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Session Name 8/9/2019
1
INSTRUCTOR: RACHEL VENCE
OUTLINE: MICHELLE MEDINA, MSN, WHNP, CNM
Postpartum Nutrition & Exercise
OBJECTIVES
At the conclusion of this session the student will be able to:
Possess greater understanding of basic nutrition and the nutrition needs for post-partum
Review goals for weight loss and promotion of breastfeeding
Increased awareness and understanding of nutrition needs for women with diabetes postpartum
MNNC - 2018 - POSTPARTUM NUTRITION & EXERCISE 2
GOALS OF NUTRITION IN POSTPARTUM PERIOD
Optimize maternal & infant nutrition
Supplement vitamin/mineral stores as needed
Support appropriate weight loss
Promotion and support of breastfeeding
MNNC - 2018 - POSTPARTUM NUTRITION & EXERCISE 3
Session Name 8/9/2019
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MACRONUTRIENTSFOUR BASIC NUTRIENTS
BY CHOOSING THE HEALTHIEST FORMS OF EACH OF THESE NUTRIENTS & EATING THEM IN THE PROPER BALANCE, YOU ENABLE YOUR BODY TO FUNCTION AT IT’S OPTIMAL LEVEL
Water Carbohydrates Proteins Fats
MNNC - 2018 - POSTPARTUM NUTRITION & EXERCISE4
WATER
Water helps your body:
Keep your temperature normal
Lubricate & cushion joints
Protect your spinal cord & other sensitive tissues
Get rid of wastes through urination, perspiration, & bowel movements
MNNC - 2018 - POSTPARTUM NUTRITION & EXERCISE 5
CARBOHYDRATES
Provide energy
Carbohydrates are your body's main fuel source
During digestion, sugars & starches are broken down into simple sugars absorbed into your bloodstream, as blood glucose glucose enters your body's cells with the help of insulin & is used by your body for energy
Extra glucose is stored in your liver, muscles & other cells for later use, or is converted to fat
MNNC - 2018 - POSTPARTUM NUTRITION & EXERCISE 6
Session Name 8/9/2019
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CARBOHYDRATES (CONT.)
Protecting against disease
Whole grains & dietary fiber from whole foods help reduce your risk of cardiovascular diseases
Fiber also protects against obesity & type 2 diabetes & is essential for optimal digestive health
Controlling weight
Eating plenty of fruit, vegetables & whole grains can help you control your weight Bulk & fiber content aids weight control by helping you feel full on fewer calories
Very few studies show that a diet rich in healthy carbohydrates leads to weight gain or obesity
MNNC - 2018 - POSTPARTUM NUTRITION & EXERCISE 7
CARBOHYDRATES (CONT.)
Dietary Guidelines for Americans recommends that carbohydrates make up 45-65% of your total daily calories
Most carbohydrates occur naturally in plant-based foods, such as grains
Common sources of naturally occurring carbohydrates include:
Fruits
Seeds
Nuts
Legumes
Vegetables
Grains
MilkMNNC - 2018 - POSTPARTUM NUTRITION & EXERCISE 8
CARBOHYDRATES (CONT.)
