Breastfeeding and Body Composition (Nursing, Lifting, and Fat Loss) | Ep 451
"Just breastfeed and the weight will fall right off." That's what every nursing mother hears.
And then it's a struggle because of what's going on hormonally while you're producing milk.
Lactation does a few things. It suppresses estrogen to near-menopausal levels, shifts fat storage toward your midsection, and creates anabolic resistance in your muscles, all while burning 350 to 450 extra calories a day.
One side says don't touch your nutrition until you're done breastfeeding. The other says eat in a deficit and train hard like everyone else. Both are inadequate.
Philip walks through the actual research on calorie restriction during established lactation, including the landmark New England Journal of Medicine study that showed zero effect on infant growth with a moderate deficit. You'll learn what's really happening with your hormones, why protein needs are 50 to 100 percent higher than the RDA suggests, why sleep may matter more for body composition than your nutrition plan, and 3 signs that tell you your approach might be too aggressive.
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Episode Resources
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Timestamps
0:00 - Breastfeeding and body composition
3:55 - Two types of bad advice for nursing mothers
6:15 - Calorie restriction while nursing
9:09 - How lactation suppresses estrogen and shifts fat storage
10:45 - Anabolic resistance and insulin sensitivity during nursing
11:30 - Perimenopause and lactation
12:15 - Oxytocin as a cortisol buffer
14:17 - Sleep quality while nursing
16:38 - Nutrition, protein, and calorie floors for nursing mothers
21:00 - Why sleep deprivation prevents fat loss
23:26 - NEAT and practical movement tips
25:53 - Eat more and lift heavy
27:47 - 3 signs your deficit is too aggressive while nursing
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Philip Pape: 00:00
What do you do if you are breastfeeding, but you also care about body composition post-pregnancy? You've probably gotten mixed messages like don't touch your diet while nursing, or just eat less and move more like everyone else. These are all incomplete prescriptions, then they often ignore what's happening inside your body while you're producing milk. Today I'm going to walk through the hormonal and metabolic picture of a nursing mother, what the research says about when and how it's safe to adjust your nutrition, and three signs that tell you if you've pushed too far, because of course the priority is always your baby and your health first, and then your physique goals second. Welcome to Wits and Weights, the show that puts a popular piece of fitness advice under the microscope, finds the hidden reason it doesn't work, and gives you the deceptively simple fix that does. I'm your host, Philip Pape, and today's episode was inspired by a listener question. It's one of the best that I've gotten in a while. Katie S wrote in she's 42 years old, 5'2, nursing her nine-month-old, which is her eighth baby. She's been lifting for about three years. She hits her protein most days, and she's watching her body slowly change. She's at about 145 pounds, which is 20 pounds above what used to be her normal weight. But her goal is not to get back to 124. It's more like 130 because she's accounting for some of that muscle that she's built. And Katie, if you're listening, that right there is what tells me that you are thinking about this correctly because you are not chasing a number from 10 years ago. You're building a different body for a different time of life. And what you described, losing five pounds during a winter illness and then seeing muscle definition emerge because the muscle was already there underneath shows me that you were going through body recomp, right? It is happening. And sometimes that's very hard to see. I just had a client call where she had lost 1.2 pounds, but within that was about six or seven pounds of fat loss and about four or five pounds of muscle gain. So sometimes it's hard to see that because it's it's slow enough that it doesn't always feel like progress when you're living it day to day. Now, quick note before we go further: I am not a doctor, I'm not a lactation consultant. Nothing in this episode replaces working with those experts. What I am is someone who reads research. I coach women through these situations. Yes, I'm a husband. Yes, I have children as well. And I care about these things. I care about all the women in my life, no matter who they are. And I think breastfeeding is an important topic. I think we need to talk about these things and understand what's happening with the body. I've worked with women pre and post-pregnancy, those who lift up to very late in term, and then even right after. One of my friends and former clients, she probably knows who she is listening to the show, you know, won a powerlifting meet just a few months after being uh having her child. So everything I'm gonna share today is grounded in peer-reviewed evidence. I'll be specific about where it's strong and where it's not so strong. But if you have, you know, specific medical concerns about your milk supply, your hormones, your baby's growth, please, please work with your healthcare team on that. Um, and then stick around to the end because after the main content, I am gonna share three quick signs that tell you whether your nutrition approach is too aggressive for nursing. These are simple things you can check this week. They'll give you some real-time feedback on whether your body is handling the adjustment well so that you know this before you make any changes. So here's what we're gonna cover today. First, why the two main camps of advice for nursing mothers tend to miss the mark in different ways. Second, what's actually happening hormonally, metabolically while you're breastfeeding, and why that tends to change the equation for things like muscle, fat storage, and even, of course, your recovery. And third, I'll give you some practical tips for supporting your body composition while protecting your milk supply and your health, because the order of those priorities does matter. And we're gonna try to get that right for you. All right, let's get into it.
