Losing Weight After Pregnancy Nhs

Why do I still look pregnant?It takes time for your body, and especially your tummy, to fully recover from pregnancy. You've had your baby, but you may look as if you're still six months pregnant, with a tummy that's squishier and rounder than you expected.

Imagine your tummy as a balloon, slowly inflating as your baby grows. Giving birth doesn't pop the balloon, it just starts a slow leak. The decrease in your tummy size may be slow, but it will be steady.

From the moment your baby is born, hormonal changes cause your tummy to decrease in size. However, it takes another six to eight weeks for your womb (uterus) to contract to its pre-pregnancy size (Berens 2019).

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The extra fluid that built up in your body during pregnancy will gradually decrease, reducing swelling and bloating (Berens 2019). And any extra fat you put on to nourish your baby will start to burn off, especially if you're breastfeeding and exercising (Berens 2019). But it takes at least a few weeks to see noticeable results.

After giving birth you may still have a dark line down your tummy called a linea nigra, as well as a web of stretch marks.

The linea nigra is caused by pigmentation in the skin where your tummy muscles have stretched and slightly separated, to accommodate your baby as she grew (APA nd). This line of pigmentation usually fades within a few months of giving birth (APA nd).

Weight Loss After Pregnancy

Stretch marks are caused by your skin stretching over your fast-growing body during pregnancy (NHS 2019c). You may have them on your tummy, thighs and breasts (NHS 2019c).

You can't get rid of stretch marks completely, but they will fade over time. Eventually, the lines will look like fine streaks that are closer to your skin colour (NHS 2019c). Try to be patient. You may not like your stretch marks now, but they will look a lot better in six months' time.How long will it take for my belly to shrink back to normal?We've all heard stories of new mums who regain their pre-pregnancy bodies within weeks of giving birth. Although this is possible, it doesn't happen that way for most mums. Bear in mind that your body may change shape after pregnancy. You may find it difficult to return to your exact pre-pregnancy weight or shape.

Patience is the key. It took nine months for your tummy muscles to stretch to accommodate a full-term baby. So it makes sense that it can take weeks or months to tighten up again (Berens 2019).

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Most women don’t get back to their pre-pregnancy weight until about six months after their baby's birth (IQWiG2018, Adegboye et al 2013). How can I safely lose weight to help my belly look better?Breastfeeding may help, especially in the early months after giving birth. If you breastfeed, you'll burn extra calories to make milk – about 300 calories a day (NHS nd), though the exact amount is different for everyone. You may lose your pregnancy weight more quickly than mums who formula-feed their babies but it’s not guaranteed (Jarlenski et al 2014).

Breastfeeding also triggers contractions that help to shrink your womb, which may help you to get in shape faster. However, if you eat more than you burn off, you will put on weight, even if you breastfeed (Adegboye et al 2013).

It's fine to lose weight while you are breastfeeding. Your body is very efficient at making milk, and losing up to 1kg (about 2lb) a week shouldn't affect the amount of milk you make (Adegboye et al 2013, NICE 2010).

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However, if you have a newborn to look after, you'll need plenty of energy. Trying to lose weight too soon after giving birth may delay your recovery and make you feel even more tired (IQWiG 2018). It’s especially important not to attempt a very low-calorie diet (NHS 2019a). So try to wait until you've had your postnatal check before trying to lose weight (NICE 2010).

Eating healthily, combined with gentle exercise, will help you to get in shape (Adegboye et al 2013). The following general guidelines will help you to achieve and maintain a healthy weight:

There's no right answer about how many calories a day you should have. The amount you need to eat depends on your weight and how active you are (Amorim Adegboye et al 2013). For more tips on healthy weight loss after birth, see our diet for a healthy breastfeeding mum and parents' tips for managing your weight after having a baby.

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What else can I do to help regain my pre-pregnancy belly?Exercise can help to tone stomach muscles and burn calories (Evenson et al 2014, Amorim Adegboye et al 2013). You can do light exercise like walking and stretching even in the early weeks after having your baby (POGP 2017).

If you stopped exercising during your pregnancy or are a newcomer to fitness, start slowly and gradually build up your exercise levels (POGP 2015).