Beans, peas & lentils are the most versatile & nutritious foods available
Typically low in fat & high in folate, potassium, iron, magnesium, & contain beneficial fats & fiber
A good source of protein & a healthy substitute for meat, which has more saturated fat and cholesterol
MNNC - 2018 - POSTPARTUM NUTRITION & EXERCISE 9
Session Name 8/9/2019
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TIPS FOR EATING ”GOOD” CARBOHYDRATES
Emphasize fiber-rich fruits & vegetables
Choose whole grains
Stick to low-fat dairy products
Limit added sugars (<10%)
MNNC - 2018 - POSTPARTUM NUTRITION & EXERCISE 10
FIBER
Fiber is a material found only in plant food
Our digestive systems cannot digest or break down fiber
Whole grains, fruits, & vegetables are all excellent sources of fiber
High-fiber foods –
Tend to be low in fat & calories
Take longer to chew allowing more time to realize that you are full
By absorbing water, fiber creates bulk & can help you feel full
Slows glucose absorption, preventing spikes in blood sugar
MNNC - 2018 - POSTPARTUM NUTRITION & EXERCISE
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GRAINS Food made from wheat, rice, oats, cornmeal, barley or another cereal grain is a
grain product
Bread, pasta, oatmeal, breakfast cereals, tortillas, & grits
Grains are divided into Whole Grains & Refined Grains
Whole grains contain the entire grain kernel, the bran, germ, & endosperm
Examples include: Whole-wheat flour, bulgur (cracked wheat), oatmeal, whole cornmeal & brown rice
Refined grains have been milled, a process that removes the bran & germ
This is done to give grains a finer texture and improve their shelf life, but it also removes dietary fiber, iron, & many B vitamins
Some examples of refined grain products are:
White flour, de-germed cornmeal, white bread & white rice
MNNC - 2018 - POSTPARTUM NUTRITION & EXERCISE
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Session Name 8/9/2019
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MNNC - 2018 - POSTPARTUM NUTRITION & EXERCISE 13
MNNC - 2018 - POSTPARTUM NUTRITION & EXERCISE 14
PROTEIN
Curbing hunger by stabilizing blood glucose
Loosing/maintaining weight
Improves ability to learn & concentrate
Reduces brain fog
Boost energy levels
Speeding recovery after exercise
Reducing muscle loss
Building lean muscle
Support your muscles and bones and support the absorption of important nutrients
MNNC - 2018 - POSTPARTUM NUTRITION & EXERCISE 15
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PROTEIN
All foods made from meat, poultry, seafood, beans, peas, eggs, processed soy products, nuts, & seeds
Protein is needed in your diet to help your body repair cells & make new ones
Protein is important for growth & development in children, teens, & pregnant women
Unlike carbohydrates & fat, your body does not store protein it has no reservoir to draw from when you’re running low
When proteins are digested, they leave behind amino acids, which the human body needs
MNNC - 2018 - POSTPARTUM NUTRITION & EXERCISE 16
FATS
SOURCES OF SATURATED FAT IN THE US
MNNC - 2018 - POSTPARTUM NUTRITION & EXERCISE 17
SATURATED FAT
All foods containing fat have a mix of specific types of fats Even healthy foods like chicken & nuts have small amounts of saturated fat
Saturated fat is mainly found in animal foods, but a few plant foods are also high in saturated fats, such as coconut, coconut oil, palm oil, & palm kernel oil
The Dietary Guidelines for Americans recommends getting less than 10% of calories each day from saturated fat
The American Heart Association goes even further, recommending limiting saturated fat to no more than 7% of calories
To reduce your risk for heart disease, cut back on saturated fat & trans fat by replacing some foods high in saturated fat with unsaturated fat or oils
MNNC - 2018 - POSTPARTUM NUTRITION & EXERCISE 18
Session Name 8/9/2019
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TRANS FATS
Trans fatty acids are made by heating liquid vegetable oils in the presence of hydrogen gas & a catalyst, a process called hydrogenation
Partially hydrogenating vegetable oils makes them more stable & less likely to become rancid This process also converts the oil into a solid, which makes them function as margarine or shortening
Partially hydrogenated oils can withstand repeated heating without breaking down, making them ideal for frying fast foods
Trans fats are also naturally found in beef fat & dairy fat in small amounts
MNNC - 2018 - POSTPARTUM NUTRITION & EXERCISE 19
TRANS FATS (CONT.)
Trans fats are worse for cholesterol levels than saturated fats because they raise LDL & lower HDL
Create inflammation – which has been implicated in heart disease, stroke, diabetes, & other chronic conditions
Contribute to insulin resistance
Each additional 2% of calories from trans fat consumed daily increases the risk of Coronary Heart Disease by 23 %
MNNC - 2018 - POSTPARTUM NUTRITION & EXERCISE 20
MNNC - 2018 - POSTPARTUM NUTRITION & EXERCISE 21
Session Name 8/9/2019
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UNSATURATED FATS
Liquid at room temperature, considered beneficial fats because they can improve blood cholesterol levels, ease inflammation, stabilize heart rhythms, & play a number of other beneficial roles
Predominantly found in foods from plants, such as vegetable oils, nuts, & seeds
There are two types of “good” unsaturated fats:
Monounsaturated fats
Polyunsaturated fats
MNNC - 2018 - POSTPARTUM NUTRITION & EXERCISE
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UNSATURATED FATS (CONT.)