Philip Pape: 03:55
So you are a woman who's nursing, or maybe you plan to nurse, or you wanna, you know somebody who's nursing, you want to share this with them. You care about how you look and how you feel. You do want to get back to some level of, you know, feeling like yourself again, let's say. Although having a baby is is an incredible experience in its own right. And please don't be so hard on yourself, ladies. But that's easy for me to say as a guy, right? I get it. So you've probably run into different messages on social media, and they tend to be in opposition, but kind of two sides of the same coin. The first one is that you shouldn't mess with your diet while you're breastfeeding, that your baby needs every calorie, just wait till you're done nursing, then worry about your body. And it sounds protective and responsible, right? You're trying to nurse and bring up a human being and help them grow really quickly, you know, quickly compared to when they get older, right? Because babies consume a lot and grow very fast. Um, so it comes from a real place of love. And in that first six to eight weeks postpartum, your supply is being established. There's all the new habits and the bond with your baby. Any significant calorie restriction can genuinely interfere with milk production. That part is totally true. And then during that early window, the the absolute right call for most women is you got to eat enough and you have to focus on your recovery and let your body do what it needs to do and just focus on the baby, focus on that bonding, focus on that, you know, your milk supply and all that, because you've gone through what amounts to kind of a trauma, right? Having gone through pregnancy. But then those same people, they take that legitimate early postpartum caution and then they stretch it across the entire duration of breastfeeding, which could be a year, two years, or longer. I mean, we have two daughters. Our first um had trouble getting enough from breast milk because she would spit up a lot, so we supplemented with formula. And so she didn't breastfeed for too long, maybe up to a year max. And our second went almost two years because she was, you know, she was drinking it up and growing from it, and that's all she needed. And then we started to add in food when the time was right in addition to the breast milk. So it can be quite a long time. So, you know, the first few months, as we just said, are super important to focus on the recovery in the milk supply. But then after that, we could start looking at these other approaches. The evidence just doesn't support a blanket prohibition that far out. There was a landmark study published in the New England Journal of Medicine by Love Lady and colleagues. What a nice name, Love Lady. 40 overweight exclusively breastfeeding women were randomized to either a 500 calorie-a-day deficit with exercise four times a week, or the control group. And they started this at four weeks postpartum. So the diet plus exercise group lost about 4.8 kilograms over 10 weeks, and there was no effect on infant growth. None at all. Another group went even more aggressive here, imposing a 35% deficit for 11 days in exclusively breastfeeding women. Again, no adverse effects on milk volume, milk composition, prolactin levels, or infant weight. So the idea that a calorie restriction during established lactation, right? You've gotten to the point where you've had a baseline of successful established lactation that it's going to hurt your baby, that is not supported by the research in well-nourished women. Now that distinction matters. You have to have established lactation, adequate total intake, and be well-nourished. Not close to postpartum, not extreme restriction of your diet, not malnourished. Now, the other camp, camp two here, has the opposite problem, I'll say, where they give generic postpartum body composition advice. You've heard of this, like just eat in a deficit, train hard, track your macros, same as everyone else. And that might work fine for some women, but it ignores the pretty significant hormone and metabolic shifts, right? Shifts in your metabolism that happen during lactation. Because what's happening? Your estrogen is suppressed, your prolactin is elevated, your body's allocating hundreds of calories a day to producing milk. Your sleep is probably terrible. And these definitely change the whole equation for how aggressive you can be, like it would anybody, but in your case, you've got these specific pressures and it changes these, changes what your protein needs are. It changes what your body does with the calorie deficit. You know, the calories in an equation can change drastically. And so treating a nursing mother's body the same as a non-nursing body is just sloppy. It's it's the generalization and oversimplification that so many people get into, even when they mean well. But honestly, I don't think you mean too well if you don't get to that next level. Now, if you're nursing in your say late 30s or 40s, so we're getting to, I hate the term geriatric pregnancy, right? It seems crazy at that age. But you know, as we as you get closer to that, you know, menopause age and you're but you're you're nursing, there's like another layer of stuff to deal with where perimenopause is entering the picture and you have these two different hormonal states clashing together. And I don't think that's been studied at all, to be honest, but we are gonna talk a little bit about that. So those are the camps that we have. That's where the advice is coming from as a baseline. If we look at you know what's generally discussed out there. But I
