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The objective of this study was to investigate the relationships between postpartum health disorders and mid-lactation performance, feed efficiency, and sensor-derived behavioral traits. Multiparous cows ( n = 179) were monitored for health disorders for 21 days postpartum and enrolled in a 45-day trial between 50 to 200 days in milk, wherein feed intake, milk yield and components, body weight, body condition score, and activity, lying, and feeding behaviors were recorded. Feed efficiency was measured as residual feed intake and the ratio of fat- or energy-corrected milk to dry matter intake. Cows were classified as either having hyperketonemia (HYK; n = 72) or not ( n = 107) and grouped by frequency of postpartum health disorders: none (HLT; n = 94), one (DIS; n = 63), or ≥2 (DIS+; n = 22). Cows that were diagnosed with HYK had higher mid-lactation yields of fat- and energy-corrected milk. No differences in feed efficiency were detected between HYK or health status groups. Highly active mid-lactation time was higher in healthy animals, and rumination time was lower in ≥4th lactation cows compared with HYK or DIS and DIS+ cows. Differences in mid-lactation behaviors between HYK and health status groups may reflect the long-term impacts of health disorders. The lack of a relationship between postpartum health and mid-lactation feed efficiency indicates that health disorders do not have long-lasting impacts on feed efficiency.

Assessment of the Relationship between Postpartum Health and Mid-Lactation Performance, Behavior, and Feed Efficiency in Holstein Dairy Cows