Monounsaturated fats-
found in high concentrations in:
Olive, peanut, & canola oils
Avocados
Nuts such as almonds, hazelnuts, & pecans
Seeds such as pumpkin & sesame seeds
MNNC - 2018 - POSTPARTUM NUTRITION & EXERCISE 23
UNSATURATED FATS (CONT.)
Polyunsaturated fats –
Found in high concentrations in:
Sunflower, corn, soybean, & flaxseed oils
Walnuts
Flax seeds
Fish
Canola oil – though higher in monounsaturated fat, it’s also a good source of polyunsaturated fat
MNNC - 2018 - POSTPARTUM NUTRITION & EXERCISE 24
Session Name 8/9/2019
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OMEGA 3 FATTY ACIDS
Omega 3 poly-unsaturated fatty acids include docosahexaenoic acid (DHA), elcosapentaenoic acid (EPA) & alpha-linoleic acid (ALA)
An important type of polyunsaturated fat
The body can’t make these, so they must come from food
Fish & seafood are the highest sources of DHA & EPA
An excellent way to get omega-3 fats is by eating fish 2-3 times a week of low-mercury & preferably fatty fish
Leafy, green vegetables, canola, soybean oil, walnuts, flaxseeds & their oils as well as algae are the richest sources of ALA
MNNC - 2018 - POSTPARTUM NUTRITION & EXERCISE 25
Micronutrients:
Nutrients required by the body in small amounts, vital to development & disease prevention
Vitamins Folic acid: 500 mcg/day for lactating mothers. Most multivitamin supplements contain >400 mcg
Minerals
Minerals Calcium: 1000 mg/day (RDA for 19-50 years)
Iron: decrease back to non-pregnant levels after 6 weeks
MNNC - 2018 - POSTPARTUM NUTRITION & EXERCISE 26
FRUITS & VEGETABLES
Vegetables may be raw or cooked; fresh, frozen, canned, or dried/dehydrated; & may be whole, cut-up, or mashed
Vegetables are organized into 5 subgroups, based on their nutrient content
Dark green vegetables
Starchy vegetables
Red & orange vegetables
Beans and peas
Other vegetables
Fruits may be fresh, canned, frozen, or dried, & may be whole, cut-up, or pureed
Organic, fresh fruits and vegetables are always the better choice
MNNC - 2018 - POSTPARTUM NUTRITION & EXERCISE 27
Session Name 8/9/2019
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NUTRITIONAL NEEDS
Energy intake: Minimum of 1800 kcal/day to meet energy requirements of lactation while promoting weight loss
Milk production estimated energy output is 500 kcal extra first 6 months, then 400 kcal extra the second 6 months
Many of your nutrient needs remain the same as with pregnancy but some increase Carbohydrate – 175 210g with breastfeeding
Protein – Unclear 71g same as with pregnancy
Water Aim for 13 cups a day
Vitamin needs increase as you are now trying to meet the needs of yourself & your infant
Continue to take PNV for 6 months
MNNC - 2018 - POSTPARTUM NUTRITION & EXERCISE 28
HEALTHY EATING WITH BALANCED NUTRITION
When putting together a meal plan, include a variety of the following foods:
Grains – whole-grain pasta, breads, brown rice
Vegetables – spinach, tomatoes & other colorful vegetables
Protein – lean meat, chicken, fish, eggs, lentils & beans
Fruit- fresh, colorful fruits
Dairy – yogurt, milk & cheese
Fats – avocado, walnuts, olive oil
MNNC - 2018 - POSTPARTUM NUTRITION & EXERCISE 29
WEIGHT LOSS
Most women lose most of the weight they have gained
Greatest weight loss occurs in the first 3 months after childbirth
10-13 lbs at time of birth
7-11 additional lbs lost in the first week
Weight loss slows down after 6 months
Goal weight loss if breastfeeding
Average of 1-2 lbs a week is normal healthy weight loss to maintain adequate milk production
MNNC - 2018 - POSTPARTUM NUTRITION & EXERCISE 30
Session Name 8/9/2019
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RETURNING TO EXERCISE
Return to exercise slowly -
Start with something low impact and simple — such as a daily walk
Start with 10 min then gradually increase the intensity & length of your sessions, slowly add resistance to a bike, or incrementally increase the incline if you’re working out on the treadmill
Aim get at least 150 min (or 30 min, 5 days/week) of moderate intensity, aerobic exercise + 2 days/week of muscle/strength training activities
MNNC - 2018 - POSTPARTUM NUTRITION & EXERCISE 31
RETURNING TO EXERCISE (CONT.)
