Your post-baby belly: why it's changed and how to tone it

Why do I still look pregnant?

It takes time for your body, and especially your tummy, to fully recover from pregnancy. You've had your baby, but you may look as if you're still six months pregnant, with a tummy that's squishier and rounder than you expected.

Imagine your tummy as a balloon, slowly inflating as your baby grows. Giving birth doesn't pop the balloon, it just starts a slow leak. The decrease in your tummy size may be slow, but it will be steady.

From the moment your baby is born, hormonal changes cause your tummy to decrease in size. However, it takes another six to eight weeks for your womb (uterus) to contract to its pre-pregnancy size (Berens 2019).

The extra fluid that built up in your body during pregnancy will gradually decrease, reducing swelling and bloating (Berens 2019). And any extra fat you put on to nourish your baby will start to burn off, especially if you're breastfeeding and exercising (Berens 2019). But it takes at least a few weeks to see noticeable results.

After giving birth you may still have a dark line down your tummy called a linea nigra, as well as a web of stretch marks.

The linea nigra is caused by pigmentation in the skin where your tummy muscles have stretched and slightly separated, to accommodate your baby as she grew (APA nd). This line of pigmentation usually fades within a few months of giving birth (APA nd).

Stretch marks are caused by your skin stretching over your fast-growing body during pregnancy (NHS 2019c). You may have them on your tummy, thighs and breasts (NHS 2019c).

You can't get rid of stretch marks completely, but they will fade over time. Eventually, the lines will look like fine streaks that are closer to your skin colour (NHS 2019c). Try to be patient. You may not like your stretch marks now, but they will look a lot better in six months' time.

How long will it take for my belly to shrink back to normal?

We've all heard stories of new mums who regain their pre-pregnancy bodies within weeks of giving birth. Although this is possible, it doesn't happen that way for most mums. Bear in mind that your body may change shape after pregnancy. You may find it difficult to return to your exact pre-pregnancy weight or shape.

Patience is the key. It took nine months for your tummy muscles to stretch to accommodate a full-term baby. So it makes sense that it can take weeks or months to tighten up again (Berens 2019).

The speed and degree of this tightening up depends on a few factors, including:

• What shape and size you were before you conceived your baby.
• How much weight you gained during pregnancy (NICE 2010).
• How active you are (NICE 2010).
• Something you can't do anything about: your genes.

You may find it easier to shed the weight if:

• You gained less weight than average during pregnancy.
• You breastfeed.
• This is your first baby.
  (Berens 2019)

Most women don’t get back to their pre-pregnancy weight until about six months after their baby's birth (IQWiG2018, Adegboye et al 2013).

How can I safely lose weight to help my belly look better?

Breastfeeding may help, especially in the early months after giving birth. If you breastfeed, you'll burn extra calories to make milk – about 300 calories a day (NHS nd), though the exact amount is different for everyone. You may lose your pregnancy weight more quickly than mums who formula-feed their babies but it’s not guaranteed (Jarlenski et al 2014).

Breastfeeding also triggers contractions that help to shrink your womb, which may help you to get in shape faster. However, if you eat more than you burn off, you will put on weight, even if you breastfeed (Adegboye et al 2013).

It's fine to lose weight while you are breastfeeding. Your body is very efficient at making milk, and losing up to 1kg (about 2lb) a week shouldn't affect the amount of milk you make (Adegboye et al 2013, NICE 2010).

However, if you have a newborn to look after, you'll need plenty of energy. Trying to lose weight too soon after giving birth may delay your recovery and make you feel even more tired (IQWiG 2018). It’s especially important not to attempt a very low-calorie diet (NHS 2019a). So try to wait until you've had your postnatal check before trying to lose weight (NICE 2010).

Eating healthily, combined with gentle exercise, will help you to get in shape (Adegboye et al 2013). The following general guidelines will help you to achieve and maintain a healthy weight:

• Make time for breakfast.
• Eat at least five portions of fruit and vegetables a day.
• Include plenty of fibre-rich foods, such as oats, beans, lentils, grains and seeds, in your diet.
• Include a starchy food such as bread, rice, pasta (preferably wholegrain varieties for added fibre) or potatoes in each meal.
• Go easy on high-fat and high-sugar foods, such as biscuits, cakes, fast food and takeaways.
• Watch your portions at mealtimes and the number and type of snacks you eat between meals (NICE 2010).

