From the Guidelines
Normal weight loss after birth typically involves a gradual process, with most women returning to their pre-pregnancy weight within 6-12 months, and breastfeeding mothers may experience faster weight loss, burning an extra 300-500 calories daily 1.
Key Factors Influencing Weight Loss
- The initial weight loss after delivery includes the baby, placenta, and amniotic fluid, totaling around 10-13 pounds, followed by an additional 5-15 pounds lost in the first six weeks as excess fluid is eliminated 1.
- Breastfeeding can contribute to faster weight loss due to the increased caloric expenditure, but it's essential to ensure adequate nutrition to support both the mother's health and milk production 1.
- A gradual weight loss of 1-2 pounds weekly is recommended, achieved through balanced nutrition and moderate exercise, allowing the body sufficient time to heal and recover from childbirth 1.
Considerations for Postpartum Weight Management
- Women should wait until after the six-week checkup before starting a structured weight loss plan, ensuring that their body has had time to recover from delivery and that any potential complications have been addressed 1.
- Rapid weight loss attempts can be detrimental, potentially depleting the energy needed for recovery and, in breastfeeding mothers, affecting milk supply 1.
- Hormonal changes, such as elevated prolactin levels, can influence weight loss patterns, making it essential for women to be patient and focus on gradual, sustainable lifestyle changes 1.
Evidence-Based Recommendations
- The most recent and highest quality study 1 emphasizes the importance of addressing lifestyle barriers to support postpartum weight management, including poor diet, low physical activity, and lack of sleep, which can be particularly challenging for mothers with certain sociodemographic characteristics or psychological morbidities.
- Interventions targeting postpartum women should focus on improving engagement by addressing these barriers, as demonstrated by a systematic review using the Capability, Opportunity, Motivation, and Behaviour (COM-B) behaviour change framework 1.
From the Research
Normal Weight Loss After Birth
- All infants lose weight after they are born, regardless of their feeding method 2
- The amount and timing of initial weight loss, as well as the timing of birth weight recovery, can vary among healthy, full-term, exclusively-breastfed infants 2
- By 2 days after birth, mean weight loss among neonates is typically 6% to 7% of birth weight, and by Day 3, mean weight loss is usually 7% to 8% 3
- The nadir of lost birth weight often occurs on Days 2,3, or 4 after birth, and some breastfed newborns may lose 10% or more of their birth weight 3
- Most newborns regain their birth weight by 10 to 14 days after birth 3
Factors Influencing Weight Loss
- Rates of exclusive breastfeeding decrease when newborns lose greater amounts of weight 3
- Intrapartum intravenous (IV) fluids may cause excessive weight loss in some newborn infants 2
- Maternal and infant factors, such as maternal age, education level, and parity, can influence breastfeeding outcomes and weight loss 4
Breastfeeding Recommendations
- The American Academy of Pediatrics (AAP) recommends exclusive breastfeeding for approximately 6 months after birth, and continued breastfeeding along with complementary foods until at least 2 years of age 5
- Breastfeeding support interventions can increase the prevalence of any or exclusive breastfeeding up to and at 6 months 6