Dear Alice,

I just had a baby five months ago and am having a problem losing weight around the middle — my belly hangs down like a kangaroo pouch! I am breastfeeding and eating a healthy diet, but I can't seem to lose the weight. What can I do?

— Mommy's mammoth midsection


Dear Mommy's mammoth midsection,

Congratulations on the birth of your new baby! After carrying around extra weight for nine months, it's understandable that you are eager to get back to your pre-pregnancy weight. Weight loss after any pregnancy needs to be achieved gradually by making healthy food choices (as you noted) and exercising regularly.

For breastfeeding women like you, losing about half-a-pound a week is generally a healthy goal. Breastfeeding uses an extra 500 calories per day — this may help you to shed the extra pounds. Up to two pounds per week is acceptable for non-breastfeeding women after six weeks have passed since giving birth. More rapid weight loss is not recommended since it can contribute to fatigue, nutrient depletion, and decreased breast milk supply. It is not uncommon for women to lose 60 percent or more of the weight they gained during pregnancy in the first month after childbirth. Subsequent loss is often slower, and women invariably experience intermittent weight plateaus.

In devising a healthy eating plan, be sure that you are taking in plenty of fruits, veggies, and whole grains. A breastfeeding woman needs four servings of calcium-rich dairy foods (calcium supplements may be necessary for the lactose-intolerant), and smaller amounts of lean meat, fish, and/or poultry per day. It's key to eat a balanced, nutritious diet because certain nutrients may be low or missing in the mother's milk if her nutrient intake is low. Be aware of your portion sizes, and try to eat snacks to prevent becoming overly hungry. Since you didn't mention your body size or activity level, these are just general guidelines. Have you considered an appointment with your obstetrician, midwife, or nurse practitioner, or get a referral to a registered dietitian, to determine a plan that is appropriate for you? How about meeting with a personal trainer or fitness specialist to give you some exercise tips? Remember to be patient, because rapid weight loss is generally attributed to a loss of fluids and muscle mass.

In terms of your "kangaroo pouch," abdominal muscles are stretched during pregnancy, and become loose in the postpartum period, which contributes to the look you describe, and may be more noticeable if you had a Cesarean section rather than a vaginal delivery. Abdominal exercises can certainly help tone your muscles, but don't fool yourself into thinking hundreds of sit-ups will get rid of excess fat. The only way to rid the body of excess fat is through expending more energy than one takes in. This is best achieved through dietary modifications AND moderate aerobic exercise. For specific recommendations on postpartum exercise and abdominal workouts, check out the American Council on Exercise. Best of luck and happy parenting!


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