Spine Health and Posture in Postpartum

The fourth trimester is a critical period for new mothers as they adapt to the physical and emotional demands of caring for a newborn. During these first three months postpartum, maintaining spine and posture health is essential to prevent and alleviate discomfort. Several factors, including hormonal changes, breastfeeding positions, and the physical demands of motherhood, contribute to common issues such as pelvic pain, low back pain, and upper back tension. Understanding these challenges and implementing strategies to address them can significantly improve your well-being and support you on your journey as a new mother.

## Hormonal Changes and Their Impact on Posture

### Relaxin and Ligament Instability

During pregnancy and breastfeeding, the hormone relaxin increases to help the pelvis expand and accommodate childbirth, by acting on the ligaments and soft tissues. Whilst breastfeeding, relaxin levels can stay elevated and it can take up to 5 months for your levels to return to pre-pregnancy levels. Increased relaxin levels cause ligament instability, especially around the lower back, pelvis, ankles, and wrists.

### Postural Changes Due to Relaxin and Weight Gain

This combined with inevitable weight gain during pregnancy can cause postural alterations and pelvic and lower back pain postpartum. This instability can make everyday activities, such as walking or standing for extended periods, uncomfortable.

## Feeding Positions and Upper Back Tension

Breastfeeding and bottle-feeding positions often lead to neck pain and upper back tension due to prolonged periods spent in a forward-leaning position. Additionally, the increased weight of the breasts can strain the upper back muscles, exacerbating discomfort. While this may seem unavoidable as you focus on nourishing and connecting with your baby, there are things that can be done to optimise the positions.

Experiment with different breastfeeding positions to find one that places less strain on the neck and back. Using supportive pillows can help. Creative use of breastfeeding pillows can help. Pay attention to posture while breastfeeding. Ensure that your back is supported and that you are not hunching over. Use of a supportive breastfeeding chair can help. Also, explore options of breastfeeding in a lying position so you don’t have to constantly hold your baby and can relax yourself. https://content.iospress.com/articles/work/wor203162 Whilst it’s important to make sure your baby is latching and drinking properly, try not to spend the whole time looking down (even though it is completely natural to want to admire your little miracle!) If you’re having difficulty with feeding, consult a lactation specialist for advice.

## Postpartum Core and Pelvic Floor Strength

Due to the separation of the abdominal muscles and the stress on the pelvic floor muscles, pregnancy often leads to a significant loss of core strength. This loss of strength can have a dramatic impact on posture and make it challenging to perform daily tasks without experiencing pain or discomfort. To regain the connection with your core and pelvic floor muscles and rebuild strength it’s important to engage in postpartum exercises as soon as you are given the green light from your doctor or midwife. Pilates and hypopressive exercises can be particularly effective in strengthening care and pelvic floor muscles. Start with gentle exercises and gradually increase intensity as your strength improves. Aim to build a regular and sustainable routine for yourself around caring for your baby.

## Carrying a Newborn and Its Impact on Posture

The constant need to hold and carry a newborn can lead to increased upper back tension and shoulder pain. This repetitive strain can affect posture and lead to chronic discomfort. When carrying a baby, try to maintain a good posture (shoulders back, head lifted, neutral low back & pelvic position) and use pillows or support whilst seated. Frequently switch the side on which you carry your baby to prevent muscle imbalances. Use ergonomic baby carriers that distribute the baby's weight evenly across your body to reduce strain on the back and shoulders. Look to Incorporate upper back strengthening exercises, such as rows and shoulder blade squeezes, into your postpartum exercise routine.

## Postpartum Pain Due to Childbirth Complications

Complications during childbirth, such as prolonged or very short labour, the birthing position, or injuries like tearing, caesarean sections, prolapse, and epidural use, can cause pain and alter posture postpartum. Whilst some discomfort is to be expected, prolonged or intense pain needs to be addressed. Consult with healthcare providers, such as a physiotherapist or chiropractor experienced in postpartum care, to address specific injuries and receive tailored treatment plans. Engaging in gentle, low-impact exercises like walking can promote circulation and also help with healing. Use of pelvic stability belts can be useful in providing support and stability until your body can heal.

**By addressing these common issues and implementing recommended strategies, new mothers can significantly improve their spine and posture health during the fourth trimester, enhancing their overall comfort and well-being as they care for their newborn. But most of all, it is important to allow ample time for rest and recovery, recognising that healing is a gradual process. **