| Kilo counting
Don’t eat for two, and don’t get obsessed with the bathroom scales. Dr Howard Lee gives you the low down on weight gain in pregnancy Pregnant women used to be weighed at every antenatal appointment, but research showed that the practice was of little value because it was often inaccurate; so you can heave a sigh of relief, you won’t be put through that. If, however, you are significantly over – or under – weight, you’ll be asked to ‘stand on the scales’ more frequently than other women in your antenatal group. Weight gain in pregnancy is still a source of great anxiety Many women worry about putting on too much, and being unable to lose it afterwards, or about not gaining enough, and how this might affect their baby. Naturally, it is essential, and we (the medical care team) should be concerned if you’re not gaining weight, as it could indicate that you are not getting adequate nourishment, and that, in turn, could affect the growth and development of your baby. Because of this, your doctor or midwife will certainly keep an eye on your weight, while you are pregnant, and they’ll also be watching for any sudden increase, which could herald the onset of pre-eclampsia. For more information about this complication in late pregnancy see my article about pre-eclampsia. Pregnancy will obviously put extra demands on your energy reserves, and you’ll need to increase your total calorie intake – particularly, towards the end of your pregnancy (the third trimester). The old idea of ‘eating for two’ is not, of course, sensible or necessary. In fact, research at St.Thomas’s Hospital, London, has indicated that eating in excess (especially, the wrong types of food) could put the unborn baby at risk of heart disease, diabetes and blood pressure in later life. As a guide, think of your extra energy requirements as around 250-300 calories per day. You probably won’t notice any change in your appetite in the first trimester (3 months), it may even be reduced because of the early-pregnancy changes on your digestive system – like ‘morning sickness’. In the second trimester, your appetite and weight will usually increase gradually, but it is in the third – last trimester – when your appetite really increases and you put on most weight, meeting the demands of your growing baby.
If you are overweight, many experts will recommend that you try to lose some of the excess before you become pregnant. Being on the heavy side before you start having a baby can make a pregnancy seem much more of a ‘burden’. Pregnancy itself is no time to worry about looking ‘large’, and it’s certainly not the time for dieting; both you and your baby need to be well nourished. There is really no ‘ideal weight’ gain People will obviously vary – just as metabolism (which is the body function of ‘burning off the calories’) varies from one person to another. How much you should gain will depend a lot on your pre-pregnancy weight and height, your metabolism and your level of activity. The range of normal weight gain in pregnancy is large, some women gaining very little, others anything up to 23kgs. But rather than worrying too much about precisely how much, or how little you have gained, the important thing is that you should eat well. See Healthy eating in pregnancy. If you take a full and balanced diet then, usually, ‘nature’ will take care of the rest. There are disadvantages if you’re at the limits of weight gain A very low weight gain tends to be associated with premature birth and lower birth weight babies – especially, if associated with smoking, poor diet, and alcohol or drug abuse. However, if you are a non-smoker, healthy, and having a good nourishing diet, your baby’s weight will not increase simply because you start eating more. If you are at the upper end of the weight scale – gaining a lot of weight by the end of your pregnancy – you are more likely to develop some of the problems and complications associated with pregnancy and labour. These include ‘heart burn’ and indigestion, tiredness, breathlessness, varicose leg – and vulval – veins, haemorrhoids (piles), low back pain and increased joint pains and, more importantly, diseases like increased blood pressure (with the added possibility of pre-eclampsia) and pregnancy-induced diabetes. Women who are overweight in pregnancy do tend to have slightly larger babies. Now, for all of those who would like to learn what happens to your weight, and why, here – despite my earlier comments – are some figures for you.
An average weight gain, by the end of a full-term pregnancy:
It usually means that your body is storing excess fat or fluid – and this could complicate your pregnancy and labour. A weight gain of more than 33 lbs in pregnancy is usually followed by a permanent increase in weight, unless a sensible, post-pregnancy diet is planned and followed. Hopping on the scales If you do decide to weigh yourself at home, don’t do it too frequently, there is often a marked difference from day to day. Try to standardise how and when you weigh yourself, in order to accommodate the normal daily fluctuations of weight. A rapid weight gain during the last trimester (3 months) needs to be reported to your midwife or doctor – this could be fluid retention and a sign of pre-eclampsia. Do keep in mind that weight gain recommendations also change often over time. It is more important to pay attention to a healthy diet for both of you than to how much you gain while doing it. Please try to enjoy your pregnancy and your eating – then you’re more likely to enjoy your baby. |