Postpartum recovery: what really helps your body recover

Several things heal at the same time, at different rates.

The uterus gradually returns to its size over around six weeks. The perineum and, in the case of a caesarean section, the abdominal wall heal over several weeks to several months. The abdominal muscles, stretched for nine months, slowly readjust. Iron stores are often low, due to the demands of pregnancy and blood loss during childbirth. And hormones drop sharply as soon as the placenta is delivered.

This explains why this fatigue is unlike any other.

This is the area where you have the most control. The postpartum period is a time when needs are high and eating well is often difficult due to lack of time. Three priorities:

• Protein, at every meal. It supports tissue repair and the maintenance of muscle mass, particularly useful if you return to sport or exercise sessions. A simple guide: a portion the size of your palm at each meal, whether meat, fish, eggs or pulses. It also supports your energy over time, long before any product or supplement.
• Iron, often low after childbirth, due to the demands of pregnancy and blood loss during delivery. Red meat, black pudding and pulses are the best sources; combine them with a food rich in vitamin C to improve absorption, and keep tea and coffee away from meals, as they hinder its absorption. If fatigue persists despite a diet that covers these bases, a blood test can check your stores and guide management.
• Adequate intake. The postpartum period is not the time to restrict your diet. If you are breastfeeding, energy requirements increase significantly, by around 500 kcal per day according to ANSES guidelines (8). Restricting your diet during this period can affect both your recovery and, if breastfeeding, milk production.

These postpartum nutrition guidelines are those routinely recommended; a dietitian can adapt them to your situation, particularly in the event of confirmed iron deficiency.

It is also the most frustrating, because it is the one you have the least direct control over. The suggestions below are general principles: they do not apply to every situation, depending on whether you are alone or have support, what your baby does at night, or how breastfeeding is going.

Sleep when the baby sleeps help when possible, even if only for a twenty-minute nap. This is not always feasible, and it is not a failing if it is not for you.

If you have support around you, having someone take over for a night from time to time, with expressed milk or a bottle, can make a real difference to recovery. If this option is not available to you, it is not a problem you need to solve alone.

If lack of sleep is linked to breastfeeding difficulties (poor latch, endless feeds, pain, baby never unlatching), the right person to speak to is an IBCLC lactation consultant. Many difficult nights improve significantly once the breastfeeding issue has been identified and addressed.

Don’t wait until you’re exhausted to ask for help, if you can: a loved one taking over for two hours while you sleep is a real act of support for your recovery. The role of those around you matters just as much as any nutritional advice during this period.

It is rarely discussed, yet water requirements increase significantly postpartum, particularly if you are breastfeeding: milk production uses around 700 to 800 ml of additional water per day on top of your usual needs, and this production depends directly on your own hydration.

The simplest guide remains the colour of your urine: if it is pale, hydration is sufficient; if it is dark, it is time to drink more. Keep a bottle of water within reach where you breastfeed or bottle-feed, as this is often where thirst strikes and you do not have a free hand to fetch one.

Herbal teas and broths also count towards your daily intake and can be a pleasant way to vary things.

It is the question every sporty mum asks: when can I get back to it? The answer can be summed up in one word: gradually.

Rehabilitation first. French recommendations advise pelvic floor rehabilitation in cases of urinary incontinence persisting 3 months postpartum (9). In practice, a pelvic floor assessment before returning to exercise is also widely recommended as a preventive measure, even without symptoms, as the pelvic floor plays a central role in almost every exercise, including those that seem unrelated. Returning to running, fitness or traditional abdominal exercises without this assessment is not a good idea. Have your abdominal wall assessed too, particularly in the case of diastasis: a separation of the abdominal muscles along the midline, common towards the end of pregnancy, which resolves for most women in the months following childbirth, but not always. A physiotherapist can assess it precisely and guide you on which exercises to prioritise or avoid in the meantime.

Walking, straight away. It does not require any particular clearance, and it already counts as physical activity.

Then short, gradual sessions. Three twenty-minute sessions are better than one long session that leaves you exhausted for two days. Gentle strengthening, adapted core work and mobility exercises. High-impact exercises and traditional abdominal exercises come last, once your pelvic floor has been assessed.

A coach trained in postpartum care, if you can. A postnatal specialist fitness coach or physiotherapist will know how to adapt your sessions and exercises to your actual condition rather than your pre-pregnancy level. This is different from a conventional performance coach, whose programmes do not always take ongoing healing into account. Ask your coach whether they have specific training or experience in postpartum care: not all fitness coaches do.