Philip Pape: 09:09
want to actually go into the next topic here, which is what's happening in your body, what's going on with hormones? Okay, when you're breastfeeding, especially when it's frequent breastfeeding, all you know, you you it's a it's a common thing for you, your body is suppressing the estrogen. You've got prolactin is high. That's that's what drives the milk production. The elevated prolactin shuts down normal hormonocycline. So your estradiol drops to somewhere around four to 47 picograms per milliliter, if you were to look at it on the lab. Whereas a normal premenopausal woman is like up at 30 to 400, right? Quite a bit higher. A breastfeeding woman who doesn't have her period, so we call that amenorrheic, can be sitting at like as low as four picograms per milliliter. And that's comparable to a postmenopausal woman. So your progesterone is basically zero because you're not ovulating. And hormonally, a nursing mother's body looks like a menopausal body in terms of estrogen status. And that that's whatever age you are, whether you're 28 or 42 or whatever, that the lactation hormones do all that. Now, why does all this matter? Why is a dude on Wits and Weights talking about this? Okay, a few reasons. First of all, we've never talked about this, and so this is like a definitive episode on this. Low estrogen shifts fat storage toward your midsection. Okay, we know this is a challenge for post for perimenopause, right? It causes menobelly, that it's a popular term. Research shows that when estrogen drops, whether from menopause or from lactation, you're going to preferentially deposit visceral fat. So if your body shape feels like it's changing during breastfeeding, if you're carrying more around the middle than you used to, that's probably a real thing. There's an actual hormonal mechanism behind that. And I know that's tough when you've just had a baby and you're trying to lose that belly weight, but now it seems to be counteracting it. Low estrogen also creates anabolic resistance. Your muscles become less responsive to the signals that drive that muscle growth, like your training and your protein. This means you probably need more protein, maybe more per meal, more per day, for the same muscle protein synthesis response. And then your insulin sensitivity can be affected because lactation adds insulin resistance to support milk production. And then that tilts the metabolism toward fat storage as well. So combined with low estrogen, your body's in a state where it is prioritizing the baby's energy supply. And that makes total sense, right? From an evolutionary standpoint, your body's doing its job, but it means you just can't follow standard advice and think it's going to work. Now, if you're nursing in your late 30s or 40s, there's that second layer I mentioned. We talked about estrogen, estrogen fluctuating wildly irregular cycles, you know, your progesterone's declining. And then that combines with the lactation stuff going on. And now you have this like deeper, more sustained, low estrogen state than either of those would create on their own. And I don't I don't know that this has been studied directly. I'm gonna be honest about that. I think any recommendation for a woman who is simultaneously nursing and perimenopausal is probably extrapolated from like adjacent research, right? Not not direct studies for that population, which is a problem in women's health in general, as we know. There is a bright spot here. I always like to find the silver linings here. Every time you nurse, your body releases oxytocin. Oxytocin suppresses cortisol and lowers blood pressure. This is the this is the one released because of the bond with your baby, right? It's the motherhood coming out. It even have even fathers can have an impact when you're with your baby. That's why they like all the touching and being close, you know, right after the baby's born. So after about six weeks of breastfeeding, this buffer on your stress persists. Even six weeks after of breastfeeding, even between feedings. So the breastfeeding is giving you some protection against the cortisol-driven visceral fat storage that sleep, you know, sleep deprivation and the stress you have would otherwise cause. So it kind of gives you a little bit of an advantage there. One more thing worth knowing is that extended breastfeeding seems to delay menopause onset. Uh, data from the nurses' health study found that women who breastfed 25 or more months total had AMH levels. That's like your ovarian reserve, like a marker of your ovarian reserve, how many eggs you have? It's about 39% higher than those who breastfed less. So, our listener who wrote in, Katie, with your history, your perimenopausal symptoms could be partly lactation-driven and partly reversible once you wean off. It doesn't change what you're doing now, but it's it's worth knowing that context. So, when we summarize it all together, what do you have? You have suppressed estrogen, elevated prolactin, some insulin resistance, tendency to store more fat in your belly, anabolic resistance in your muscles, but also a built-in buffer against the stress, the cortisol from because of the nursing. So that's kind of what you have to play with. What do you do with this information now? Okay,
