Breastfeeding-injury link: are concerns warranted?

Objective: Recreational and elite athletes report avoiding breastfeeding when returning to physical activity following childbirth due to a perceived increased risk of injury; yet, there are no empirical data to support this relationship. We aimed to examine the complex interaction of breastfeeding and physical activity and its potential impact on musculoskeletal injury.

Methods: Individuals (≥18 years) who participated in physical activity during their first year following childbirth were recruited to complete an online questionnaire that covered maternal demographics, reproductive history, health outcomes (preconception to postpartum), breastfeeding habits, physical activity characteristics and musculoskeletal conditions and complaints.

Results: 590 people completed the survey (age at delivery 33.0±3.5, months postpartum 27.9±26.7) and identified that 22% (n=129) reported a musculoskeletal injury in the first year after childbirth. The proportion of individuals exclusively breastfeeding for a minimum of 6 months following delivery was not different between injured and non-injured groups (OR 0.97, 95% CI 0.65 to 1.45). However, a previous or current history of an eating disorder increased the risk of postpartum injury (OR 2.76, 95% CI 1.54 to 4.94). A 50% decrease in weekly metabolic equivalent of task minutes from preconception to trimester 1 or trimester 2 was associated with an 89% increased risk of postpartum injury (OR 1.89, 95% CI 1.25 to 2.86; p=0.002).

Conclusion: In this retrospective study, breastfeeding did not increase the risk of musculoskeletal injury during the postpartum period. Maintaining preconception physical activity during pregnancy may reduce the risk of postpartum injury.