Martica

Q: I had a baby via c-section two months ago. What kind of exercises can I do that won't put much pressure on the area that's healing, but that will help me to get rid of some—if not all—of the belly fat? Even before I was pregnant, I seemed to store more abdominal fat in the lower part of my torso. What exercises can target that?

A: Most women who have vaginal deliveries get the go-ahead to start exercising about six weeks after birth. But if you've had a c-section or a severe episiotomy, you may need to wait longer, and you should only start once your doctor has said that it's safe for you to do so. Once you start, the key is to ease into things gently and progress gradually.

Few moms lose all their baby weight right away, and if you're breast-feeding, you're likely to carry an extra reserve to help fuel the milk-making process. Nursing moms need an extra 500 calories a day. While that seems like a lot of calories, it's easy to eat much more than that amount, thwarting your plans to slim down.

Like many moms, you seem to be in a hurry to shed the excess fat. And most people mistakenly believe that abdominal exercises are the best way to accomplish that. No research has shown that abdominal exercises can decrease belly fat. Plus, many ab moves can increase the pressure on your belly, pelvic floor and back, and if your abdominal separation—or diastasis recti—is not fully healed, some exercises can impede its healing process. The book I wrote with Lisa Druxman, M.A., the founder of StrollerStrides, provides a full nine-month postpartum exercise plan. Lean Mommy  gives lots of specifics to lose fat and firm up all over, including several exercises that target your core belly and back muscles.

An exercise for postpartum bellies

After your doctor gives you the go-ahead to exercise, try this visualization exercise called "belly lacing": Imagine that you have a ribbon woven in and around your ribcage. Close your eyes and imagine pulling on the ends of the ribbon to compress the entire area so that your ribcage narrows. Hold the tightened torso for as long as you comfortably can while you breathe normally. Then relax and repeat.

This type of core-strengthening exercise will help firm up your midsection, but none of these moves will decrease your body fat. Lots of moms (and other people, too) incorrectly believe that stomach moves can reduce inches of fat from their waistline. Since very few calories are burned during these moves, and they only strengthen the musculature, this is just not possible. The way to reduce fat in your belly—and all over—is by moving more, and that means more walking and other types of cardio (swimming, cycling, using cardio machines, etc.). How much you should do depends what you have time for, but moving for at least 30 to 60 minutes per day on most days of the week is recommended. If that seems impossible, that's what strollers are good for—getting baby outside so mom can walk!

Snooze, baby, snooze

Other areas that play a role in body fat include how much sleep you get. A lack of sleep has been linked to adult obesity, and a recent study found an association with post-pregnancy weight retention as well. A 2007 study in the American Journal of Epidemiology compared how much sleep 940 moms were getting six months after birth to the amount of excess weight they still carried one year after birth. Moms that were getting fewer than five hours of sleep per 24-hour period six months after having a baby were 2.3 times more likely to still carry at least 11 extra pounds.

This finding held even after the researchers accounted for other factors that might influence weight gain, including how much weight had been gained during pregnancy; how heavy women were before they got pregnant; how many kids they had had; and certain behaviors like dieting, food intake, exercise, and amount of TV watching. Also, women who reported getting decreasing amounts of sleep from six months postpartum to one year were two times more likely to be holding on to excess weight.

While there's no proof that sleeping more aids weight loss, research has shown plausible mechanisms for insufficient sleep to contribute to weight gain. Sleep deprivation seems to cause imbalances in hormones such as leptin, which affects energy expenditure, and ghrelin, which affects how hungry you are. Cortisol, a stress hormone, may also be altered, leading to increased hunger—and, therefore, increased caloric intake.

Of course, getting enough sleep is a luxury for many moms, especially those who work outside the home, those who are juggling a baby along with other young children, or moms who have little or no outside support. But this study suggests that it's a good idea to brainstorm for ways to sneak in more ZZZs whenever possible.

Fuel up on the most nutritious foods

Also, don't forget the quality of your diet. Some moms are quick to cut out calories, but do so without choosing the most nutritious foods they can. And food quality may have an important effect on how much belly fat is stored and lost. A 2007 study in the American Journal of Clinical Nutrition found that obese men and women with metabolic syndrome (poor cholesterol, large waist size, etc.) all lost weight and improved their health-risk factors when they dieted. But those who dieted by including more whole grains, as opposed to refined grains, lost more belly fat. While this study was not conducted on pregnant women, the more healthful effects of eating less processed food are likely to hold true for most people.

Whole grains include actual whole grains and whole food products. Go for the bona fide, unadulterated grains first: brown or wild rice, barley, quinoa, whole rye and wheat kernels, and oatmeal. Cooking any grain is super easy: All you need to do is boil it like rice. Then, add it to beans or soups or serve it with vegetables or meats. For more whole-grain cooking ideas, check out these books: The New Whole Grains Cookbook by Robin Asbell and Whole Grains Every Day Every Way by Lorna Sass.

