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Can Babywearing Stop Your Diastasis From Healing?

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I love babywearing. Unfortunately, I’m a bit crap at it. I gaze longingly at the amazing mamas with their beautiful wraps (especially Oscha Roses. I want the roses), but I never managed to get the hang of them. In a way this may have been a good thing: having seen the size of some of the stashes out there, I think it’s a slippery slope to wrap addiction…

I managed a stretchy wrap with my second when he was teeny, then moved on to a soft structured carrier (SSC) for back carries as soon as I could (4 months). I got to keep him close, while staying hands free to play with big brother (and do household chores and stuff. But I won’t pretend any of that got done very often).

babywearing and diastasis recti

Back carry with the Boba!

And after starting out in the dreaded Baby Bjorn (more about why the ‘dreaded’ part later), big brother progressed to a toddler SSC too.

But what was happening to my diastasis recti while I was strapping baby to my back for hours every day?

There are 2 aspects I want to look at here: the core itself, and what the pressure of a strap around the tummy is doing to it; and posture, and how baby wearing can affect that.

The reason I’m so keen to do this is that, if done incorrectly, babywearing could hinder the recovery of your core and pelvic floor. However, I don’t believe this needs to be the case, and I have seen advice out there warning mothers to stay away from front carries until diastasis has healed, or questioning if it’s ok after c-section. And I don’t want anyone to be scared off. BECAUSE BABYWEARING IS AMAZING. Did I mention that?

The Core

I’m going to start with the core itself. And perhaps not the core as you think of it, because for many of us, core means ‘abs’. The ‘Core 4’ that I want to focus on are the diaphragm, the transversus abdominis (TVA), multifidis (low back muscles), and the pelvic floor. This video from physiotherapist Julie Wiebe explains it brilliantly:

So, as you can see, pressure from wrapping too tightly around the tummy is going to put a lot of strain on the diaphragm and the pelvic floor. Plus the first step in post natal recovery is training the breath, and this can interfere with that big time!

 This was my mistake.

 I wanted baby as high up on my back as I could get him. I was advised to have the strap up on my ribs, but I couldn’t get it to stay there, it would slip down. So I strapped it as high up on my tummy as I could, and it felt like if I didn’t have him strapped tight he would drop down and the strap at the front ride up. So I would pull the strap firm, pulling my tummy in with it. This is over utilising that TVA muscle, and tiring for my low back. After 3 hours of this (he went through stages of having MEGA naps back there!) it would feel pretty achy!

It also had the effect of giving me some rib flare (or at least exaggerating some that may have been there as a result of my pregnancy).

So should I babywear if I have diastasis recti?

I have seen the advice that front loading carriers should not be used until any diastasis is closed, to avoid pressure on the abdomen. This advice was accompanied by a picture of a front facing out Baby Bjorn. Just like this lovely holiday photo of me with baby number 1.

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Is a forward facing front carry bad for postnatal abdominal seperation?

BB carriers don’t get such a deep seat for baby as SSC or wraps (you can see my little one’s legs dangling in this picture, rather than being in a hip healthier ‘froggy’ position), and the facing out position is often not advised anyway. Plus, BB is the worst culprit for pulling the shoulders forward into hyper kyphosis (see below). So with regards to this particular carrier, I agree. But others?

Certainly, increased abdominal pressure could worsen diastasis.

And because babywering is usually done for a fairly long period of time (up to an hour+, compared to picking up a buggy or a short time carrying baby in your arms) then comparitavely it is likely to put more pressure on your pelvic floor.

Making sure you engage your core and floor while you babywear is important, and ideally seeing a Women’s Health Physio will make sure you’re doing this correctly, and assess how much babywearing your pelvic floor can cope with.

But you’re going to be carrying baby anyway, and a good fitting wrap or carrier will keep baby snug and closer to your centre of gravity, so easier to carry. And it should also be easier to correct your posture using a carrier, compared to having baby in your arms. In fact, a wrap can make baby feel even lighter, as it spreads the weight. So babywearing won’t necessarily delay healing, or increase abdominal pressure.

But you need to consider duration.

How long will you babywear for? You may need to start with short periods of babywearing and build up as you get stronger. Again, having your pelvic floor assessed for endurance by a WH Physio is the best way to know what’s suitable.

And you need to have the right posture.

You could be doing excellent work on rehabilitating your core, but if you stand in poor alignment all day you will be undoing all that work.

After having a baby you are left with a weakened core- the transverse abdominis, multifidis, pelvic floor and diaphragm work together to maintain stability as a unit, and your TVA and pelvic floor have just had a hard few months! So many women have postural problems after birth as it is. A poor wrap or fitting carrier will not help this.