Realistic goals. The first few months are not the time to aim for performance. The goal is to rebuild a solid foundation, as most specialist physiotherapists recommend, not to regain your pre-pregnancy results in six weeks.

Creatine is involved in energy production in muscle cells, a mechanism that is the same in women and men. Among male and female athletes, creatine monohydrate is one of the best-documented supplements for muscle recovery after exercise. These same recovery mechanisms are of interest for the postpartum period. It is associated with less muscle damage and inflammation after intense exercise, and it supports muscle mass and strength, particularly in women. (1)

Two other avenues are of interest for the postpartum period, although they have not been tested in this specific context. The first concerns mental fatigue. Under normal circumstances, the brain produces the creatine it needs. But in cases of significant stress or lack of sleep, two situations that are very common after giving birth, this production is no longer sufficient, and the brain becomes more dependent on what is provided by food or a supplement. It is in these specific situations that supplementation has shown an effect on mental fatigue in studies. The second avenue concerns sleep itself, where preliminary research suggests a positive effect on its duration and quality. (2, 3)

These avenues remain extrapolations from other populations: no study has specifically involved postpartum women.

Safety, dosage and other practical considerations

In women generally, the safety of creatine monohydrate is well established. A systematic review of 29 studies involving nearly 950 women found no serious adverse effects, nor any significant difference in digestive issues, weight, or kidney and liver function. (4)

There is no validated dosage protocol specifically for the postpartum period. The usual guideline is 3 to 5 g per day, taken continuously. A loading phase at a higher dose for a few days is not mandatory: it speeds up the saturation of stores without improving the final outcome.

Creatine is a natural component of breast milk, where it covers around 9 to 10% of an infant’s daily requirements, with the remainder produced by the baby itself. Its concentration is highest in colostrum, just after birth, then decreases markedly over the first two weeks. (5, 6)

What is not known, however, is what happens to this creatine from breast milk when the mother takes a supplement: no study has measured its level in this situation or assessed any potential effects on the breastfed baby (5).

This is why, as with any supplementation during breastfeeding, advice from a healthcare professional is essential before starting. This is also the position of LactMed, the National Institute of Child Health and Human Development’s reference database on substances and breastfeeding.

One final practical point: creatine is converted into creatinine, both in the mother and in the baby. This may increase the infant’s blood creatinine level and affect the assessment of kidney function during a check-up.

Creatine is found in foods of animal origin: mainly meat and fish, with small amounts in dairy products. Despite their reputation, eggs provide virtually none, as it is stored in muscles. However, they do provide methionine, one of the three amino acids the body uses to produce it, along with glycine and arginine.

The estimated dietary requirement for adult women is around 0.75 g per day, while the body produces around 1 g itself. (7) (10) One to two portions of meat or fish per day are generally sufficient.

If you follow a vegetarian or vegan diet, your intake is naturally lower, and blood creatine levels are lower in vegan mothers than in omnivorous mothers. (11) This is something to discuss with a dietitian as part of your wider postpartum nutrition.

Créatine Mama

Our Creavitalis® creatine monohydrate, a patented form and the best documented to date. Each serving provides 3 g of pure creatine, the amount used in studies.

Most research on creatine has been conducted in men, often athletes. Créatine Mama is designed for women at every stage of life. One serving a day in a large glass of water, with no loading phase.

Pregnant or breastfeeding? Ask your healthcare professional for advice before starting.

Worsening fatigue, lasting sadness, the feeling that you are no longer yourself, thoughts that worry you: this is not a lack of willpower and it is not a deficiency to correct. The postpartum depression is a common condition, and it can be treated. Heavy bleeding, persistent pain or a fever also warrant prompt medical advice.

In these situations, contact your doctor or midwife.

Postpartum recovery: key points to remember

Postpartum recovery takes longer than people say, and the factors that matter are not particularly spectacular: the sleep you manage to catch up on, nutrition that meets your protein and iron needs, and a gradual return to exercise, with rehabilitation first.

Creatine is an interesting complementary option, well tolerated by women, with consistent indications regarding muscle recovery and mental fatigue. However, no studies specifically concern the postpartum period, and in the case of breastfeeding, the recommendation is to avoid supplementation unless advised by a doctor