Be reasonable
Listen to your body
Too much exercise when the body is healing can be more harmful than helpful
Looks for fitness classes and trying to incorporate baby into the routine
Always stop the exercise if you feel pain & rest for 1-2 minutes
If the pain persists, contact your personal trainer or physician
Always do needed stretches prior to exercising in order to bring the body back into a state of balance
Always stop the exercise at the point where you feel that you could only do 2 more repetitions with good form (-2 reps)
MNNC - 2018 - POSTPARTUM NUTRITION & EXERCISE 32
ACOG RECOMMENDATIONS
Recommended that you get at least 150 minutes (30 min, 5 days/week or smaller intervals) of moderate-intensity aerobic activity (moving large muscle groups: walking/biking) every week
Mod-intensity: moving enough to raise your heart rate and start sweating You can still talk normally, but you cannot sing
Aim to do muscle –strengthening activities at least 2 days/week
Examples include yoga, Pilates, lifting weights, sit-ups, & push-ups
Appropriate exercise level will depend on each woman’s medical history, obstetrical course, level of fitness, & recovery
MNNC - 2018 - POSTPARTUM NUTRITION & EXERCISE 33
Session Name 8/9/2019
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ACOG RECOMMENDATIONS (CONT.)
Some women may be able to start an exercise routine within days of delivery; others may need to wait 4-6 weeks
If you have stitches, make sure the exercise is light and there is little pain or discomfort during exercise
Exercises to restore abdominal muscle tone after a cesarean section can begin as soon as abdominal soreness diminishes, sometimes even days after birth
Pelvic tilts, planks and a variety of yoga moves are a great way to reintroduce engaging core muscles without too much strain
Abdominal strength is important for maintaining proper posture, as well as attaining adequate pelvic control
MNNC - 2018 - POSTPARTUM NUTRITION & EXERCISE 34
0-6 WEEKS
MNNC - 2018 - POSTPARTUM NUTRITION & EXERCISE 35
Pelvic tilt Try the pelvic tilt a few times a day to strengthen your abdominal muscles
Lie on your back on the floor with your knees bentFlatten your back against the floor by tightening your abdominal muscles & bending your pelvis up slightlyHold for up to 10 seconds repeat five times & work up to 10
to 20 repetitions
MNNC - 2018 - POSTPARTUM NUTRITION & EXERCISE 36
Use this exercise to tone your pelvic floor muscles, which support the uterus, bladder, small intestine & rectum
Contract your pelvic floor muscles, as if you're attempting to stop urinating midstream
Hold for up to 10 seconds & release, relaxing for 10 seconds between contractions.
Aim for at least three sets of 10 repetitions a day
Session Name 8/9/2019
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7-12 WEEKS
Low impact, moderate exercise
Yoga
Swimming
Pilates
PiYo
Light weight training
MNNC - 2018 - POSTPARTUM NUTRITION & EXERCISE 37
MNNC - 2018 - POSTPARTUM NUTRITION & EXERCISE 38
TESTING FOR DIASTASIS RECTI
Place two fingers on top of the where the worst part of the abdominal split has occurred. Have client do a modified crunch a few times
If anything pushes the finger out away from the body the client may need surgery, refer your client out and begin abdominal exercises once they are cleared for abdominal exercises
If the fingers remain in place or get sucked in, perform the following exercises
If you have a split & you pass the test or have been cleared for abdominal exercise, perform the next two exercises
MNNC - 2018 - POSTPARTUM NUTRITION & EXERCISE 39
Session Name 8/9/2019
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ABDOMINAL WORK FOR DIASTASIS RECTI –UPPER ABDOMINALS
1. Sit with legs bent, feet shoulder width apart
2. Round the spine into flexion to isometrically contract the upper abdominals. Cross the right arm over the chest, dorsiflex the left hand and reach that arm straight toward the right knee. Keep your feet on the floor
3. With a limited end range of motion, reach the left hand toward the right knee, moving only about 4-6 inches across. Chin tucked & exhale during the entire movement, looking toward your left hand
4. Inhale at the start and exhale through the movement. Repeat 10-30 times and switch sides
