Literature review for - Flourish Paediatrics

1.70 kg; 95% CI -2.08 to -1.32), or diet plus exercise programme (four trials; n = 169; WMD -2.89
kg; 95% CI - 4.83 to -0.95), lost significantly more weight than women in the usual care. There was
no difference in the magnitude of weight loss between diet and diet plus exercise group (one trial; n
= 43; WMD 0.30 kg; 95% CI -0.60 to 0.66). The interventions seemed not to affect breastfeeding
performance adversely.
Authors’ conclusions: Preliminary evidence from this review suggests that both diet and exercise
together and diet alone help women to lose weight after childbirth. Nevertheless, it may be preferable
to lose weight through a combination of diet and exercise as this improves maternal cardiorespiratory
fitness and preserves fat-free mass, while diet alone reduces fat-free mass. This needs confirmation
in large trials. For women who are breastfeeding, more evidence is required to confirm whether diet
or exercise, or both, is not detrimental for either mother or baby.
6. Su Cohort study in Perth. (Su, Zhao et al. 2007)
Objectives: To study the relationship between exercise by the mother and breastfeeding initiation
and duration, and its effect on infant growth.
Design: A cohort study of mothers and infants, recruited at birth. Infant feeding methods were
recorded in detail and breastfeeding was categorised as 'any' or 'full'. Exercise levels were
categorised using the metabolic equivalent tasks approach based on details of physical activity
recorded in questionnaires.
Setting: Perth, Western Australia.
Subjects: A total of 587 mothers were interviewed on seven occasions over a period of 12 months.
Results: There was no difference in the means of infant weight and length changes, indicating that
exercise appeared to have no significant influence on infant growth up to 52 weeks after birth
(P=0.236 and 0.974, respectively). The mother's level of exercise was not significantly associated
with breastfeeding to 6 or 12 months. This applied to 'full' and 'any' categories of breastfeeding.
Conclusion: Exercise does not affect breastfeeding outcomes at the usual levels of activity
undertaken by mothers. Breastfeeding and exercise are important for maintaining and promoting
health, and this study provides reassurance to health professionals wishing to encourage mothers to
continue both behaviours.
7. McCory (McCrory 2001)
For some women, postpartum retention of weight gained during pregnancy may contribute to
obesity. A recent 70-week randomized intervention showed that infants of initially overweight,
lactating mothers who exercised and dieted to lose an average of 0.5 kg/week grew normally. The
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