the back muscles. See pages 116-117, for example.

Before pregnancy, you might have been accustomed to holding a heavy purse or lugging a gym bag. Suddenly, you are hoisting an extra ten, twenty, or even thirty pounds on an hourly basis as you carry your child and all the stuff that goes with him! Your back and shoulders are not the only body parts to bear the brunt of this added weight. Your wrists can become strained, too. You could be prone to carpal tunnel syndrome, a condition caused by excess pressure on a nerve in the wrist caused by edema, or swelling. Bending at your wrist can exacerbate this problem. You may experience numbness, tingling, or pain in your fingers, thumb, and hand when you push the stroller or hold baby. Carpal tunnel syndrome can appear during pregnancy or in the postnatal period.

What you can do about it:
Resting your wrists and maintaining proper wrist alignment when you pick things up or push your stroller can alleviate the problem. When you are pain- free, wrist flexion and wrist extension strengthening moves, along with stretches to the hand and fingers, can prevent further aggravation. Some breastfeeding moms notice that their pain recedes after weaning. Lean Mommy focuses on these and other subtle actions that can put pressure on a body that's already been taxed from pregnancy. See page 65.

Eating can become a physical-and emotional-struggle for a new mom. From a practical perspective, you are so focused on taking care of baby and the rest of your family that your own mealtimes can be rushed or forgotten altogether. If you skip meals, you may be so famished that you head straight for the easiest thing to eat-fast food or a bag of cookies! At the same time, your awareness of your excess flab can trigger pangs of guilt: Should I be eating this? When it comes to fitting in workouts or time to relax, the same mental battles arise where you pit your welfare against that of your baby or family: I need to exercise, but I can't leave baby. Usually, you accept the sacrifice and tough it out. But putting self- care on hold completely can seriously impair a new mom's quality of life.

What you can do about it:
It's a fact that you now have less time than before. That's not going to change. But what you can change are your choices. You can choose foods that are nourishing and fast and easy to prepare. When you pack up baby wipes, you can throw in almonds and walnuts for yourself. When you mash up banana for your child, you can slice an extra piece for yourself and mix it with yogurt and oatmeal flakes. Or you can plan ahead what you're going to eat when eating out, so that you're less likely to succumb to the most fattening and least nutritious item on the menu. And maybe you don't have time to work out. But you do have time to do what it takes to be a good mom. And when baby is crying his eyes out, you can entertain him or her by strapping him into his front- pack carrier and then doing a series of lower body toners like squats and lunges while you talk or sing him into a more joyful mood. (And voil?! there's your workout squeezed into your day.) Or you can give baby his dose of sunshine by joining other moms for a stroller walk around the park-an impromptu playgroup for the kids, and a much needed adult timeout for you. This way, mothering turns into me-time.

Who knew you could get by on so little sleep? (Chances are, you're barely coping.) Although I was lucky to have help from my family after the birth of my children, I was reluctant to accept it because I felt such a strong need to bond with my babies. With all that waking up in middle of the night, I got so tired that I became totally disoriented, experiencing impaired vision, a feeling of being off balance, and extreme grumpiness! At times, the sheer exhaustion made me trip and knock into things and react sooooo slowly to everything. And while that only went on for months, it felt like years.

What you can do about it:
Short of hiring a full- time, live-in nanny and spending a full month under the covers catching up on ZZZs, there's not much you can do to replenish lost sleep. Ideally, find a way to do shifts with your partner so you can at least get a solid block of shut- eye. But you can also enact some lifestyle changes that give you moments of rejuvenation. The Lean Mommy plan outlines quick Mommy Meditations to do when you need a mental recharge. I know you feel you don't have time to stop and meditate, but you'll be surprised at how much these few moments can help. Eating well and exercising can also help to rev you up when you need it.

