Weight gain during pregnancy

How much is too much and too little weight gain during pregnancy

Everyone knows eating a healthy and balanced diet helps the baby get adequate and appropriate nutrients that are needed for baby’s growth at a healthy rate. But what most pregnant women do not know is how many extra calories do they really need? Many times they are told to “eat for two”!! However, this usual age old advise of ''eat for two'' is a myth and medically incorrect.

The average pregnant woman needs only about 300 healthy additional calories. This will help them gain the right amount of weight during pregnancy. So, the question many women have in their minds is what is right amount of weight gain during pregnancy? How much is too much? How much is too little?

Here are some facts:

During the first trimester of pregnancy tiny fetuses have very tiny nutritional needs. There is no need to gain any weight at all and it is perfectly normal. In fact, some women may even lose a few pounds because of morning sickness that is usually okay, as long as weight gain in later part of pregnancy is appropriate.

However, the same is not true when we talk about weight gain in second trimester. As the baby gets bigger, demand for calories and nutrients increases and to keep up with that increased demand, there is a need for steady weight gain. There comes that question again-How much is normal gain, how much is too much and how much is too little weight gain?

The amount of weight a woman gains during pregnancy depends on several factors which include:

• Pre-pregnancy body mass index (BMI)
• Number of Fetuse
• Physical activity levels
• Nutritional habits

By the second trimester, weight gain aim for women with different BMI weight ranges should be as follows:

(1 pound= approximately 450 grams)

• Underweight (BMI under 18.5) before pregnancy: About 1 pound per week (28 to 40 total pounds total during pregnancy)
• Normal BMI (18.5 to 24.9) before pregnancy: Less than 1 pound per week (25 to 35 pounds total during pregnancy)
• Overweight (BMI 25 to 29.9) before pregnancy: About 0.6 pounds per week (15 to 25 pounds total during pregnancy)
• Obese (BMI 30 or more) before pregnancy: About 0.5 pounds per week (11 to 20 pounds total during pregnancy)

If the woman is carrying twins, she needs to gain roughly 50 percent more weight (again depending on her pre-pregnancy weight). It's especially important to gain the right amount of weight when you're expecting twins because your weight affects the babies' weight. And because twins are often born before the due date, a higher birth weight is important for their health. When carrying twins, you may need between 3,000 and 3,500 calories a day.

Where does the extra weight go during Pregnancy?

• Baby: 8 pounds (approximately)
• Placenta: 2-3 pounds
• Amniotic fluid: 2-3 pounds
• Breast tissue: 2-3 pounds
• Increased Blood supply: 4 pounds
• Stored fat for delivery and breastfeeding: 5-9 pounds
• Larger uterus: 2-5 pounds
• Total: 25-35 pounds

How to ensure that you gain the right amount of weight during Pregnancy?

Following are the tips to gain right amount of weight instead of gaining too little or too much:

1. Eat five to six small meals every day.
2. Keep quick, easy snacks handy, such as nuts, raisins, cheese and crackers, dried fruit, and ice     cream or yogurt.
3. Spread peanut butter on toast, crackers, apples, bananas, or celery. One tablespoon of creamy peanut butter gives you about 100 calories and 7 grams of protein.
4. Add nonfat powdered milk to mashed potatoes, scrambled eggs, and hot cereal.
5. Add extras to your meal, such as butter or margarine, cream cheese, gravy, sour cream, and cheese.

What if you gain too much weight during Pregnancy?

Gaining too much weight can dramatically increase your risk of gestational diabetes. It also may pose several risks for your baby in the form of having bigger babies with increased risk of operative delivery, babies with breathing problems and children who later in life are overweight and/or develop diabetes.

If you have gained more weight than recommended, it is wise to talk to the obstetrician about it. In most cases, it is worthwhile to wait until after delivery to lose weight. However below are some tips to slow down the weight gain:

1. When eating fast food, choose lower-fat items such as broiled chicken breast sandwich with tomato and lettuce (no sauce or mayonnaise), side salad with low-fat dressing, plain bagels, or a plain baked potato. Avoid foods such as French fries, mozzarella sticks, or breaded chicken patties.
2. Avoid whole milk products. You need at least four servings of milk products every day. However, using skim, 1%, or 2% milk will greatly reduce the number of calories and fat you eat. Also, choose low-fat or fat-free cheese or yogurt.
3. Limit sweet or sugary drinks. Sweetened drinks such as soft drinks, fruit punch, fruit drinks, iced tea, lemonade, or powdered drink mixes have lots of empty calories. Choose water, club soda, or mineral water to skip extra calories.
4. Don't add salt to foods when cooking. Salt causes you to retain water.
5. Limit sweets and high-calorie snacks. Cookies, candies, donuts, cakes, syrup, honey, and potato chips have a lot of calories and little nutrition. Try not to eat these foods every day. Instead, try fresh fruit, low-fat yogurt, strawberries, or pretzels as lower-calorie snack and dessert choices.
6. Use fats in moderation. Fats include cooking oils, margarine, butter, gravy, sauces, mayonnaise, regular salad dressings, sauces, lard, sour cream, and cream cheese. Try lower-fat alternatives.
7. Cook food the healthy way. Frying foods in oil or butter will add calories and fat. Baking, broiling, grilling, and boiling are healthier preparation methods.
8. Exercise. Moderate exercise can help burn excess calories. Walking or swimming is usually safe for pregnant women. The obstetrician can suggest what exercise would be right for you before getting started.

