Postpartum RED-S (Relative Energy Deficiency in Sport)
Picture this: you go through an entire morning and afternoon of chasing kids, vacuuming up glitter, nursing, washing pump parts, walking the dog, and/or also working a job where you’re on your feet all day. You FINALLY have a moment of peace to yourself, and think about sneaking in a quick 10-minute run around the perimeter of your house as you watch that baby monitor. Maybe you go for that run. Or maybe you sit back in that recliner chair and decompress that mental load of motherhood. Or maybe you take your clothing out of the dryer that has been sitting there for the last 4 days. Or maybe you’re overwhelmed with all the options and can’t decide. And then it hits you…. “oh, I haven't eaten since breakfast”.
Your body has been working on a state of deficiency for that entire day. Let’s talk about “low energy availability” (LEA). LEA is a mismatch between energy received from our diet (calories) and the energy cost of activity. If this LEA becomes severe and/or prolonged enough, it can result in RED-S.
RED-S (Relative Energy Deficiency in Sport) is a name given to a range of health and performance problems that are related to this energy mismatch. This “underfueling” impacts the ability of our body systems to keep us in optimal health. While this term was originally applied to the athletic population, it can impact ANYONE experiencing an imbalance between energy intake and energy output. And LEA/RED-S is VERY prevalent in the postpartum population. Oftentimes, RED-S is unintentional, and people aren’t aware that this is affecting them. People may say “I eat well and I eat healthy foods, I’m not restricting anything”, and this may very well be true! But are we getting the calories we need? Are we eating enough to meet the demands of our daily lives? Add in the awful “bounce back culture” mentality ... we're told “to lose weight, you need to consume fewer calories” (and my argument against that statement is a story for another day…)
You need to fuel properly to be a mom, just like you need to fuel properly for a high-intensity sport. (Also, who even knows how to “fuel” properly? It’s really hard! Female athletes - did you get this education in high school? I don’t think I did)!
RED-S impacts the following body systems:
Reproductive (irregular, absent periods can affect fertility later in life)
Skeletal (low bone density, fractures, increased risk of osteoporosis later in life)
Gastrointestinal (abdominal pain, cramps, gut distress)
Cardiovascular (abnormal cholesterol levels, increased risk of heart disease later in life)
Immune (increased risk of illness)
Hematologic (increased risk of iron-deficiency, anemia)
On top of that, if you’re breastfeeding, RED-S can impact milk production (specifically the volume and the composition). Energy deficiency can prolong postpartum recovery, increase the risk of complications, and exacerbate fatigue and mood disturbances. Mothers with LEA are also more likely to stop breastfeeding sooner than those with sufficient energy availability.
Alright. So now that we know about the impact of RED-S in the postpartum population, how can we prevent it?
1. Strive for nutrient-dense foods:
Whole grains, lean proteins, healthy fats, fruits + veggies, electrolytes. Specifically, to support lactation, consider oats, flaxseeds, leafy greens. Consider setting up a meal train. If you’re able, freeze a bunch of meals before the baby comes.
2. Monitor energy intake and expenditure:
Don’t ignore hunger cues. To prevent nutrient depletion, it’s imperative to balance energy expenditure (including caregiving and breastfeeding) and energy intake. If you’re looking to get back to physical activity while also committing energy toward breastfeeding, this becomes even more important.
3. Seek professional support:
Lactation consultants, registered dietitians, nutritionists. Your needs are unique and need to be considered on an individual basis. Ask your healthcare providers about their knowledge/experience related to RED-S.