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Female participation in sport is growing, including at the elite level. The Tokyo 2020 Olympic Games saw the most gender-equal athlete pool in Summer Olympic Games history along with a female athlete-led campaign to prevent the separation of a lactating athlete from her infant.1 Despite growing numbers of females participating in exercise and sport during pregnancy, there is very little evidence to guide the return to sport following childbirth, and even less evidence on the relationships between lactation and sport participation and performance.2 Exercise has been shown to be compatible with lactation and does not negatively influence milk production or nutritional quality.2 However, elite athletes have reported several barriers to training and competing while lactating, including (1) lack of access to lactation consultants, (2) lack of knowledge among healthcare providers on guiding lactation while meeting the training requirements of an elite athlete and (3) fear of sustaining a bone stress injury (BSI) while lactating.3
The unique physiological status of a lactating female athlete combined with the relative lack of evidence on postpartum exercise poses a clinical challenge to healthcare providers working with these athletes. Several factors, such as changes in endocrine function and increased caloric needs, may influence a lactating athlete’s risk …
Contributors Dr RED came up with the concept and was the primary author of the paper. Dr MLM revised the manuscript and provided guidance on updated REDs diagnostic criteria.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests MLM is an Associate Editor of the BJSM and a member of the editorial board of the BJSM IPHP.
Provenance and peer review Not commissioned; externally peer reviewed.