FOOD AND WEIGHT GAIN DURING PREGNANCY ...

Weight Gain DURING PREGNANCY

 Gaining the right amount of weight during pregnancy helps to make sure the pregnancy outcome for both mother and baby is healthy. Women who gain too little weight are at risk of having a small baby (less than 5 1/2 pounds). On the other hand, women who gain too much weight have a greater risk of having an early baby or a large baby. Additionally, gaining too much weight during pregnancy may be associated with health problems such as gestational diabetes, high blood pressure (preeclampsia), and varicose veins in the mother. In addition to weight gain associated with the growth of the baby during pregnancy, pregnant women store fat to prepare for breastfeeding. Women below optimal weight need careful monitoring and meal planning advice in preparation for breastfeeding. The chart, “Where Does Weight Gain Go?” highlights the typical distribution of weight during pregnancy.

GOALS FOR WEIGHT GAIN        

 Goals for weight gain should be based on pre-pregnancy weight, height, age, and usual eating patterns. In 1990, the IOM issued guidelines for weight gain during pregnancy, which are still used today. Because every woman and every pregnancy is unique, pregnant women should talk to their healthcare provider to ensure proper weight gain throughout their pregnancy. A weight gain of 25 to 35 pounds is considered normal for healthy women of normal weight (with a BMI of 18.6 to 24.9). BMI is one way to determine if individuals are at an appropriate weight. This tool can also be Baby 71⁄2 Placenta 11⁄2 Amniotic fluid 2 Mother Breasts 2 Uterus 2 Body fluids 4 — Blood 4 — Maternal stores of fat, protein, & other nutrients 7 TOTAL 30 lbs. SOURCE: Planning Your Pregnancy and Birth, Third Edition, American College of Obstetricians and Gynecologists (ACOG). Approximate Weight Gain, in pounds WHERE DOES THE WEIGHT GO? Women should listen to their bodies’ signals and stop eating when they feel full, instead of overeating because “you’re eating for two.” used to determine how much weight a woman should gain during pregnancy. See chart on page 3. Obese women (BMI > 30) can have successful pregnancies and healthy babies if they watch their weight gain. Obese women should gain no more than 15 pounds, but cutting calories below required levels during pregnancy has been associated with reduced birth weight and is not recommended. It is also suggested that obese women receive nutrition counseling to ensure they get enough nutrients and regular physical activity, and to discourage weight loss during pregnancy. Carrying multiple babies presents unique challenges. Regardless of their pre-pregnancy weight and height, women carrying twins should gain 35 to 45 pounds, and women carrying triplets, 50 pounds. PATTERN OF WEIGHT GAIN Patterns of weight gain are as important as total weight gain. While setting goals for total weight gain is important, weight gain progress needs to be carefully monitored. These records of weight gain will begin with taking accurate measurements from the first prenatal visit with regular weigh-ins recorded at each visit. Weight maintenance or slight weight losses are normal during the first trimester, or first 13 weeks of pregnancy. However, women should aim to gain a total of four pounds during this time. Weight gain should come from the nutrient-dense foods described earlier in this brochure. Women should listen to their bodies’ signals and stop eating when they feel full, instead of overeating because “you’re eating for two.” Women with healthy pre-pregnancy weights should gain an average of one pound a week during the second and third trimesters. Women who are underweight before conception should gain slightly more than one pound per week. Those who were initially overweight should gain at a slower rate (slightly more than a half a pound per week). 

FOOD CRAVINGS AND AVERSIONS 

Food cravings and dislikes of certain foods are common during pregnancy. There is no evidence that food cravings result from nutritional deficiencies, and their cause remains a mystery. It is acceptable to satisfy food cravings within reason, especially when they supply nutrients to the diet. In rare cases, some pregnant women crave nonfood substances, such as laundry detergent or clay. This is called pica. The consumption of nonfood items can be dangerous for both mother and baby. In some cases pica involves eating large amounts of nonfood items that displace foods and interfere with getting enough nutrients. Examples of these nonfood items include clay, starch, ice, coffee grounds, or baking soda. If a woman experiences nonfood cravings, she should talk to her healthcare provider right away.

 PHYSICAL ACTIVITY 

                                             

Physical activity is another critical part of good health. Pregnant women are encouraged to include 30 minutes or more of moderate physical activity on most, if not all, days of the week. Activities may include walking or swimming, but should not include those associated with a high risk of falling or injury. If being physically active for 30 minutes at one time is not possible in your schedule, you can split up the time into three 10-minute intervals throughout the day. Women with special circumstances should consult with their healthcare provider about how much exercise and at what intensity is right for them.

Breastfeeding Pregnancy and Breastfeeding Research has shown that there is no better food than breast milk for a baby’s first year of life. Breast milk provides good nutrition, immunity boosters, and nutrients aimed at brain development for newborns and infants. Also, current scientific evidence shows that breastfeeding may help prevent childhood obesity. Some components of breast milk enhance the baby’s natural defenses and promote development of the immune system. In fact, research suggests that breastfeeding may be associated with a reduction in risk of food allergy in high-risk infants (those with a parent or sibling with food allergies). That said, there is still some debate surrounding the degree to which breastfeeding prevents, reduces, or delays the development of allergy. Research has also shown that children who are breastfed may have a lower risk of developing asthma. The World Health Organization (WHO)/UNICEF infant feeding guidelines support exclusive breastfeeding for the first six months of life and the continuation of breastfeeding, together with age-appropriate solid foods, up to two years of age or beyond. While breastfeeding is highly encouraged, iron-fortified and water-based soy formulas can also be given to infants, if breastfeeding is not possible