Philip Pape: 14:17
so I just got done telling you that sleep might be the single most important variable for body composition while nursing, and that a three-hour difference in sleep changed fat loss by more than half in a controlled study. And I know if you're nursing a baby, the idea of getting better sleep seems uh hilarious, maybe, maybe like a cruel joke. Whether or not your husband's helping out. Now, I was working, my wife wasn't. Fortunately, I was able to get a little more sleep because she was breastfeeding, but that's not always the situation. You can't control when the baby wakes up either. So there's that. But here's what you do control: what happens when you finally lie down? How fast you fall asleep, how deeply you stay asleep during those windows that you actually get, and that's where the physical environment matters a ton more than people think. Temperature regulation is a huge one. Nursing mothers tend to run warmer, especially at night, and overheating is one of the most common sleep disruptors. So, naturally, I'm gonna segue into our sponsor for today's episode, Cozy Earth, because Cozy Earth, who I love as a company, very ethical, really good people at that company. They make bamboo-derived bedding and sleepwear that regulates temperature and it does so better than anything I've tried. So if you're nursing, this could be a nice luxurious gift for you, for yourself, or maybe hint hint to somebody who's looking to get you a gift. Maybe for the baby shower, I don't know. Their sheets are very breathable, they stay cool without feeling cold, they get softer over time instead of piling. I also use their bamboo-derived pajamas along with the sheets and the cuddle blanket. And anyway, the difference for me with all of this is falling asleep faster, waking up less. And so for someone who's nursing who only gets sleep in two or three hour blocks, getting deeper sleep during those blocks is a huge advantage. So that's cozy earth. Go to witsandweights.com slash cozy earth if you want to support the podcast and also improve your sleep quality. They have a hundred night sleep trial, a 10-year warranty. So absolutely no risk on that. Go to wits and weights.com slash cozy earth. You'll get a code Wits and Weights for 20% off when you go to that link, witsandweights.com slash cozy earth. If you're in that season where every hour of rest has to count, then just make it count. And Cozy Earth is a great move for that, and you would support the show. Witsandweights.com slash cozy earth. All right, so
Philip Pape: 16:38
after that very natural segue to our sponsor, we're now gonna get back to the framework here. What is happening in the body is what we just covered. Now we're gonna talk about what the approach should look like. Now, the goal here is not to lose weight while breastfeeding. Okay, let me say that again. The goal is not to lose weight while breastfeeding, the goal is to support your health, to protect your milk supply, to preserve and build your muscle, and let your body composition improve as a byproduct of doing those things well. Does that make sense? I hope that makes sense. It's a very healthy approach to take that I prefer for anybody, let alone nursing mothers who have these extra challenges going on. If you approach it that way with the baby and your health as the top priorities, then the physique changes actually follow, from what I've seen. So don't look at this as a guy trying to, you know, tell you what to do and that you can't lose weight or can't lose fat. I'm saying that actually a more efficient way to do it is to prioritize the health and your muscle and things like that. If you flip those around, if you chase the number on the scale while you nurse, you're definitely gonna run into problems because there's a lot of other variables at play that are that make it more complicated. Right? So we've got we've got our four pieces here. We've got nutrition, protein, sleep, and movement. For nutrition, I'm gonna say that after you've established your lactation and you've been well fed and well nourished and not worried too much about calories during those first two to three months, then a moderate calorie adjustment, which usually comes by tracking in awareness, is totally doable. It's totally supported by the research. It doesn't, shouldn't be a huge deficit if you're still breastfeeding. But as much as 500 calories a day, which is one pound a week of weight loss, is totally doable. It's totally doable, it's perfectly healthy, it's perfectly fine. Of course, it's gonna, the actual number is gonna depend on your size and how you can handle