Controlling Weight During Pregnancy

Weight gain is an inevitable part of pregnancy, but you can make every pound count.
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A Weighty Issue

Pregnancy -- the one time in your life when you feel it's acceptable to put on pounds. But if you're assuming that pregnancy gives you free reign to eat junk food, think again. And although occasional treats won't hurt, eating for two doesn't mean eating twice as much. The truth is, a healthy diet has never been more important.

If you followed a well-balanced diet before baby, you may not need to make any major changes. But the changes you should make will help to provide all the nutrients your child will need for healthy growth and development. Eating right will also give you all the ingredients you need for a healthy weight gain. Here's how to make every calorie count.

Eating for Two

Now that you're eating for two, you may need to eat a bit more -- but not as much as you think. So how much is too much? That depends on your age and what you weighed before you became pregnant. If you began your pregnancy at a normal weight, you should expect to gain between 25 and 35 pounds. That may sound like a lot, but it translates into eating about 300 more calories a day. A healthy snack, such as a small bowl of cereal with milk and fruit, can easily do the trick. Women who follow this guideline should gain four to six pounds in the first trimester and about one pound a week during the second and third trimesters.

However, if you began your pregnancy under- or overweight, you have different weight gain goals. Underweight women need to gain more (28 to 40 pounds), while overweight moms-to-be may need to put on 15 to 25 pounds. Women who exceed their recommended weight gain can develop health problems, including backaches, varicose veins, high blood pressure, and gestational diabetes. They may also be more likely to have a difficult labor resulting in cesarean delivery. Women who don't gain enough weight may risk going into premature labor. The bottom line? Putting on the proper number of pounds is the healthiest way to go.

The Best Diet for Baby

Eating the right amount of food from each of the five groups in the USDA Food Guide Pyramid will ensure that you and your baby get the nutrients you both need. But before you get too excited about the number of servings you're allowed, pay attention to what constitutes a serving. For example, one pancake the size of a CD -- not three giant ones smothered in butter and syrup -- equals one serving of grains. Whether you have three big meals a day or six small ones, it's important to eat consistently. You may also be more comfortable eating smaller meals later in your pregnancy as your baby puts more pressure on your abdomen. Here's how your diet divides up:

Grains (6 to 11 servings) provide carbohydrates, your body's main source of energy. Try to work in as many whole grains as you can; they provide fiber and ease constipation, a common problem during pregnancy. One serving of grains is roughly one slice of bread or one cup of cooked rice, cereal, or pasta.

Fruits (2 to 4 servings) and vegetables (3 to 5 servings) are packed with essential vitamins and nutrients as well as fiber. These foods enable you to use iron more efficiently and help your baby build tissue. A veggie serving can consist of one cup of raw leafy or cooked vegetables. One fruit serving can be one medium-size whole fruit, one cup of canned fruit, or one cup of fruit juice. Moms-to-be should strive to eat at least one daily serving of produce rich in vitamin C, such as citrus fruits and tomatoes.

Protein (2 to 3 servings) is found in foods such as meat, fish, and beans, and is crucial for your baby's tissue growth. Two to three ounces of cooked lean meat, poultry, or fish (about the size of a deck of cards) is considered one serving. One egg, two tablespoons of peanut butter, or 1/3 cup of nuts can also count as one ounce of meat.

The Best Diet for Baby Continued

If you're vegetarian, be sure to meet your protein needs by eating eggs; tofu and other soy products, such as soy burgers and soy milk; and dried beans, such as split peas. It's important to check with your healthcare provider to make sure you're getting enough protein.

Dairy (3 to 4 servings) gives your body the calcium it needs to help build baby's bones and teeth. This amount should bring your daily intake of calcium to at least 1,000 milligrams. A serving is 1 cup of milk or yogurt, two one-inch cubes of natural cheese, or 2 ounces of processed cheese. Avoid unpasteurized soft cheeses such as Brie, feta, Camembert, and Roquefort, as they can be sources of listeriosis, a bacterial form of food poisoning that's particularly dangerous in pregnancy. Women who can't eat dairy should consult their doctor about taking a calcium supplement.

Fats should be approached the same way as when you weren't pregnant -- sparingly. We're not talking about the healthy fats found in fish and olive oil. The kinds you need to be wary of occur in foods such as butter, meat, and full-fat dairy products. During pregnancy, fats should make up 30 percent of your daily calories. They give you energy and help your body use certain crucial vitamins.

Take Your Vitamins

A well-balanced diet will supply most of the nutrients you need, with the following two exceptions:

Folic acid: This important nutrient helps reduce the risk of serious brain and spinal-cord birth defects (called neural tube defects) during pregnancy. It's also essential to support your baby's rapid growth. In fact, a 2002 study of Swedish women suggested that folic acid may even reduce the risk of early miscarriage. If you're pregnant now, your doctor has probably already prescribed a prenatal multivitamin that contains folic acid. But you can continue to integrate this essential nutrient into your diet by eating foods such as fortified cereals, leafy green vegetables, and citrus fruits. Planning a pregnancy? Start taking a multivitamin that contains folic acid, and eat foods rich in this important nutrient.

Iron: Your need for this crucial mineral doubles during pregnancy, from 15 to 30 milligrams daily to prevent anemia. It's especially important to take a 30-milligram supplement each day during the last two trimesters of your pregnancy, when the fetus is growing rapidly and maternal blood volume increases. Late in pregnancy, your baby is also storing iron for use in the early months of life.

Now that you're expecting, eating right is doubly important -- and it's easy to do. Following a smart diet plan and taking your daily multivitamin are the best ways to ensure a healthy pregnancy for you and your baby.

We all want our bodies to bounce right back after pregnancy. Here is how to stay healthy during pregnancy.

Dr. Schwarz, obstetrical consultant to the March of Dimes, is past president of the American College of Obstetricians and Gynecologists; Vice Chairman for Clinical Services, Department of Obstetrics and Gynecology, Maimonides Medical Center; and Emeritus Distinguished Service Professor of Obstetrics and Gynecology, SUNY Downstate Medical Center, both in Brooklyn.

Originally published in American Baby magazine, March 2004.

American Baby


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