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The Weight We SHOULD Gain During Pregnancy

The Institute of Medicine has issued guidelines of the amount of weight women should gain during pregnancy. And while the guidelines aren't much different than those issued in the 1990s, some women may still be surprised at both the numbers and other recommendations.

Women who start out their pregnancy at an average weight should gain between 25-35 pounds. Overweight women, though, don't have quite the same luxury. They're looking at 15-35 pounds while obese women should be gaining 11-30 pounds. Underweight women need to pack on a few more pounds than most, between 28 and 40 pounds.

"To improve maternal and child health outcomes, women not only should be within a normal BMI range when they conceive but also should gain within the ranges recommended
in the new guidelines," says the report. "Meeting these challenges means that women will need preconception counseling, which may include plans for weight loss; and both women and their care providers need to know and understand the new guidelines. For many women, this will mean gaining less weight, which may be particularly challenging for women who are overweight or obese at conception."

Challenging is right. The subject of weight gain during pregnancy is one that some of us downright loathe. Having spent too much of my life on obsessive yo-yo diets, I'm a big fan of eating when you're hungry. For my first child, that was just about non-stop. And yes, I gained WAY, WAY, WAY more weight than I wanted to or needed. Turns out, a year after he was born, I was diagnosed with a medical condition that can cause weight gain. Maybe if the focus had been on looking at my body's nutritional desires rather than simply chiding about a number on the scale, someone might have discovered the problem earlier. For the second child, I was well within these guidelines, gaining about 18 pounds. However, I spent the entire pregnancy stressing about every bite of food and that scale. In the end, when the baby was measuring too big, doctors decided I was gestational diabetic and sent me to a dietitian. About a third of my weight gain in that pregnancy came AFTER I was following the dietitian's diet rigorously.

The Institute's intentions are good. It wants to alleviate the health burdens that excess weight can put on mother and child. However, it's recommendation to adopt a revised version of the birth certificate to include fields for maternal pre-pregnancy weight, height, weight at delivery, and age at the last measured weight, seems like overkill. I certainly wouldn't want them on my kids' birth certificates.

How did you approach pregnancy food/weight gain? How much did your doctor talk to you about it? If you had your way, how would your doctor have approached the topic?

By Stacey Garfinkle |  May 29, 2009; 2:43 PM ET
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I gained 60 pounds with my twins but it was not too hard to lose as I did not have time to eat after they were born!

Posted by: EBOA | May 29, 2009 3:16 PM | Report abuse

I never quite understood the weight guidelines.
I gained 36 pounds when I was pregnant with my son but I retained TONS of water. I had to wear slippers to work since my feet were too swollen for anything else.
Within two weeks of his birth I had lost 25 pounds and was (luckily) left with only 9 more left. So, does that mean I gained 36 pounds or only 9 pounds since that was what I was left with?

Posted by: NHmom | May 29, 2009 4:52 PM | Report abuse

My mother, very slim, was only permitted 15 pounds with her first pregnancy (me)in 1948 and I weighed 8lb. 12 oz. I gained around 35 lbs. with each child, but nursing took it off. How much weight has been an ongoing discussion for decades now. This latest recommendation is just the current best thinking. It will change again.

Posted by: abbyandmollycats | May 29, 2009 5:51 PM | Report abuse

I got nagged about weight-gain constantly during both pregnancies (1992 and 1997). I'm 5'6" and weighed between 120 and 130 before each. I gained between 50 and 60 pounds each time. And I took off every ounce within 3-4 months. The first baby weighed 7 pounds 5 1/2 ounces, and the second was 8 pounds 10 ounces.

In the last few weeks of the first pregnancy, I had pre-eclampsia that went all the way to severe toximia when labor was starting, and resulted in a crash cesarian delivery. No problems with the second pregnancy, and I had a successful VBAC delivery.

I trusted my body - always have - and ate and ate and ate because I was always ravenous. Once the babies were born, my appetite went back to normal.

Posted by: SueMc | May 29, 2009 6:34 PM | Report abuse

I've been very fortunate with this pregnancy - my first. I started at 250 lbs - I'm now at 261 and the baby's due to come any time now (I'm past my due date). I only gained most of the weight in the last month so I was pretty well monitored throughout. In my case, I was glad I did stay within the guidelines. I was worried about health consequences if I did not - and I had no big ones - no gestational diabetes and no high blood pressure.

