Nearly half of pregnant women gain more pounds than the government recommends. That's a scary statistic, considering that more and more studies are linking excessive weight gain during pregnancy to serious health problems. In response to this research, the government is currently re-examining the weight-gain guidelines for pregnant women that have been in place since 1990. For now, use these simple strategies to put on pounds healthfully.
The more you weigh when you become pregnant, the more likely you and your baby will have health problems over the next nine months -- and later on down the road. Ideally, you should have a body mass index (BMI) of between 19.8 and 26 prior to conception. To calculate your BMI, go to nhlbisupport.com/bmi.
According to the current Institute of Medicine (IOM) guidelines, women with a normal BMI should gain 25 to 35 pounds during their pregnancy. If you're overweight (meaning your BMI is between 26 and 29), you should put on only 15 to 25 pounds during pregnancy. Underweight women (those whose BMI is less than 19.8) should aim to accumulate 28 to 40 pounds.
The U.S. Department of Health and Human Services recommends that expectant mothers put in at least two and a half hours of moderate-intensity aerobic activity (such as brisk walking) each week. Unless you're experiencing a complication like placenta previa or bleeding, you should be able to continue your pre-pregnancy exercise routine. If you weren't active before you conceived, you can still start now. Having a hard time getting motivated? Enlist a friend to become your walking partner. Wear a pedometer and aim for 10,000 steps daily. Of course, be sure to first discuss with your doctor any exercise regimen you plan to start.
People may joke that you're eating for two, but "you're really eating for 1.02 people, and you might get up to 1.1 by the end of your pregnancy," says Matthew Gillman, MD, director of the obesity prevention program at Harvard Medical School, in Boston. The IOM recommends that normal-weight women consume no extra calories in the first trimester, eat an extra 340 calories per day in the second trimester, and an additional 452 daily in the third. (An extra 340 calories translates into a peanut-butter sandwich, a piece of fruit, and a glass of skim milk. Add a banana for 450 calories.) The best way to add healthy calories to your diet is to up your intake of fruits, veggies, and dairy products. Craving sweets? Try a lower-calorie substitute, like chocolate rice cakes instead of a candy bar.
Doctors say the majority of normal-weight women need six to 12 months to get back to their pre-baby body weight. In the meantime, hop on the scale at least once a week, ideally at the same time of day. "If you're not losing steadily, you may need to reduce your caloric intake," says Christine Olson, PhD, professor of nutritional sciences at Cornell University Institute for the Social Sciences, in Ithaca, New York. You can even do this if you're breastfeeding, by replacing high-fat foods with more fruits, vegetables, and foods high in calcium and vitamin D. Ask your ob-gyn if you should take a multivitamin and a calcium supplement.
The most common way women shed postpartum pounds is by walking, says Dr. Olson. As soon as your baby is old enough to be outside, put him in a stroller and go. A 2007 Harvard study found that women who walked at least 30 minutes per day, watched fewer than two hours of TV daily, and consumed the least amount of trans fats (found in baked goods and fried foods) had a 77 percent lower risk of retaining at least 10 pounds postpartum compared with women who did none of these things.
You already know that breast milk is the best choice for your baby, but there's another reason to breastfeed for as long as you can. In a 2008 study, Danish researchers found that women who breastfed exclusively for the first six months of their child's life were less likely to retain pregnancy pounds than those who nursed for a shorter time.
Helping your baby sleep through the night as soon as possible will jump-start your weight loss. A 2007 Kaiser Permanente study showed that women who got five or fewer hours of sleep each night at six months postpartum were twice as likely to retain at least 10 pounds at one year postpartum. Sleep benefits your baby too: Another recent Harvard study found that infants who sleep less than 12 hours daily are at risk of being overweight by age 3.
Are you seeing a pattern here? What's good for your baby -- sleep, fresh air, and breastfeeding -- is good for you too.
The more excess pounds you put on during pregnancy, the higher your chances of having these complications.
A 2007 study in Obstetrics & Gynecology found that normal-weight women were twice as likely to develop dangerously high blood pressure if they gained more than 35 pounds during pregnancy. This condition can cause premature birth or infant death.
Gaining too much weight during pregnancy may lead to a large baby (weighing more than 9.9 pounds), and your doctor may need to perform a c-section or use a vacuum or forceps to deliver the baby.
Research shows that kids whose mothers gained too much weight during pregnancy have a fourfold greater risk of becoming overweight by age 3.
Originally published in the June 2009 issue of Parents magazine.