What is known as the baby blues affects up to 80 percent of new moms within the first three weeks of having the baby, according to Postpartum Support International (PSI). You may feel weepy, moody, sad, anxious, and it may be difficult to concentrate. Up to 20 percent of new moms experience more severe depression, worry, and anxiety. A smaller percentage may progress to develop more serious mood disorders where they become obsessive, panicked, or even psychotic. Any mood changes are a real problem and should not be ignored. Women don't often talk about this aspect of motherhood, because everyone expects you to be ecstatic about being a new mom. At the same time that you are supposed to be glowing with confidence over your new role, you may find yourself worrying that you are not up to the task, missing your old life, questioning whether you did the right thing, and feeling worthless because you are discovering that nursing isn't working as well as it should. If you are really in a funk, you may even be reaching a low point where you neglect or hurt yourself or your child. This state can only exacerbate an already sinking body image, and you're likely to feel totally unmotivated to do much of anything, let alone get back into shape.

What you can do about it:
The hormone fluctuations and personal stresses that each mom experiences are unique. For serious depression, your doctor and a psychotherapist can provide the help you need. To help determine how serious your symptoms may be, you can use an online checklist (http://www.pndsa.co.za/ms- fc .htm). Most moms will experience at least some down moments, and I think that chronic sleep deprivation and utter exhaustion play a huge role. Trying to find ways to revitalize yourself can help. For minor cases of the baby blues, most doctors recommend exercise because of its mood- boosting effects. Many new moms are told to avoid exposing their baby to germs. So they stay cooped up inside and avoid contact with people other than their immediate family. This will not only make you stir- crazy, but contribute to the onset of depression and sadness. Getting out of the house and socializing with other moms and babies can enhance the exercises' feel- good benefi ts. What you eat can boost your energy. Many cells in your body do not work to their potential if you are lacking in nutrients. So making nutritious eating choices can help your body and your mind function in a more positive way. The Lean Mommy plan helps your well- being with positive eating and exercise experiences.

"POSTPARTUM depression struck me out of the blue after my second child. I had always been healthy, positive, and active and I loved being a mom. But nothing could prepare me for the devastation of depression. It was more than just feeling sad. I was angry, miserable, irritable, and overwhelmed. When my baby was six months, I told my husband that I wanted a divorce and that he could have everything- the house, the kids, the car-as long as I could get some peace. He found a doctor who helped me with counseling and medication. As I recovered, I noticed that on the days that I exercised I was able to avoid a bad mood coming on. After my third baby, Lisa's program helped me avoid the recurrence of the postpartum depression."
-ADRIENNE GRIFFEN, 41,

Make sure to get your doctor's clearance before following the tips in the Lean Mommy plan or before starting any other exercise program. You can begin by implementing the healthful eating strategies right away. You can instantly boost your body image by envisioning your wonderful mommy- body in a whole new healthy light! And when your doctor gives you the all- clear to start exercising, usually after six weeks, you can follow the Lean Mommy routines that address the changes that happened to your body while you were pregnant, such as saggy breasts, excess fat, and a flabby tummy. (Okay, there's not much I can do for your saggy breasts.) Lean Mommy also tackles your new functional needs; for example, since you will now spend much of your time hunched forward, whether it's from breastfeeding or hoisting a stroller, carrier, and car seat, you need to work on good spinal alignment. The goal of Lean Mommy is not just to show you what to eat and what kind of exercises to do, but for you to want to eat that way and to look forward to working out. And Lean Mommy will help you start to feel good about your body again (or for the fi rst time!). Get ready to enter a new phase of motherhood: Get ready to become a Lean Mommy.

"AFTER several miscarriages and a high- risk pregnancy, I became a first- time mom at forty and 260 pounds. Baby blues became postpartum depression. Medications and my therapist helped me realize that isolation was making me worse. My daughter and I attended Stroller Strides and our lives changed forever. Not only did the social support help, I lost seventeen pounds and worked up the courage to enter my fi rst 10K walk/run. I still have seventy pounds to lose but I know that I will. And the best part is that other moms in class comment on how Caroline is always smiling and is the happiest baby they've seen. I chuckle to myself and think that I'm now the happiest mommy."
-ANGIE BERMAN, 41,
mom of Caroline, 2, Glen Allen, Virginia

Copyright © 2007 by Lisa Druxman and Martica Heaner. Excerpted from “Lean Mommy: Bond with Your Baby and Get Fit with the Stroller Strides(R) Program" by Lisa Druxman and Martica Heaner. All rights reserved.  No part of this book may be used or reproduced without written permission from Hachette Book Group USA.