Diastasis Recti and Baby Tummy Time

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This week I started thinking about getting active again, and about getting my body back. It’s not the priority – my priority is having this special time with my little lady, making sure I take time to just hold her, just stare at her beautiful teeny tiny face (corny but true), nurse her, sing to her, keep her alive 😉 you get the idea…

However, self-care for mom is important too, and for me that includes getting back in shape. Prior to pregnancy I was very active – I typically work out at least 4 days a week (often more). I try to eat healthy, but balanced – I love food and wine (in moderation).

So over the last three weeks, even though I was mostly ignoring these thoughts until this week, I did measure myself – because the truth is a lot of progress has already been made without taking any action – just by letting nature run its course (the human body is amazing, and knows what it’s doing!).

When my daughter was 1 week old – the largest part of my belly measured : 39″ (99cm)

At 2 weeks old : 34.5″ (87.5cm)

Today, at 3 weeks old :

At the 1 week mark, I started wearing my belly bandit. I’m not sure if I believe in this product yet. I didn’t use it with my first child, and did (eventually) get my belly back to its pre-pregnancy size – even though I don’t believe the stomach muscles ever fully returned. This time, I’m older, its my second child, and I just thought it might be worth it to try the product out – it certainly can’t hurt.

This week (PP week 3) I started dealing with my diastasis recti. Keep in mind I am not a health care professional and am only sharing my personal experience.

• What is diastasis recti?
  • Short answer – diastasis recti is separation of the abdominal muscles during pregnancy
  • It is officially defined as a distance between the two sides of the rectus abdominis muscle of two centimeters or more
  • It affects at least 60 percent of women six weeks after birth and 30 percent of women have it a year after birth
  • It is caused by pressure on the rectus abdominis muscles leading to overstretching, which is why it occurs so commonly during pregnancy
• Do I have it?
  • Technically, we should wait at least 6 weeks to check manually for DR – the reason being that before 6 weeks the uterus is still working/shrinking and your body is still recovering in general (for many women the separation will correct itself by 6 weeks)
  • My midwife checked me in the hospital before I left, and the early check indicated that I do have a significant separation
  • To perform a manual check –
    • Lie on your back with your knees bent, and the soles of your feet on the floor.
    • Place your fingertips just above your bellybutton
    • With your abdominal wall relaxed, gently press your fingertips into your abdomen.
    • Roll your upper body off the floor into a very small ‘crunch’ – lifting your head off the ground but keeping shoulders on the ground
    • Check how many fingers can fit in the ‘opening’ created by the cruch
    • Repeat and test for separation a few inches higher above your belly button and below your belly button.
    • Two fingers of separation would indicate possible DR (to check again at 6 weeks PP) – Three fingers could indicate a more serious separation and you should consult with your doctor or a physical therapist (this is always a good idea).
  • Truthfully – the actions to correct diastasis recti are beneficial for anyone, so there is no harm is proceeding with an assumption of DR
• How do I fix it?
  • There are some specific exercises that can help you, and some that can really hurt you (make your diastasis worse)
  • Avoid:
    • abdominal sit-ups
    • crunches
    • oblique curls
    • double leg lifts
    • upper body twisting exercises
    • exercises that include backbends over an exercise ball
    • yoga postures that stretch the abs, such as “cow” pose and “up-dog” pose
    • pilates exercises that require the head to be lifted off the floor
    • lifting and carrying heavy objects
  • Make sure you consult with a doctor before starting any exercise postpartum.
  • For me, I started with these exercises this week. I kept a close eye for any bleeding or other signs that I might be overdoing it, and especially focused on the Alternating Heel Drops, Seated Tummy Flex and Hip Bridges as these were specific exercises stressed by my midwife.

This graphic below is from https://www.pinterest.com/pin/426223552234538866/

Now, speaking of tummies – I also started daily tummy time with my daughter this week. This is time the baby spends on her stomach while awake and supervised.

Why is tummy time important?

• Helps baby develop head control
• Promotes motor skills
• Prevents conditions such as flat head syndrome (given that our babes always go to sleep on their backs, tummy time offers them a different position to spend some time).
• Tummy time helps your baby build strength needed for sitting up, rolling over, crawling and walking

When should I start?

• Your baby can start tummy time right away after coming home from hospital
• Each session should last about three to five minutes at first.
• My first week or so at home I tried tummy time with my little one periodically, but this week we completed two to three times a day.
• Don’t be surprised if your baby doesn’t enjoy tummy time at first – it can be uncomfortable for them compared to the position in which they regularly spend their time. Just take a break and try again later. Tummy time is easy to skip especially if you have a baby that doesn’t enjoy it, but stay committed mama!
• As your baby gets used to tummy time, place your baby on his or her stomach more frequently or for longer periods of time. Aim for around 30 minutes a day of baby tummy time by the time he is 2-3 months old.
• You can even arrange age-appropriate toys within his or her reach once they show interest in toys – mirrors also work really well!
• Your baby should work up to an hour of Tummy Time per day by 4 months of age.
• Eventually we want to see baby pushing up on her arms and picking her head up on her own. 
• Then keep the practice up until baby can roll over on his own, a feat many babies accomplish around 6 or 7 months of age.

How do I do it?

• There are a few options, I try to incorporate all of them throughout the day:
  • Lay your infant facedown on your stomach or chest or across your lap (this is perfect after feeding assuming babe stays awake) – I also think this is the best method when starting out as it keeps baby calm.
  •  A blanket or a tummy time mat on a firm, flat surface (floor). Here we would lay right next to her so we are in her line of sight. As a bonus, I could do some of my DR exercises while laying on the ground with her!
  • Boppy Nursing pillow – I use this for breastfeeding (I actually have 2, one upstairs and one that stays downstairs) but it is great as a tummy time pillow as well – it creates a slight elevation.
• The purpose is for baby to try lifting her head, so if she doesn’t do this just as a result of the positioning, try to engage her! Put your face close, or a rattle, etc. 

Remember – every bit of Tummy Time with your baby makes a difference and adds up, so keep going!

If you have done plenty of Tummy Time with baby, but are concerned they are not meeting their milestones, bring your concerns to baby’s pediatrician or healthcare provider.