Do at least 3 sets of as many as you can do
If it is too hard, you are curling too far back
MNNC - 2018 - POSTPARTUM NUTRITION & EXERCISE 40
DIASTASIS RECTI – LOWER ABDOMINALS
1. Lie on your back, place a small book or pad about an inch and a half thick under your hips, at the base of the pelvis- Left leg crossed over right and pick your feet up off the floor
2. Cross your arms, with elbows in line with the shoulders, arms over the chest
3. With a limited end range of motion, draw your left knee toward your right elbow, reaching only about 4-6 inches, exhale throughout the entire movement
4. Inhale at the start & repeat 10-30 times on each side for 3 sets
MNNC - 2018 - POSTPARTUM NUTRITION & EXERCISE 41
EXERCISE & BREASTFEEDING
Exercise isn't thought to have any adverse effects on breast milk volume or composition, nor is it thought to affect a nursing infant's growth
Some research suggests that high-intensity exercise might cause lactic acid to accumulate in breast milk and produce a sour taste a baby might not like rare
If vigorous exercise is a priority during the first few months of breast-feeding, consider feeding your baby before your workout or pumping before your workout and feeding your baby the pumped breast milk afterward
Alternatively, exercise first & then take a shower, express a few milliliters of breast milk &, after a half-hour or an hour, offer the breast
Wear a supportive bra &, if you're breast-feeding, nursing pads in case your breasts leak
At risk for plugged ducts if lifting weights or doing other repetitive arm movements
If this happens cut back and start again more slowly. STAY HYDRATED!!
MNNC - 2018 - POSTPARTUM NUTRITION & EXERCISE
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Session Name 8/9/2019
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BREASTFEEDING CONSIDERATIONS WITH DMWomen with DM while breastfeeding (particularly type 1) are at risk for hypoglycemia as glucose is preferentially shunted towards production of breastmilk
May need snacks to prevent hypoglycemia in the early postpartum period and throughout lactation
Avoid exercise if BG level >250 mg/dl to prevent ketoacidosis d/t increased activity & counter-regulatory hormones
Type 1 Diabetes:
Advise frequent BG testing, including 1 hr after breastfeeding for the first 3 days postpartum
Nocturnal hypoglycemia common
If BG <100 mg/dl prior to breastfeeding, eat a 15g CHO snack with protein to prevent hypoglycemia
Episodes of hypoglycemia can also cause temporary release of epinephrine which can cause temporary decrease in milk production
Type 2 Diabetes:
Continue to check BG levels, especially if on glyburide or insulin
MNNC - 2018 - POSTPARTUM NUTRITION & EXERCISE 43
RELAXIN
During pregnancy, the
hormone relaxin is
present in 10 times its
normal concentration
in the female body &
can remain high for up
to five months after
giving birth
Relaxes the joints in
the pelvis so baby has
room to pass through
the birth canal
Also causes abnormal
elasticity & motion in
many other joints of
the body, causing
inflammation & pain
This can lead to
injury if exercise is
too aggressive after
giving birth
Therefore, creating
strength & stability
in the body is very
important
MNNC - 2018 - POSTPARTUM NUTRITION & EXERCISE44
HOW TO RELIEVE SCIATICA
The following yoga poses & exercises can help relieve sciatic nerve pain: Downward dog Spinal rotation Baby cradle Upward dog Piriformis release with ball and foam roller Twisted warrior Anything that helps with SI joint pain
Acupuncture Movement – light cardiovascular exercise Myofascial release
MNNC - 2018 - POSTPARTUM NUTRITION & EXERCISE 45
Session Name 8/9/2019
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DOWNWARD DOG – OPENS BACK & RELIEVES TENSION Come onto the floor on your hands & knees, set your knees
directly below your hips & your hands slightly forward of your shoulders. Spread your fingers, gripping the mat & turn your toes under
Exhale & lift your knees away from the floor, keeping the knees slightly bent & the heels lifted away from the floor
Lengthen your tailbone, pressing your hips up toward the ceiling. Lift the front of your thighs & activate the inner thigh
Relax the belly if you feel any discomfort in the abdomen.