There's no right answer about how many calories a day you should have. The amount you need to eat depends on your weight and how active you are (Amorim Adegboye et al 2013). For more tips on healthy weight loss after birth, see our diet for a healthy breastfeeding mum and parents' tips for managing your weight after having a baby.

What else can I do to help regain my pre-pregnancy belly?

Exercise can help to tone stomach muscles and burn calories (Evenson et al 2014, Amorim Adegboye et al 2013). You can do light exercise like walking and stretching even in the early weeks after having your baby (POGP 2017).

If you stopped exercising during your pregnancy or are a newcomer to fitness, start slowly and gradually build up your exercise levels (POGP 2015).

Fitness aside, all new mums can begin pelvic floor exercises and work on gently toning up lower tummy muscles as soon as they feel ready (Evenson et al 2014, POGP 2017). This may help you to get back to your pre-pregnancy shape and help to flatten your tummy (POGP 2017).

When you feel up to it, take your baby out for walks in his buggy (Evenson et al 2014). Getting out and about will help to lift your mood and exercise your body gently (Evenson et al 2014, NHS 2019b). You may find there are buggy workouts with other new mums in your local park.

Read about toning up after a caesarean.

My tummy muscles feel slack. Is this normal?

If your tummy muscles feel very slack, it could be because pregnancy has over-stretched them (St George's Healthcare 2018, Berens 2019). If this is the case, you may also notice a bulge developing on the front of your tummy, above and below your belly button (St George's Healthcare 2018).

The medical term for this over-stretching is diastasis recti (DR) (St George's Healthcare 2018). Diastasis simply means separation.

There are four layers of muscle across your tummy. The top layer is a pair of long, flat muscles that run vertically down each side of your abdomen (rectus abdominis), commonly known as the six-pack (Guy's and St Thomas' 2014). DR happens when the two halves pull away from each other, stretching and thinning the connective tissue between them (St George's Healthcare 2018).

At least half of women experience DR after having a baby (St George's Healthcare 2018). It's more likely to happen if you:

• have given birth more than once (Nahabedian and Brooks 2019)
• had twins or more (Donnelly 2019, Nahabedian and Brooks 2019)
• have had more than one caesarean birth (Nahabedian and Brooks 2019)
• regularly strained your abdominal muscles during pregnancy through frequent heavy lifting (Sperstad et al 2016), straining on the toilet, or chronic coughing or vomiting (Donnelly 2019)

There's not enough research to tell us whether being obese before pregnancy, or gaining a lot of weight during pregnancy, also makes DR more likely (Nahabedian and Brooks 2019).

It's likely that DR may run in families (Donnelly 2019), so if your mother or sister has DR, you're more likely to develop it too.

If you’re unsure whether you have DR, here's how to check:

• Lie on your back, with your knees bent and your feet flat on the floor or bed.
• Place your palm down on your tummy, just below or above your belly button.
• Lift your shoulders off the floor slightly and look down at your stomach. With the tips of your fingers, feel between the edges of the muscles, both above and below your belly button.
• See how many fingers you can fit into the gap between the muscles. The number of finger widths is the size of your diastasis. Do the test regularly - as your muscles get stronger, the gap should reduce.
  (NHS 2019d)

If the gap you feel is bigger than two finger-widths, you may have DR (Nahabedian and Brooks. 2019).

The separation gap often returns to normal within the first eight weeks after giving birth (NHS 2019d, St George’s Healthcare 2018). If the size of the gap hasn’t decreased, or you’re worried about it, see your GP or health visitor. She may be able to refer you to a women's health physiotherapist who can give you specific exercises to help you (NHS 2019d). In some areas of the UK, you may be able to refer yourself directly for physio.

Leaving DR untreated isn't harmful, but it may weaken your abdominal core. This can increase your chances of getting a bad back and will make exercise and other activities more difficult (Hills et al 2018, Nahabedian and Brooks 2019).

More information:

• Find out more about diastasis recti.
• Check out these real-life post-baby belly pics.
• See Sarah Cawood's brutally honest diastasis recti journey.
• Learn more about exercising after having a baby.