ASK DR.MOORE February 04, 2005
Dr. Mark Moore, author of the gender selection book Baby Girl or Baby Boy--Choose the Sex of Your Child, answers readers' questions on pregnancy and pediatrics.
Pregnancy and Weight Gain
Q: I'm having difficulty getting back to my pre-pregnancy weight because I gained too much weight while pregnant. Do you have any suggestions?
Dr Moore: Weight gain during pregnancy is one of the most common concerns of the pregnant woman—now more than ever. Once the baby is born, it is a straight forward matter of caloric intake versus output. Mothers that become pregnant before they have lost all their weight from a previous pregnancy have a harder time returning to their original weight. The stress and commotion of a newborn is not conducive to eating right or exercising. It takes hard work and motivation to do it; and do it you will. Applying the same principles listed below for pregnant patients will help get you started.
Because prevention is often easier than the cure, I’d like to discuss managing weight gain during pregnancy for those planning to get pregnant or those who have recently conceived. Statistics on obesity and the American diet are frightening. Excess weight gain during pregnancy has become very common—we regularly see patients who have gained 50 pounds and it is not unusual to see women who have gained over 100 pounds during pregnancy.
Take control of this issue before you even become pregnant and you will be a happy mother. Start with this simple checklist:
1. Plan to be at a healthy weight before you get pregnant, which by the way, increases your fertility and the chance that you will become pregnant.
2. Continue healthy eating habits during your pregnancy.
3. Limit weight gain during pregnancy.
4. Do pregnancy approved exercise regularly during your pregnancy
5. After delivery, breast-feed for six months, eat a healthy diet (similar in amounts to your pre-pregnancy intake) plus do a daily walk; take the baby in a stroller if necessary.
There are two basic types of people. Those that have to "work at it" to stay fit (I’m this type), and those that seem to stay thin naturally (my wife is this type). The pregnancy weight gain issue is much more challenging for the "work at it" types than the "natural" types.
Biggest pregnancy myth: Pregnant women need to eat for two; Fact: it’s only 1 and 1/6. A pregnant mother only needs 300 extra calories per day–that’s the equivalent of two slices of bread.
Second biggest myth: Breast-feeding mothers need to eat for two. Fact: breast feeding mothers burn more calories than none breast-feeding mothers, which will help you get back to your pre-pregnancy weight easier. It is not necessary to gain weight to support milk production.
Many pregnant women are hungriest in the first trimester—be careful! Pregnancy is not a free pass to eat anything you want and without feeling guilty about weight gain. I have known some to start overeating the minute they even "think" their pregnant.
Expect an average weight gain of 15-25 lbs, smaller height women, and overweight women towards 15 lbs, taller and underweight towards 25 lbs. Don’t forget, the baby only weighs an average of 7.5 to 8 lbs (other aspects of the pregnancy account for the additional weight gain—placenta, increased blood volume, enlarged breasts, amniotic fluid and uterus growth). Multiple birth pregnancy and weight gain –expect higher amounts (35 lbs or more).
Get on a scale every morning—first trimester (first 13 weeks), minimal gain no more than 3-4lbs; for the remainder of the pregnancy (27 weeks), do not gain more than one-half to one pound per week. Realize that every calorie you put in your mouth counts. If you eat ten candy bars in one single day, you’ve passed your caloric requirement but failed your babies nutritional needs. In today’s world, calories are all too common. Read food labels. Look for low calorie/low fat foods with good protein content. Your prenatal vitamin supplement will ensure you receive many of the vitamins and minerals your growing baby needs. Eliminate or severely curtail the following in your diet as best as you can while during your pregnancy: Sugar, candy and other sweets; donuts, cakes and pies; soda and sugar drinks; french fries, potato chips and processed snacks. Drink skim milk or 1% instead of whole milk. Eat more vegetables, whole fruits, grain breads and broiled meats. Avoid fast food as much as possible. Bring your lunch to work.
Reasons to avoid obesity and too much weight gain during pregnancy: increased risk of a big baby (fatter baby, but not necessarily taller). Larger babies are harder to deliver and get stuck in the birth canal more often. They have a higher risk of nerve and brain injury due to difficult delivery. They also place the women at higher risk for surgical delivery of the baby (cesarean section). Gestational diabetes and pre-eclampsia (high blood pressure) are both increased in a pregnancy in which there has been too much weight gain. It is harder to get accurate measurements of the baby’s intrauterine growth and heartbeat on overweight pregnant women. There is more fatigue and unsteadiness on your feet. Recent studies have shown that excess weight gain during pregnancy may affect your child’s future risk for obesity.
Should you ever lose weight during pregnancy? It is not recommended. Every pregnancy is a unique pregnancy for that mother. Your doctor will help you with these guidelines and nutritional and dietary information for pregnancy is readily available in their office.
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Readers may send questions to our email address. This column is for informational purposes only and is not a substitute for professional or medical advice.
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