Open the shoulder blades by turning the palms out as if opening a jar
Relax the head & look toward your belly button
If you cannot get the heels to the floor, bend your knees
Hold this pose for 5 breaths.MNNC - 2018 - POSTPARTUM NUTRITION & EXERCISE 46
SPINAL ROTATION
Lie on your back with knees bent and feet placed wider than your hips
Drop both knees to the left, and look right, keeping the shoulders on the floor
Hold this pose for 5 breaths
Repeat on other side
This can be done with a block between the knees for more support
MNNC - 2018 - POSTPARTUM NUTRITION & EXERCISE 47
BABY CRADLE
Sit with one leg extended and place the foot of the opposite leg in the crease of the elbow
Keep the chest lifted as you place the other arm outside the knee, as if you were cradling a baby
Gently rock side to side for 5-10 breaths
Repeat on other side
MNNC - 2018 - POSTPARTUM NUTRITION & EXERCISE 48
Session Name 8/9/2019
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UPWARD DOG
Lie prone on the floor, stretch your legs back with the tops of your feet on the floor
Bend your elbows & spread your palms on the floor beside your waist, so that your forearms are almost perpendicular to the floor
Inhale & press your inner hands firmly into the floor & slightly back, as if you were trying to push yourself forward along the floor.
Then, straighten your arms and simultaneously lift your torso up
Contract your thighs firm & slightly turned inward, buttocks tight & tops of the feet on the floor
The arms are firm & turned out so the elbow creases face forward, gaze forward
Hold this pose for 1-5 breaths
MNNC - 2018 - POSTPARTUM NUTRITION & EXERCISE 49
PIRIFORMIS RELEASE
• Sit with one leg crossed over the other & place a small tennis ball, yoga tune-up alpha ball (this is best) or any type of myofascial release ball under your hip near pocket area
• Roll around on the ball back & forth for 20-30 seconds
• Switch sides
• Repeat 3-5 times
MNNC - 2018 - POSTPARTUM NUTRITION & EXERCISE 50
TWISTED WARRIOR
From standing, feet shoulder width apart, hands on your hips, step your left foot back 3-4 feet & angle your left foot to about 11:00 (30 degrees)
Keep your right foot pointing forward. With your left heel firmly anchored to the floor & the outer edge of the foot connecting to the mat, exhale & bend your right knee over the right ankle so the shin is perpendicular to the floor
If it is hard to keep the heel down, lift it off the floor
Keep your hips square to the front of the mat
Raise your arms & reach actively through the little-finger sides of the hands toward the ceiling
Squeeze your shoulder blades together & relax your shoulders away from your ears
Reach your left hand across the right leg & place it on a block, reach the right arm straight up
MNNC - 2018 - POSTPARTUM NUTRITION & EXERCISE 51
Session Name 8/9/2019
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PIGEON – OPENS HIPS & RELEASES EMOTIONS, CAN HELP WITH SCIATICA
• Begin on all fours.
• Cross your left leg so that the bottom of your foot is against your right knee
• Slowly lengthen your right leg straight behind you, keeping the top of the foot on the floor
• Align your hips so they are square, flex your left foot to protect your knee
• Place your hands beneath your shoulders & press into the floor to lift your upper torso & raise your chest while keeping your shoulders down & away from the side of your head
• Hold for 3 to 5 breaths
• Uncross your left leg, straighten & shake it, then repeat on other side
MNNC - 2018 - POSTPARTUM NUTRITION & EXERCISE 52
PRONE COBRA
MNNC - 2018 - POSTPARTUM NUTRITION & EXERCISE 53
• Lie on stomach & extend upward, rotating your palms out & squeezing your shoulder blades together
• Make sure that the shoulders are externally rotated, not internally rotated
• Squeeze your buttocks & keep your feet on the floor.
