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General Guidelines for Breastfeeding Women

Exercise During Lactation
Being physically active is an important aspect of a healthy lifestyle and helps create a positive outlook on life. Women who exercise regularly may wonder whether breastfeeding imposes any restrictions on their level of activity. Research has shown that moderate aerobic exercise has no adverse effect on lactation, and it significantly improves the cardiovascular fitness of mothers. Some breastfeeding women report that their babies are fussier and even refuse to nurse after they exercise. One study has shown that babies prefer preexercise milk over the milk their mothers express following strenuous physical activity. Presumably, babies temporarily were turned off by the increased levels of sour-tasting lactic acid present in milk after mothers worked out. Plan to nurse your baby just before you exercise, since lactic acid remains elevated in milk for approximately ninety minutes afterward. Another reason it is preferable to nurse before exercising is that vigorous jostling of the breasts when they are full can cause leakage of milk into the tissues. This, in turn, can produce a local inflammation that predisposes a woman to a full-blown breast infection (mastitis). In my experience, lactating women are more prone to mastitis following vigorous upper body activities such as jumping rope, rowing, raking, vacuuming, scrubbing, and aerobic exercise. The risk can be reduced by exercising after the breasts have been emptied well by nursing or pumping. You should wear an athletic bra that provides good support. If you experience one or more bouts of mastitis that occur within a day or so after vigorous upper body exercise, you should switch to a lower-impact activity and see if the problem resolves.

Hygiene for Breastfeeding Women
Every new mother has days when she wonders where she'll find the time to shower, let alone dress. Feeding and caring for a newborn can be all-consuming at first. When a mother is nursing, feedings initially take longer, are closely spaced, and can't be delegated to anyone else. It's easy for a mother to doubt that she will ever have time to put on makeup, fix her hair, take a bubble bath, or do her nails again. Many a new mother is still wearing her bathrobe by midafternoon, having found no time to spend on her personal care and appearance. In addition to the time crunch, some new mothers are so preoccupied with their baby's welfare that they are reluctant to shower while leaving their baby unattended and out of earshot in another room.

Remember, we parent and nurture others from our own emotional overflow. Taking time to attend to your daily hygiene needs is fundamental to self-care. And self-care is not selfish; it is self-preservation. Structure your time to allow for a daily shower or bath at the minimum. I recall one woman who got up early for a leisurely bath and personal time before her husband awoke to go to work. Another-a frazzled mother of twins-postponed her shower each day until her teenage daughter came home from school and could watch the babies. Many depleted mothers find a shower to be thoroughly rejuvenating, no matter how exhausted they are. Enlist the help you need to spend some precious time each day refreshing yourself.

A daily shower or bath provides sufficient cleansing for your breasts and nipples. You also should wear a clean nursing bra every day, as long as you are leaking milk. Most nursing mothers need to wash their bra daily because it inevitably becomes soiled with milk. If you wear breast pads, change them frequently, as moist pads can harbor germs.

It's surprising how many people don't adhere faithfully to the basic principles of hygiene taught in kindergarten: Wash your hands before meal preparation or eating and after using the bathroom. If you have grown lax in this area, now is a good time to begin reinforcing sound hygiene habits. For a breastfeeding mother, this also means washing your hands before you nurse your baby or pump your breasts and after all diaper changes. With a new baby in your home, you're probably worried about the risk of illness in your infant, and frequent handwashing is one of the best ways to reduce infections in your family. Don't be shy about telling relatives and guests that the doctor says they should wash their hands before holding the new baby and after changing her diapers.

Getting Sufficient Rest
New parenthood and sleep deprivation go hand in hand, since the night feedings that are essential for newborns inevitably disrupt the parents' sleep. Although new parents are wisely admonished to "sleep when the baby sleeps" during the day, most succumb to the temptation to do laundry, address baby announcements, prepare and clean up meals, or perform other chores whenever their baby dozes off. Too often, parents underestimate the magnitude of their exhaustion and the vital importance of rest. Even if things are going relatively smoothly, round-the-clock care of a new baby day after day, week after week, takes a physical toll. When breastfeeding isn't going well, you can bet that parental exhaustion is even greater. Troubled feedings can take an inordinate amount of time, yet fail to satisfy the baby's hunger, leading to chronic infant fussiness and poor family sleep patterns. Profound parental fatigue can cloud one's judgment, cause depression and discouragement, and squelch the joys of new parenthood. To keep from getting so depleted, temporarily curtail any activity that isn't absolutely essential, go to bed earlier, take your daytime naps like a prescription, sleep with your baby if it makes nighttime feedings easier, or arrange for a relief caretaker for a few hours.

From Dr. Mom's Guide to Breastfeeding by Marianne R. Neifert. Copyright © 1998 by Marianne R. Neifert. Used by arrangement with Plume, a member of Penguin Group (USA) Inc.

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