Whole-grain products include whole-grain, whole-wheat bread and whole-grain pasta. The less processed the grain is, the more nutrients and fiber it has. (Watch out for labels that read "Made with whole grains"; they may contain just a minuscule amount.) Always choose brown over white, and whole over refined. And when your child is old enough to eat solid foods, choose whole grains for him or her, too.

Find more from Martica.

Do you have a fitness or weight-loss question for Martica? Send e-mail to experts@microsoft.com. Please include Ask Martica in the subject line. Each of our experts responds to one question each week and the responses are posted on Mondays on MSN Health. We regret that we cannot provide a personalized response to every submission.


Martica is a Manhattan-based exercise physiologist and nutritionist and an award-winning fitness instructor. She has written for a variety of publications including Self , Health , Prevention , The New York Times and others. Martica is the author of seven books, including her latest, Cross-Training for Dummies . (Read her full bio.)

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Saturday, August 01, 2009 9:01:18 PM
I am still breastfeeding my daughter and now she is 15 months old. From my own experience, I believe that breastfeeding does not contribute to weight lost at all. I've gained 75 lbs during my pregnancy and still need to lose 15 more pounds to get back to my pre-pregnancy weight. However, I've noticed that ever since my baby walks, which means I need to move more, I've lost 1-2 lbs easily in a week. There you go, it's the exercise and moving part which really helps me to lose weight.....not the breastfeeding part!
Saturday, August 01, 2009 5:57:09 PM
I Breastfed for  3months and lost all my baby fat from breastfeeding and watching what i ate but if you stop breastfeeding is when you gain it back if u don't watch what your eating.....But I agree breastfeeding is the only way to lose it fast...
Saturday, August 01, 2009 6:53:06 AM
 I disagree about breastfeeding. I am a mom of 2 and each time, I lost a majority of my baby weight by breastfeeding.  Granted I didn't lose ALL of my baby weight , but i did loose a lot of it. My other friends, who did not breast feed, had a harder time trying to loose their baby weight compared to my friend who did.
Wednesday, July 29, 2009 4:12:09 PM
I disagree.  I watched what I ate and worked out but I carried around that "extra reserve" until I weaned my son at 14 months.  Out of all my friends, I actually know of only ONE that lost all the baby weight while breastfeeding.
Wednesday, July 29, 2009 10:21:28 AM
breastfeeding may help you lose weight, BUT, you need an extra 500 calories a day to make sure your baby is getting enough to eat and YOU are getting enough to take care of your baby and yourself. so if you tend to carry your extra weight in your abdominal area, that extra 500 calories isn't gonna help you get back into your pre=pregnancy jeans. so if you're gonna breastfeed, don't worry about getting back into your pre-pregnancy jeans right away. besides, if it took you 9mons to put on the weight, it's gonna take you about 9mons to take it off. i just had my son about 6wks ago. i'm not breastfeeding, but i've lost about 25 of the 42lbs i've gained already. those last 15lbs are being walked, watered and rested off. i predict they'll be gone by christmas. of course, i plan on toning up some more (i was working out before i got pregnant and doing pretty good), so i might just stay the same weight i am now b/c muscle weighs more than fat. that last bit is another thing to keep in mind - if you're gonna work out and get toned up and slimed down, remember that muscle weighs more than fat so if you're gaining weight, but it doesn't look like it, it could be your muscles are coming in. woo hoo! and those muscles are needed to keep up with baby! :)
Wednesday, July 29, 2009 5:42:22 AM

"Few moms lose all their baby weight right away, and if you're breast-feeding, you're likely to carry an extra reserve to help fuel the milk-making process.” 

I have read and been told that if you breast feed you are more likely to loose pounds.  Breast feeding does not hinder loosing weight it burns more calories which helps you loose weight!!

#7
Wednesday, July 29, 2009 4:37:06 AM
Breastfeed,eat grains, good fats (Avocados,nuts..),ditch the salt.For sure the salt! Drink plenty of water and get that little bless of yours and put him/her in a stroller and go around the block!
 Walk it off Mamma!Thumbs up

Monday, July 27, 2009 7:11:40 AM

Weight Loss With OsoLean

Weight Loss vs Fat Loss in Getting Well-Defined Abs

There’s one one common misconception people have in mind that makes them think fat loss and weight loss is the same. This is not entirely true. They are slightly different but this small difference could means getting firm, developed abs or getting flat, plain abs.

First of all, to uncover your abs you need to get rid of belly fat that covers them. From this, you see that the goal should be fat loss.

But if I lose fat, I lose weight…so if I lose weight, I should lose fat too, right?

Not necessarily true. Your body weight comprises of many substances: water, fat, muscle, etc. Now, if you only use weight scale to measure your progress, how do you know which substance you lost most?

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Friday, April 10, 2009 8:48:41 AM
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