What are the reasons for a woman not gaining weight during pregnancy?

For most women, pregnancy weight gain comes easily. But for some the problem isn’t gaining too much weight – on the contrary it’s not gaining enough. Here is how to get your pregnancy weight gain on track, and when it is time to seek medical advice.

A number of factors can contribute to not gaining enough weight when a woman is pregnant. Causes of slow or no weight gain in pregnancy includes

• A fast metabolism
• Morning sickness
• Loss of Appetite
• Concerns over body image
•  Other medical reasons

What happens if there is not enough gain in weight during pregnancy?

Not gaining enough weight over the course of pregnancy can put the woman and her baby at greater risk of complications. Babies whose mothers gain too little weight during pregnancy are more likely to:

• Be born prematurely
• Be small for their gestational age
• Suffer growth restriction in the uterus

Some babies who are born small may have trouble breastfeeding and be at greater risk for illnesses and having delayed developmental milestones.

How to gain more weight during pregnancy?

It sounds obvious, but it's worth repeating. If you're eating the recommended calories during pregnancy and you're not gaining weight fast enough, you should eat more.

It’s easier said than done but try not to stress if you’re not gaining the advised weight. Your doctor or a registered dietitian can help create a meal plan for you.

Here are a few tips to help you put on more weight during pregnancy:

1. Choose nutrient-dense foods

If you’ve lost your appetite, focus on high-quality calories in small packages filled with healthy fats, protein and fiber. Nutrient-rich options include:

Avocados, Nuts and nut butter, Fatty fish (like salmon), Olive oil, Beans , Peas, Whole grain bread, cereal and pasta, Oatmeal, Brown rice , Lean meat or poultry, Plain Greek yogurt, Dried fruit, Eggs, Cheese.

2. Add a caloric punch to your dishes.

Try dosing your dishes with an extra tablespoon of calorie-dense olive oil, butter, cream cheese, sour cream or cheese. Or toss a couple of scoops of powdered milk in hot cereal or scrambled eggs.

3. Adding protein supplements to your meals can help you gain weight. Talk to your doctor to make sure you get the right amount.
4. Eat strategically.

It’s important to drink plenty of water during pregnancy to stay hydrated. Fruits and vegetables are a staple of a healthy pregnancy diet. They provide your baby with folic acid, a vitamin that helps form healthy cells and reduces the risk of birth defects like spina bifida.

That said, both beverages and calorie-light dishes can put a damper on your appetite. Instead of starting your meal with a salad or big glass of water, save the beverages and greens for after your main course.

5. Don’t turn to junk foods.

While it might be tempting to fill the caloric gap with doughnuts, try to resist the urge. Processed, sugary or greasy foods will add weight but not nutrition. Right now, you and your baby need both.

Try not to skip meals, even if you’re feeling nauseous. Instead of eating three large meals a day, try having six smaller snack-sized bites every two hours or so. Eating smaller, frequent meals also helps combat morning sickness.

If you don't feel like eating, make yourself a thick smoothie and add wheat germ to make it nutritious.

6. Compensate for exercise-

Have a regular exercise routine. Exercise during pregnancy is excellent for your health and your baby’s in most cases. Just be sure to check in with your obstetrician on your fitness program and make sure you’re eating enough to hit your caloric goals.

To make up for a sweat session, eat a nutrient-dense snack around the time you exercise. It’s especially important if your workout involves high-intensity exercise or lasts longer than 45 minutes.

Sometimes, severe and continuous nausea and vomiting can keep you from gaining weight during pregnancy. If you’re among the 1 to 3 percent of women who develop hyperemesis gravidarum, your baby may not be getting the vital nutrients and vitamins he needs to grow. You may also be dehydrated, which can be a problem for both you and your baby.

Be sure to let your doctor know if your morning sickness is severe. Signs of hyperemesis gravidarum include not being able to keep food or liquids down and losing weight. Your practitioner may prescribe lifestyle changes or medication to help you manage the condition.

Finally, if you’ve struggled with an eating disorder in the past, it can be challenging to accept pregnancy weight gain. Speak honestly with your practitioner about past or present disordered eating. He or she may recommend seeing a registered dietitian with expertise in eating disorders for extra guidance. Building a supportive team can make it easier to ask for help when you need it. Remember that gaining weight is essential for your baby’s growth and health.

Remember the Mantra: Everything in Moderation-Be it calorie intake, food choices, weight gain and exercise. This will ensure optimum pregnancy outcome.