If you’re not in alignment some muscles may not activate as effectively, while others overwork. Let’s look at what good posture should look like first.

posture postnatal abdominal seperation

How aignment affects diastasis recti

The cues you’re looking for are:

Ribs over hips with a slight arch in the lower back, tall upper spine, and chin tucked in (as opposed to head sticking out like a turtle).

Neutral pelvis. If you fully tilt your pelvic forwards (think glamour model back arch), then tuck your bum right under, neutral is roughly in the middle of these two extremes. The two most prominent points on your pelvis should be level with your pubic bone, forming a tripod.

For more detail here’s another video talking about rib position:

What does poor posture look like?

Imagine you’re standing with your fly undone. If your bum is tucked under (posterior pelvic tilt) or tilted forward (anterior pelvic tilt) the fly is more likely to gape. Same thing with diastasis, and your pelvic floor will not be in optimum alignment with your diaphragm. Regardless of whether you babywear, if you stand like this all day then DR is less likely to heal.

The problem is babywearing can exaggerate these postures.

Hyper-kyphosis is the ‘bell rung down’ position Julie Weibe talks about in the video above. It looks like slouching, and as well as hindering healing, it is a risk factor for pelvic organ prolapse (Altmen et al 2008).

Then there’s a sway back, which is quite common when carrying a baby- sticking out the tummy whilst leaning back to support baby up on your chest. The result- weakened core muscles, prevention of abdominal healing, and possibly low back and hip pain.

What about after C-Section?

I have seen the advice to avoid post c-section, but again, if you’ve recovered enough to lift your baby, I can’t see why you wouldn’t be able to wear him. My main concern would be pressure on the scar, and a stretchy or ring sling should sit much higher than that. I’ll discuss all the options below, along with guidelines to follow, but see here for one sling consultant’s experiences with various wraps post section.

Which carrier is best?

This is a bit like having to decide which flavour ice cream, is best, it depends who you ask! (Oh dear, I’ve got Craig David’s What’s Your Flavour in my head now.)

Stretchy Wrap

As the name suggests. It’s stretchy! Simply a length of material, but the stretch means you can pre wrap and slip baby in. Weight is distributed all over the shoulders and waist, and the stretch makes it really comfy.

Woven

A stretchy without the stretch, it takes a bit more getting used to these, but as baby gets heavier he will need more support, so this is the next step. There are multiple multiple ways to wrap with a woven, so there is loads of versatility to find a style comfortable for you, and that spreads the weight in an easy way to maintain good alignment.

Ring Sling

A sling that goes over one shoulder, you can do hip carries with an older baby, or a froggy position with a newborn. The downside is that the pressure is all on one shoulder (although it is spread over the shoulder) so keeping upright can become challenging after a bit. I struggled with more than 20 minutes with mine as it made my shoulder sore, but they were both large by this point and I was unused to the carry. The plus side is they’re quick to use, there’s no pressure on the waist itself, and newborns are light.

Soft Structured Carrier/ buckles

A panel, with a buckle at the waist and for the arm straps. Easy to use, and they come with different degrees of padding, so find the one you find comfiest and fits your shape best, so as to distribute weight as evenly as possible.

Mei Tai

Like a SSC but instead of buckles you tie the straps.

Are you wearing correctly?

Here are some tips-

  • Follow the TICKS guidelines. Having baby close enough to kiss in particular will help with posture.

  • Get help at your local sling library to make sure you’re wearing correctly, if you have one. Also try out a few different wraps to see what works best. There are online stores that rent slings, in the event there isn’t a library near you. For those local to me, Stork and the Bees are in Herts, there’s Harrow Sling Library or the Chiltern Sling Library are the nearest

  • BUY ALL THE WRAPS! Well, maybe not all, but owning a selection of carriers means you can vary the pressure on your body, kind of the same way it’s good to wear a variety of shoes for your foot health.

  • Take a break. If you do find yourself struggling with posture, or with a large DR, if possible try not to wear for long periods at a time, to give your body a rest. Also, getting dad to wear when he’s there gives you a break. And who doesn’t love a babywearing daddy?

And remember, if you get good posture to start, you’ll get stronger and it will get easier to maintain with time.

Babywearing can feel like a lifesaver if you have a clingy baby, and I wouldn’t want any mum to feel that she couldn’t do it. Plus, I see plenty of mums pushing buggies in poor alignment too.

Get it right and it’s a wonderful way to carry your baby, bond with your baby, and help build your own strength.

If you’re unsure about your alignment and how’s it’s affecting your recovery, it’s a big component of my Restore My Core programme. Click here to learn more and grab a spot on the next course.