it with things like hunger and biofeedback. But you're still burning a lot of calories, like around 350 to 450 calories a day producing milk at nine months postpartum. So your energy expenditure is higher than a non-nursing woman of the same size, and then that works in your favor because then you can eat more total food and still be in that modest deficit, right? But the calorie floor itself depends on your size. You know, the when you hear never go below X while nursing, or I don't know, 1800 calories while nursing. That comes from the love lady study I mentioned because they didn't prescribe anything below that, but that's all that was. And that population was larger women on average. There's another research-based floor from data that's 1500 calories, where below that it got a little bit dicey. But in reality, below 1500 or 1200 for most people, it starts to get a little dicey anyway. So for a smaller woman like our listener Katie at 5'2, the hard floor is probably closer to her around 1500, not 1800. But again, I don't know the exact number, it depends. So the practical approach to do it is calculate your deficit from your actual TDEE, your actual expenditure. Use something like macrofactor so you're not just doing a calculator. You want to be have been tracking. So actually, it's it's helpful if you're tracking your food while pre while postpartum, even if you're not using that to go into deficit yet, just so you know what your maintenance calories are. And it might be pretty cool to see what happens to your maintenance over the course of breastfeeding over that time. So that's something we can definitely help with if you if you wanted to reach out. But you know, if you're early postpartum or if you have any concerns with your supply, don't use a deficit. Eat to support your recovery and your baby. There's no rush on this. Now, protein, this is probably where most nursing mothers are falling short, even if you think you're doing well, because most people fall short. And the the need for breastfeeding women is probably 50 to 100% higher than the RDA. And there are there are recommendations out there that are higher. I don't know if like from an official agency, and that's before you add strength training and the other things that we want you to do on top of that. So, guess what? We're gonna go with a typical advice for protein for a pregnant woman just as well, 0.7 to 1 grams per pound or more. So for someone Katie's size, our listener at 145 pounds, that's you know, anywhere from like 120 to one, even up to 160 if you want to go above the one gram per pound, and then spread your protein across meals at least 30 to 40 per meal, so that you can just maximize all of this and make it more practical. And that that's what I would say for that. If you think about breast tissue, the mammary gland, it consumes a significant amount of those branch chain amino acids to produce milk. So you're actually draining your amino acids, and that's why probably even going higher on the protein can be helpful. All right, now sleep. Come on, this is the most important variable for of all in this population, and I'll be honest, in most people's lives, period, because we don't get enough of it, but it is also the hardest one to control. There was a study from Nedelcheva that put subjects on the exact same calorie deficit with the exact same exercise, but one group slept eight and a half hours and the other slept five and a half. Uh, this is a famous study about sleep deprivation. And the sleep restricted group lost 55% less fat and lost 60% more muscle. All right. So they had less fat loss and more muscle loss with the same food and the same exercise, but they had less sleep. So their bodies preferentially broke down muscle and preserve fat. And that's not what we want generally. We know that sleep deprivation also increases ghrelin and by 28%, decreases leptin by about 18%. And that means you're going to consume up to 500 more calories a day, and you're going to seek out higher sugar, higher fat type comfort foods. So you're hungrier, you crave foods that don't serve you as much, the deficit you're in maybe is actually coming somewhat from your muscle. And that's why aggressive dieting on bad sleep is one of the worst things you can do. So for a nursing mother where you're nursing through the night, I'm not going to pretend you can just sleep more, but there are some findings from the research that are helpful to know. The first one is that resistance training during periods of sleep restriction help maintain muscle protein synthesis at normal levels. So training kind of rescues you a bit from muscle loss, which makes sense because we talk about strength training as a way to preserve muscle. Okay. So, you know, training postpartum is still something highly encouraged. Secondly, even an extra 1.2 hours of sleep per night led to eating 270 fewer calories the next day without any other intervention. So really every extra hour of sleep you just can figure out to negotiate in there somehow. A nap when the baby naps, going to bed 30 minutes earlier, having your partner take a feeding if that's possible, all of that's gonna help you.
