Giuseppe Calcaterra, Giorgia Sinigaglia, Marcello Pinti, Valentina Bucciarelli, Chiara Martini, Federica Moscucci, Francesco Barillà, Savina Nodari, Vincenzo Montemurro, Susanna Sciomer, Sabina Gallina, Jawahar L. Mehta, Anna Vittoria Mattioli
BACKGROUND & AIMS: Breastfeeding is the optimal form of infant nutrition, conferring extensive benefits for both maternal and child health. Maternal physical activity likewise supports postpartum recovery, cardiometabolic health, and psychological well-being. Historical concerns have been raised about possible negative effects of exercise on breast milk composition, supply, and infant acceptance. This review synthesizes current evidence on the interplay between exercise and breastfeeding, with a focus on maternal and infant cardiometabolic health. METHODS: A structured literature search was conducted in PubMed and Scopus for the period January 2000-December 2024, using predefined keywords on breastfeeding, lactation, exercise, and maternal health. Eligible studies assessed maternal physical activity during lactation and reported outcomes on breast milk, maternal health, or infant development. Screening was performed independently by two reviewers following PRISMA guidelines. RESULTS: Moderate-intensity exercise (30-45 min per day) does not adversely affect milk volume, nutrient composition, or infant growth. Instead, it may enhance antioxidant levels in breast milk, improve lipid and hormonal profiles, and support maternal weight management. Transient lactate increases after strenuous exercise may alter milk taste, but normalize within an hour and have no clinical impact. Breastfeeding itself confers maternal cardiometabolic protection, lowering risks of hypertension, metabolic syndrome, and type 2 diabetes. Emerging data suggest maternal exercise during lactation may also influence infant metabolic programming, potentially reducing long-term risk of obesity and cardiovascular disease. CONCLUSIONS: Maternal exercise and breastfeeding are not mutually exclusive but synergistic in promoting maternal and child health. Accumulated evidence indicates that moderate maternal exercise does not compromise breast milk supply or its capacity to meet infant nutritional needs. IMPORTANCE: Healthcare providers should reassure postpartum women that moderate exercise is safe during lactation and encourage its integration into postpartum care. Future studies should explore high-intensity exercise, resistance training, and inter-individual variability to refine recommendations.