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Maternal Weight Gain During Pregnancy

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Many people believe that pregnancy allows a woman to “eat for two” with no concern regarding weight gain. However, nutrition experts say this is not exactly true. It is true that weight gain — within limits — is important during pregnancy. Extra calories provide nourishment to your developing baby and are also stored for breastfeeding your baby after delivery. On the other hand, excessive weight gain brings with it a variety of complicated risks such as:

  • Stillbirth
  • Preeclampsia (an abnormal state of pregnancy characterized by hypertension and fluid retention)
  • Glucose intolerance
  • Cesarean delivery
  • Macrosomia (having a large baby for the gestational period)
  • Varicose veins
  • Difficulty breastfeeding
  • Postpartum weight retention
  • Childhood obesity in your baby’s future

Unfortunately, it is not as simple as avoiding weight gain. There are risks associated with not gaining enough weight if you are not overweight before becoming pregnant, including:

  • Low birth weight or very low birth weight baby
  • Preterm birth
  • Neural tube defects

How Do You Know How Much Weight Is Enough To Gain?

1. Find your pre-pregnancy Body Mass Index (BMI). Your BMI is a measure of body composition based on height and weight. To calculate your BMI, use the following link: http://www.cdc.gov/nccdphp/dnpa/bmi/, or you can use the following equation:

Weight in kilograms
(Height in meters)2

2. After you know your BMI, you can classify your pre-pregnancy weight based on the classifications made by the World Health Organization:
Weight Gain Pregnancy Table
3. Once you know what classification you fall under, you can see how much weight you should plan to gain, based on the Institute of Medicine recommendations:
Pregnancy Weight Guide
The Institute of Medicine modified the recommended weight gain range after 19 years. The reason for the new guidelines is that there have been dramatic changes in the population of women having babies. American women are now a more diverse group; they are having more twin and triplet pregnancies, and they tend to be older when they become pregnant. Women today are also heavier; a greater percentage of them are entering pregnancy overweight or obese, and many are gaining too much weight during pregnancy. Many of these changes carry the added burden of chronic disease, which can put the mother and her baby’s health at risk.

Although there is a range of recommended weight gain among women with a BMI of 30 kg/m(2) or higher, some studies have suggested that little or no weight gain is actually associated with better outcomes for obese women and her child. Excess pregnancy weight raises the risk of pregnancy-induced hypertension and diabetes, cesarean sections and birth injuries. Further studies are currently being conducted.

At What Rate Should You Gain During Your Pregnancy?

This depends on your weight before you were pregnant.

There is no increased energy cost associated with the first trimester of a singleton pregnancy. A weight gain of 1 to 4.5 pounds is acceptable for most women. Recommendations for weight gain during the 2nd and 3rd trimesters are as follows:
Recommendations for pregnancy weight gain.
How do you gain adequate weight healthfully?

During the first trimester, it is generally recommended to consume an additional 150 to 200 calories per day. Steady weight gain is more important in the second and third trimesters, especially if you began your pregnancy at a normal weight. An extra 300 calories a day is typically enough to help you meet this goal.

Some ideas of how to add 300 calories into your diet are:

  • 1 small banana with 2 Tablespoons peanut butter
  • Half-cup trail mix with nuts, seeds and dried fruit
  • 12 almonds with 6 oz yogurt and 1 small orange
  • 1/3 cup hummus with 5 whole wheat crackers and carrot sticks
  • 1 cup milk and 4 fig bars

For women who are overweight before pregnancy, increasing daily calories by no more than 100 calories beyond the pre-pregnancy intake appears to be sufficient. Fat should be limited to less than 30 percent of calories and come in the form of “good” unsaturated fats, from sources like nuts and canola and olive oils.

Some women need more or fewer calories, depending on their individual metabolism and activity level. Gradual weight gain is ideal. There is no need to worry if you do not hit the targets mentioned above exactly. The important thing is to pay attention to your overall weight gain and to treat your body in a healthy way. See The ABC’s of Growing a Healthy Baby for more information.

All Nutrition articles were updated October 2015



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About the Author

Lauren is a Clinical Dietitian living in West Palm Beach, Florida, where she works to reduce health disparities among pregnant women and the pediatric population. She earned her undergraduate degree from the University of Florida, and her graduate degree from Rush University in Chicago.


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