Fitness aside, all new mums can begin pelvic floor exercises and work on gently toning up lower tummy muscles as soon as they feel ready (Evenson et al 2014, POGP 2017). This may help you to get back to your pre-pregnancy shape and help to flatten your tummy (POGP 2017).

Stretch Marks During Pregnancy

When you feel up to it, take your baby out for walks in his buggy (Evenson et al 2014). Getting out and about will help to lift your mood and exercise your body gently (Evenson et al 2014, NHS 2019b). You may find there are buggy workouts with other new mums in your local park.

My tummy muscles feel slack. Is this normal?If your tummy muscles feel very slack, it could be because pregnancy has over-stretched them (St George's Healthcare 2018, Berens 2019). If this is the case, you may also notice a bulge developing on the front of your tummy, above and below your belly button (St George's Healthcare 2018).

There are four layers of muscle across your tummy. The top layer is a pair of long, flat muscles that run vertically down each side of your abdomen (rectus abdominis), commonly known as the six-pack (Guy's and St Thomas' 2014). DR happens when the two halves pull away from each other, stretching and thinning the connective tissue between them (St George's Healthcare 2018).

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At least half of women experience DR after having a baby (St George's Healthcare 2018). It's more likely to happen if you:

There's not enough research to tell us whether being obese before pregnancy, or gaining a lot of weight during pregnancy, also makes DR more likely (Nahabedian and Brooks 2019).

It's likely that DR may run in families (Donnelly 2019), so if your mother or sister has DR, you're more likely to develop it too.

Common Pregnancy Symptoms Or Complications

The separation gap often returns to normal within the first eight weeks after giving birth (NHS 2019d, St George’s Healthcare 2018). If the size of the gap hasn’t decreased, or you’re worried about it, see your GP or health visitor. She may be able to refer you to a women's health physiotherapist who can give you specific exercises to help you (NHS 2019d). In some areas of the UK, you may be able to refer yourself directly for physio. 

Leaving DR untreated isn't harmful, but it may weaken your abdominal core. This can increase your chances of getting a bad back and will make exercise and other activities more difficult (Hills et al 2018, Nahabedian and Brooks 2019).

References Amorim Adegboye AR and Linne YM. 2013. Diet or exercise, or both, for weight reduction in women carrying excess weight after childbirth. Cochrane Database Of Systematic Reviews. www.cochrane.org [Accessed December 2019]

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Evenson KR, Mottola MF, Owe KM et al. 2014. Summary of international guidelines for physical activity after pregnancy. Obstet Gynaecol Surv. Jul; 69 (7): 407-14 [Accessed December 2019]

Hills NF, Graham RB, McLean L. 2018. Comparison of trunk muscle function between women with and without diastasis recti abdominis at 1 year postpartum. Phys Ther 98(10):891-901.

Jarlenski M, Bennett W, Bleich S et al. 2014. Effects of breastfeeding on postpartum weight loss among US women. Prev Med, Dec 2014, pages 146-50 [accessed December 2019]

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NHS. 2019b. Keeping fit and healthy with a baby. NHS, Health A to Z, Your pregnancy and baby guide. www.nhs.uk [Accessed December 2019]

NICE. 2010. Weight management before, during and after pregnancy. National Institute for Health and Care Excellence. NICE public health guidance 27. www.nice.org.uk [.pdf file, accessed December 2019]

POGP. 2017. Fit for the future – essential advice and exercises following childbirth. Pelvic Obstetric & Gynaecological Physiotherapy. www.pogp.csp.org.uk [accessed December 2019]

Healthy Weight Gain During Pregnancy

IQWiG. 2018.

Sperstad JB, Teefjord MK, Hilde G, et al. 2016. Diastasis recti abdominis during pregnancy and 12 months after childbirth: prevalence, risk factors and report of lumbopelvic pain. Br J Sports Med 50(17):1092-6. bjsm.bmj.com [Accessed June 2019]

Polly Logan-Banks is an experienced editor with a keen interest in producing evidence-based content. Polly is passionate about ensuring that every child gets the best start in life.Achieving healthy and normal weight loss after birth, while dealing with the changes that

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