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Do You Have Diastasis Recti?

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Maybe my first question should be have you heard of it? Because unfortunately many mums haven’t. But you know that poochy tummy some women are left with after having a baby? This can be the cause.

And those who have heard of diastasis tend to focus on closing the gap thinking then all will be well, but there’s a bit more to it than that, so read on to learn more…

What is Diastasis Rectus Abdominis?

The six-pack muscle (rectus abdominis) runs from your breast bone to your pubic bone and is joined together with a strong fibrous sheath called the linea alba.  In some pregnancies, the linea alba becomes a little darker in colour and is visible on your stomach. This is called linea negra which simply means “dark line”.

You may have heard people talk about your abdominal muscles “splitting”.  Your muscles don’t “split” because they’re already in a separated state and held together by the linea alba.  A split muscle is like a torn muscle, so if you’ve ever torn your hamstring, for example, you’ll know what this pain is like!  What happens to the abdominal muscles during pregnancy is completely painless, you aren’t aware of it, and I like to refer to it simply as abdominal “separation”.

The rectus abdominis stretches vertically (up and down your stomach) to accommodate your growing baby, and when it can’t stretch any further up and down it starts to separate horizontally (from left to right).

diastasis recti

I guess it’s a little bit like the linea alba is heavy duty cling film stretching apart. And when you’re growing a baby in there, it will stretch apart! When this happens, it’s called Diastasis Rectus Abdominis. It’s not clear how many women get this in pregnancy, as there isn’t a huge amount of reseach to go on. The latest research suggests that 100% of women develop it, but as Physical Therapist Julie Wiebe explains here, there are flaws in this study. Another one found that 66% of women had diastasis in the third trimester, and 53% continued to have it immedietely postpartum (read more here).

It should heal on its own by 8 weeks post partum, (Coldron et al 2008) but if it doesn’t don’t worry, this is far from uncommon! It just means you need to work out why it isn’t healing, and do a few restorative exercises to help.

If you don’t and your DRA remains, your body will be forced to rely on other muscles to stabilize the pelvis, which can lead to:

– Back pain

– Pelvic pain

– Incontinence

– Pelvic organ prolapse

– A tummy pooch that never goes away

It’s not just about closing the gap

In fact you can have a diastasis and still be functional. I have about a finger’s gap there still! You also need to consider the tension of the midline: there is a big difference between having a firm and functional gap, and a gap that is soft with lots of give.

You need to consider WHY the gap is there. Yes, you grew a baby (again well done for that! I never fail to be amazed by how awesome it is that we can do that!)

But it should heal in the first few months after giving birth. If it doesn’t, this is down to too much pressure in the abdomen which then pushes out on your tummy or down on your pelvic floor. This happens when your core isn’t functioning as it should, so it isn’t managing to control the pressure.

What to avoid

Any exercise that puts repeated forward pressure on your abdomen could very well be making your diastasis worse.

This means avoiding many common exercises such as crunches, sit-ups, and conventional planks. I discuss this in more detail in this blog.

Diastasis can also be worsened by poor posture and an imbalance in the muscles of the core.

So what do you need to do?

It’s about connecting with your core to recruit the right muscles, and this starts with how you breath. Which sounds too simple but it’s SOOO important, and where I start with all my clients. You can read more about this here.

And you can’t look at your core in isolation. Your alignment, nutrition and stress all affect your diastasis recti. And you have to do the exercises RIGHT (we look at all of this in my Restore My Core programme).

It sounds odd, but one of the hardest things for me is getting clients to back off: the exercises are subtle, and no way as hard as what you are probably used to doing. I struggled to get my head round it. I spent years working in gyms taking abs classes and pushing through that burn. But contracting the deep transversus abdominis muscle is subtle, and until you have connected and it is happening naturally you risk just engaging the abs and obliques and having them take over. Then they pull on the midline and stop your diastasis from healing. This blog has some diastasis safe exercises to get you started.

To learn how to test for diastasis recti sign up to my free Restore My Core mini course.

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The Post Natal Core Part 3 of 3: Alignment and Diastasis Recti.

The final video in my core series for Mums of Steel. Here I talk about alignment and how it can affect the healing of your diastasis recti.

If you haven’t already seen them, here is part 1 and part 2.

For an assessment and programme to help establish optimal alignment for diastasis repair, contact me for your free personal training consultation.

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The Post Natal Core Part 2 of 3: The Core Breath

The second in my video series for Mums of Steel, looking at how our breathing technique affects the core. An important part of core training that is often overlooked!

If you haven’t watched Part 1, click here to watch it first.

To make sure your post natal training is on the right track book onto a class here.