• Hold without extending your head back, chin slightly tucked, to lengthen through the back of the neck
• Hold this for 3 minutes
Work your way up holding as long as you can, then
resting for half the time you held
SEATED FORWARD FOLDREDUCES BACK & HEAD ACHES
Sit with legs together & move the fleshy part of bottom out of way
Bending from hips, bring your torso toward thighs
Exhale & try to grab the toes or place your hands on your thighs
If you cannot reach your toes, may use a strap around your feet
Hold for 5-10 breaths
MNNC - 2018 - POSTPARTUM NUTRITION & EXERCISE 54
Session Name 8/9/2019
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STANDING WIDE-LEGGED FORWARD BEND
Stand in mountain pose, hands on hips & jump or walk your feet 4-5 feet apart, depending on your flexibility
Make sure your feet are slightly pigeon toed
Exhale & bend forward from the hip joints, not from the waist, with airplane arms
Tighten the legs by drawing up on your knee caps as you descend
Continue to lengthen through the torso & backs of the legs & place your palms on the floor in line with your shoulders
Hold for 5 breaths
A twist can be added to open the side body
MNNC - 2018 - POSTPARTUM NUTRITION & EXERCISE 55
CHILD’S POSE REDUCES STRESS, BACK & HEAD ACHES
Kneel on the floor, touch your big toes together & sit on your heels, then separate your knees as wide as your hips
Exhale & lay your upper body between your thighs. Open across the back of your pelvis & lengthen your tailbone & gently place your forehead on the floor & relax your arms at your sides
Hold this pose for 5 breaths or a few minutes
MNNC - 2018 - POSTPARTUM NUTRITION & EXERCISE 56
OVERCOMING BARRIERS
When you're caring for a newborn, finding time
for exercise can be challenging
When you're caring for a newborn, finding time
for exercise can be challenging
Hormonal changes can make you emotional &
some days you might feel too tired for a full
workout
Hormonal changes can make you emotional &
some days you might feel too tired for a full
workout
But don't give up! But don't give up!
Exercise after pregnancy is not easy but it can do wonders for your well-being, as well as give you the
energy you need to care for your newborn
Exercise after pregnancy is not easy but it can do wonders for your well-being, as well as give you the
energy you need to care for your newborn
MNNC - 2018 - POSTPARTUM NUTRITION & EXERCISE57
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TIPS FOR STICKING WITH IT!
Looks for fitness classes and trying to incorporate baby into the routine
Vary routine
Get a workout buddy
MNNC - 2018 - POSTPARTUM NUTRITION & EXERCISE 58
EXERCISE AFTER PREGNANCY
One of the best things one can do for themselves
Regular exercise after pregnancy can:
Promote weight loss, particularly when combined with reduced calorie intake
Improve cardiovascular fitness
Strengthen & tone abdominal muscles
Boost energy level
Relieve stress
Promote better sleep
Including physical activity in ones daily routine helps you set a positive example for their child now & in the years to come
MNNC - 2018 - POSTPARTUM NUTRITION & EXERCISE 59
REFERENCES
American Dietetic Association, Dietitians of Canada. Position of the American Dietetic Association and Dietitian of Canada: dietary fatty acids. J Am Diet Assoc. 2007; 107 (9): 1599-1611.
ASPEN Core Curriculum. Cimbalik, C, Paauw, J, Davis A. Pregnancy and Lactation. 2007; 383-404. Acad Nutr Diet. 2014; 114:1099-1103.
Association or Reproductive Health Professionals. http://www.arhp.org/publications-and-resources/quick-reference-guide-for-clinicians/postpartum-counseling/diet. Updated July 2013.
American Congress of Obstetricians and Gynecologists. http://www.acog.org/Patients/FAQs/Exercise-After-Pregnancy . Updated June 2015.
Balch, P. A., CNC. (2010). Prescription for Nutritional Healing(Fifth ed.). New York, NY: Penguin Group. CDAPP Sweet Success Guidelines for Care. State program guide, 2015 Geetha Rao. Nutrition, Diabetes and Pregnancy after Bariatric Surgery. CDAPP webinar, 2016
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REFERENCES CONTINUED
Prebiotics and Probiotics: Creating a Healthier You. EatRight.org. Reviewed by T Wolfram. 2016
Riley, L., & Nelson, S. (2006). You & Your Baby Healthy Eating During Pregnancy. Des Moines, IW: Meredith Books.
Stuebe, AM et al. Duration of Lactation and Incidence of Type 2 Diabetes. JAMA 2005; 294: 2601-2610
https://www.cdc.gov/healthywater/drinking/nutrition/index.html
https://www.hsph.harvard.edu/nutritionsource/types-of-fat/
https://www.mayoclinic.org/healthy-lifestyle/labor-and-delivery/in-depth/exercise-after-pregnancy/art-20044596
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