Posted by: annwhite1 | May 29, 2009 7:21 PM | Report abuse

don't know what i gained with either pregnancy. Maybe about 30 for the first? After the first, running after him and nursing, etc, I was back to my 'regular' weight (I guess? - the reason I know is because I could get into my really hard to fit jeans) - by the time he was two. Then I got pregnant again. I'm definitely not back to what I was before the first pregnancy, but ...well...I'm older.
Trying to lose all that weight, well, the last 10 pounds, maybe.
My doctor never cared what I gained, she never talks about weight. I'd ask her about it during pregnancy, and she said: you're fine, don't worry about the scale, eat when you're hungry.

Posted by: atlmom1234 | May 29, 2009 10:08 PM | Report abuse

I wish they would stop dictating an arbitrary number, and talk about the food women should be eating while pregnant. It's a lot more positive and easier to cope with "I'm going to try to add a few extra servings of fruits and veggies, and maybe some diverse proteins to my usual diet," instead of women beating themselves up over the number on the scale. If you are consciously working on increasing your intake of spinach (for iron) and bananas (for potassium) for example, among the many other options, by default the intake of other foods, especially junk food, should go down. I still try to concentrate on eating more green veggies (which I generally don't eat enough of even though I'm vegetarian) while nursing my 3rd son. I must admit, though, I now eat more sweets than when I was pregnant, as I always easily lose weight while nursing. This is something I know I need to work on, but the main thing on my mind is "increasing healthy foods to get nutrients in my milk", NOT "how many pounds do I weigh?" He's 3&1/2 months,and weighs about 16 lbs, give or take. I'm about 160-165, which is my body's normal weight.

Posted by: HBrownWhyte | May 31, 2009 2:22 PM | Report abuse

And then there's my MIL who thinks it's appropriate to set up "contests" between various family members who happen to be pregnant at the same time.
"You should see Sharon. You can't even tell she's pregnant. Five months along and she hasn't even gained an ounce . . "
Yes, because that's really how you should "do" pregnancy. The most important thing at the end is to have the same waist size. Healthy kids? Not quite so important. (I've heard that smoking while pregnant is an excellent way to keep your weight down.)

Posted by: Justsaying4 | June 1, 2009 8:12 AM | Report abuse

Nobody ever mentioned weight gain to me during my pregnancies (first baby, gained 18 lbs, second baby, lost 2), but one doctor in my practice would lavish praise on me every time he noticed I wasn't gaining weight. And I did get a lot of dire warnings about my baby (especially the second) being huge. Those warnings were based mostly in fantasy and fat-phobia, since she weighed in at exactly 8 pounds when she was born at 40.5 weeks.

I tend to eat well during pregnancy because (a) it's the only time in my life I don't feel like eating, and (b) I'm prone to gestational diabetes, which kind of forces healthy eating.

The trick for me is sustaining those habits after pregnancy. I'm already gaining back some of the 34 pounds I lost in the month after my younger daughter was born.

Posted by: newsahm | June 1, 2009 9:20 AM | Report abuse

I found that when I religiously kept to making sure I got 5 fruits/veg and 2 litres of water per day, my weight gain was reasonable month on month, no matter what else I ate. I accidentally discovered that when 30 weeks along with my first baby and suffering from hemorrhoids for the first time in my life. My OB/GYN had told me there were no creams or ointments that would help and I had read on a parenting website's bulletin board that increasing your fiber intake might help. I went on a hummus and crudites kick just to try to alleviate the agony and it really worked -- the side effect was that when I went for my next checkup I had actually lost a little weight.

I gained roughly 28-35 pounds with each pregnancy (I had two -- I'm not sure exactly how much I gained with each because my OB/GYN weighed in kilos). I think I gained a little more in absolute terms with the second because I started from a lower initial weight, but I think I ended up at about the same place with each. Although my OB/GYN never told me I was gaining too much weight, she did mention at some point in my second pregnancy "you really ballooned up with your first, didn't you?" If I had, she hadn't mentioned it to me!

I know in Europe they are generally VERY strict about how much (or rather how little!) weight gain is acceptable. Luckily I live in England!

My advice would be to enjoy eating things you might normally think are "naughty" because (a) as a pregnant woman there is so much you're forbidden to eat, you might as well enjoy what you can eat, (b) this will be one of the last times you can eat with the GOAL of gaining weight, and (c) if you're feeling sick there might only be certain things you can keep down, and keeping hunger away is one of the best ways I know of to keep sickness at bay. I agree with one of the posters that it's more about making sure you do eat the healthy stuff (to the extent you can) -- if you do that then the less healthy stuff won't matter so much.

Posted by: mummybunny | June 1, 2009 12:42 PM | Report abuse

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