To watch the final part in this series, go to Part 3 here, about how your alignment can affect your post natal recovery.

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The Post Natal Core Part 1 of 3: What ‘Core’ Muscles Should You Be Working?

This is the first of 3 videos I did for Mums of Steel about the post natal core, looking at why the core doesn’t mean the abs, and what muscles we should be focusing on.

To watch the next video, explaining the importance of the ‘core breath’ and it’s role in stabilisation, watch part 2 here.

For a bespoke core restore programme find out more about personal training with me.

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Exercise As A New Mum: Can Less Be More?

I don’t think any mum has ever looked back at the first year of her child’s life and thought, “I wish I’d done more cleaning. Those dusty skirting boards still haunt me”.

What you do look back at and cherish are those moments when you are in a place of absolute peace; your baby is smiling at you as you lie next to him on the bed, reaching out for your finger, or sleeping on your chest, completely content in the safest place they know. Or when you were just gazing at him in wonder, still amazed that you could produce something so perfect.

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And he needs you.

He needs you at your best. You may not feel your best; you’re sleep deprived and hormonal. But you are everything that baby needs, you are perfect for him. He doesn’t care about what your tummy looks like.

What does matter is that you don’t feel exhausted from a too-long workout.

That your energy doesn’t suffer any more than necessary because you’re restricting your calories. That instead of looking in the mirror and finding faults with yourself, you can recognise that your body has just grown another human being and deserves to be treated with love and care so that it recovers as effectively as possible.

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Note that I said effectively, not quickly. For some women it may be quick: maybe they’ve followed an ante natal conditioning programme, maybe they’ve just got good genes. They don’t matter: you matter.

Your stomach muscles have stretched and most likely pulled apart. They have to repair and restore function before you can start building strength. If you do too much too quickly, you run the risk of making it worse and pushing outward on the abdominal wall.

And what about your pelvic floor muscles? 50% of women who have had children have some degree of pelvic organ prolapse (Hagen & Stark 2011). Rushing back into impact exercise, or even doing exercises that increase the pressure in your abdomen (crunches for example) put pressure on your pelvic floor muscles.  Trust me, prevention is better than cure, and you want to look after your pelvic floor.

Of course, there’s a reason so many mums overdo it.

They want to ‘get their body back’, lose the extra weight and tone their tummy. And that’s understandable. But the great thing is, the sensible gentle approach is also the most effective- if you rush and don’t allow your core to repair, you’ll be left with a poochy tummy.  And the exercises that are best at aiding this repair are gentle and can be done in as little as 10 minutes a day.

Make sure your exercise is a form of self-care, not a punishment.

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Just because you’re working to lose weight or your tummy does NOT mean you can’t embrace your body now. It has achieved something amazing, and deserves to be cared for, not forced through grueling unsuitable workouts (like a friend of mine did after her first, which she describes here), despite the fact you feel exhausted already. You are not being lazy- you’re sleep deprived!

Remember, your recovery is a process that takes months, not just the weeks leading up to your 6 week check. 100% you should exercise: regular movement is so important and will aid your recovery. But that exercise needs to be safe and effective, post-natal specific, and it doesn’t need to be anywhere near as much as some mums do. You should leave a workout feeling better than when you started it.

So enjoy your baby, and be kind to your body. There’s plenty of time for tougher workouts when you’re fully recovered and getting a good night’s sleep.

I’m going to leave you with a poem by Ruth Hulbert Hamilton that I’m sure you’ve read before, but if this doesn’t remind you to slow down and relax at this precious time, then I’ve got no chance!

BABIES DON’T KEEP

Mother, O Mother, come shake out your cloth,
Empty the dustpan, poison the moth,
Hang out the washing, make up the bed,
Sew on a button and butter the bread.

Where is the mother whose house is so shocking?
She’s up in the nursery, blissfully rocking.

Oh, I’ve grown as shiftless as Little Boy Blue,
Lullabye, rockabye, lullabye loo.
Dishes are waiting and bills are past due,
Pat-a-cake, darling, and peek, peekaboo.

The shopping’s not done and there’s nothing for stew
And out in the yard there’s a hullabaloo.
But I’m playing Kanga and this is my Roo,
Look! Aren’t his eyes the most wonderful hue?
Lullabye, rockaby lullabye loo.

The cleaning and scrubbing can wait till tomorrow
But children grow up as I’ve learned to my sorrow.
So quiet down cobwebs; Dust go to sleep!
I’m rocking my baby and babies don’t keep.

For information on post natal classes designed with all this in mind learn about my Restore My Core course here.

To find out about personal training, and get a personalised programme to follow at home along with advice on nutrition to aid recovery, click here.

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