Philip Pape: 23:26
And then we have movement. Katie mentioned that steps and swimming for her are hard to fit in. And, you know, she's right that the activity matters, but the type matters more than anything here. You guys know how I talk about strategic cardio versus your neat, your non-exercise activity, which is primarily your steps and your walking. And when I look at Katie's day, I can see where it's tough to get that neat because she's sitting in the passenger seat for her the hours her teens are driving. She's sitting while homeschooling, she's sitting while nursing, she's standing in the kitchen cooking, and that's still stationary. No offense, Katie. Standing burns a few more calories than sitting, but obviously if you're in place, it's still a lot of stationary lack of movement, not because you're not trying, it's how your life is structured and how crazy things are. And a lot of nursing mothers are going to recognize something very similar, probably in their own routines. So the fix is not, let me add in a 45-minute swim. It's rethinking or reframing the hours that you're stationary. What can you do instead? Can you stand at the counter for homeschool instead of the table? Can you walk your younger kids around the block while the teens drive? I don't know. Can you pace during the room, you know, phone calls during pace your room during phone calls? And these sound like small things, but they add up. That, you know, going from like five to seven thousand steps can be helpful. And an extra 20 minutes a day spread throughout the day could be an extra two or three hundred calories burned, right? On the swimming specifically, Katie, I think it's an awesome option for like joint-friendly conditioning. But the the cork here is that there was a study that found swimmers lost no weight over six months while walkers lost 10% of the body weight because cold water stimulates appetite. Now, I'm not saying swimming's bad for you. I'm just saying if body composition is a goal, walking in general daily movement might give you a better return per hour without appetite compensation. But that was just a little uh side tangent that I found in my research. So I guess what I'm saying is this nursing doesn't mean you have to put your body on hold for a year or two. The evidence does support a moderate patient uh protein forward approach once you've established lactation. And then the biggest threats to that process are not the calorie deficit, but things like inadequate protein, inadequate sleep, and of course inadequate patience. Before we wrap up, I did promise you three signs that tell you whether your nutritional approach is too aggressive for nursing. That's coming up in a second. But
Philip Pape: 25:53
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Philip Pape: 27:47
right, if you're nursing and you're adjusting your nutrition at the same time, here are three signs that tell you you've gone too far. Number one, when your supply dips at a specific feed, usually the late afternoon or the evening one, milk production is lowest when cortisol is highest. So if your energy intake's too low, then that vulnerable feed is the first one to drop. If you notice the baby is fussier or less satisfied at one particular feeding and then it's consistent for a few days, that's the signal. So again, your supply dips at a specific feeding. And again, it's usually late afternoon or evening, but it does not necessarily. Number two is a wet diaper count. This is this is a very objective measure. So talk about data tracking. Wet diapers. Less than six wet diapers per day in an infant probably means inadequate hydration, which can reflect reduced milk volume. No need to freak out. It's just something to track. If you've been tracking this, I think you should be. Uh most, most of us. I mean, I remember us, we knew exactly how many diaper wet diapers there were a day. If there's a drop from your baby's normal baseline, that's something to look at. That's that's what I'm suggesting. Number three is that your own hunger is constant and very intense, right? Not just like, yeah, I could eat, but I can't stop thinking about food. And if you have that level of hunger while you're nursing, it means your deficit is too big for what your body is trying to produce. That is your brain through biofeedback telling you that the energy math isn't working right now. So if you see any of these, the fix is actually quite simple. Eat more. Eat more. Add two to three hundred calories for a few days, reassess all of these things. You can always tighten it up later. You know, your milk supply is harder to rebuild than the deficit is to reintroduce. All right. I hope this was helpful. I know it's a very unique topic for wits and weights, but I think it's an important one. And thank you, Katie, for the question. Uh, if anybody wants to submit a question for the podcast, go to wits and weights.com slash question. Until next time, keep using your wits, lifting those weights. And remember, your body is doing incredible work right now. Support it first, and the results will come. I'm Philip Pape, and I'll talk to you next time here on the Wits and Weights podcast.
