Weight gain during pregnancy

Photo of a pregnant woman

During pregnancy, a balanced diet is important for both mother and child. It helps to gain weight at the right rate. But what weight gain is considered "normal" for an expectant mother? Can she eat as much as she wants – and how does she lose the extra pounds after pregnancy??

"Don’t worry – you’ll soon get rid of the extra weight if you breastfeed your baby!""Be careful – I never lost the extra weight after the second child."Eat whatever you feel like – after all, you are eating for two!"As with many issues related to pregnancy, there is a wide range of opinions on the subject of weight gain. In the face of all the conflicting advice, it can be difficult to find your way around.

Most women can simply trust their appetite during pregnancy. They don’t need a special diet and can eat what tastes good and is good for them. However, for some women, it may make sense to change their diet and exercise more. This includes women who are very overweight, gain weight very quickly, or have gestational diabetes.

What weight gain is "normal? Information on $CMS_IF( ! tt_headline.isEmpty)$$CMS_VALUE(tt_headline.toText(false).convert2)$$CMS_END_IF$

Pregnancy can upset many of the day-to-day routines and habits – including what a woman eats and whether and how she exercises. Most importantly, a pregnant woman’s body changes so that the unborn child can be adequately nourished and cared for. This already starts in early pregnancy, but becomes more and more noticeable later on. You gain more weight in the last months of pregnancy than in the first months. The reason is not just the weight of the growing child. Much of the extra weight is fluid (water) that the body stores. Among other things, it is needed for the baby’s additional circulation, for the placenta and the amniotic fluid.

In the past, physicians made quite strict recommendations that weight gain should be limited to a few kilos. But there is no particular weight gain that can be recommended equally to all pregnant women. That’s why recommendations are now based on a woman’s pre-pregnancy weight. So a small, underweight woman should gain more weight than a woman who was overweight before her pregnancy.

The BMI measurement Information on $CMS_IF( ! tt_headline.isEmpty)$$CMS_VALUE(tt_headline.toText(false).convert2)$$CMS_END_IF$

The body mass index ( BMI ) is the most common method of determining whether you are underweight, normal weight or overweight. It is a measure that describes the ratio of weight to body size. A BMI of less than 18.5 is considered underweight, between 18.5 and 25 is considered normal weight, and between 25 and 30 is considered overweight. With a BMI of 30 or more, one speaks of severe overweight (obesity / adipositas).

However, the BMI alone is not meaningful enough to conclude, for example, an increased health risk. Thus, obesity is completely unproblematic for many people – unless certain diseases, such as type 2 diabetes, are added to the mix. However, with a BMI of 30 or more (obesity), there is often a higher health risk.

Weight before and during pregnancy information on $CMS_IF( ! tt_headline.isEmpty)$$CMS_VALUE(tt_headline.toText(false).convert2)$$CMS_END_IF$

The U.S. Institute of Medicine (IOM) issues guidelines to guide physicians around the world. The IOM recommendations for BMI and weight gain in pregnancy are:

  • If underweight before pregnancy ( BMI below 18.5): between 12.5 and 18 kg weight gain during pregnancy.
  • with normal weight before pregnancy ( BMI between 18.5 and 24.9): between 11.5 and 16 kg weight gain.
  • if you are overweight before pregnancy (BMI between 25 and 29.9): between 7 and 11.5 kg weight gain.
  • in case of obesity before pregnancy ( BMI over 30): between 5 and 9 kg weight gain during pregnancy.

But a pregnant woman’s weight alone says nothing about how well her baby is doing – not even about how fast it’s growing right now. This depends on many factors. Before birth, it is not possible to know for sure how much the baby will weigh at the end of the pregnancy. Ultrasound and other tests can only give an indication of how the baby is developing and what its approximate birth weight might be.

Can too much or too little weight gain be harmful? Information on $CMS_IF( ! tt_headline.isEmpty)$$CMS_VALUE(tt_headline.toText(false).convert2)$$CMS_END_IF$

Women who gain a lot of weight during pregnancy are at higher risk for some health problems and complications during birth. Thus, they are more likely to have a very large baby with a birth weight over 4000 or 4500 g (macrosomia) and to need a cesarean section.

They are also more likely to have problems losing the extra weight after giving birth.

On the other hand, too little weight gain and malnutrition of the mother during pregnancy can harm the unborn child – often the child is then born too early or has too low a birth weight.

Very fast weight gain as a sign of disease Information about $CMS_IF( ! tt_headline.isEmpty)$$CMS_VALUE(tt_headline.toText(false).convert2)$$CMS_END_IF$

If there is a very sudden increase in weight or a regular increase of more than half a kilogram per week, the weight is monitored by a doctor or a midwife. Additional examinations may also be necessary.

Very rapid and high weight gain (about 1 kg in a week) may be a sign of health problems, such as preeclampsia. This pregnancy-related condition is most noticeable by high blood pressure, sometimes also by nausea, headaches and dizziness. Pre-eclampsia can be life-threatening for mother and child and must be treated quickly by a doctor.

Greater weight gain can be a risk factor, but also a sign of gestational diabetes ( gestational diabetes ). In this case, the blood glucose level increases in a woman who has not had diabetes before. Gestational diabetes increases the risk of preeclampsia and can lead to excessive weight gain of the unborn baby. If the baby becomes very large and heavy, the delivery may be delayed and a natural birth may become difficult.

When does it have advantages not to gain too much weight? Information about $CMS_IF( ! tt_headline.isEmpty)$$CMS_VALUE(tt_headline.toText(false).convert2)$$CMS_END_IF$

Whether paying special attention to diet and exercising more during pregnancy lowers certain risks depends on whether a woman is overweight or has gestational diabetes, among other factors. For women of normal weight, studies show no health benefits.

Women who are very overweight (BMI over 30) can reduce their risk of gestational diabetes by changing their diet and exercising more. However, studies to date have not shown that this also reduces the risk of birth complications or avoids cesarean sections.

Women with gestational diabetes are advised to change their diet to lower their blood glucose levels. This may reduce the risk of complications during childbirth.

Dietary changes and exercise during pregnancy Information on $CMS_IF( ! tt_headline.isEmpty)$$CMS_VALUE(tt_headline.toText(false).convert2)$$CMS_END_IF$

Since carbohydrates increase blood sugar, it is usually recommended in cases of severe obesity or gestational diabetes to eat fewer carbohydrates but sufficient fiber, and otherwise to ensure a balanced diet. It is also often advised to have three main meals that are not too abundant and two to three smaller meals in between.

How exactly the diet can be changed depends, among other things, on how much a woman weighs and exercises. To avoid adverse effects, special nutritional counseling may be useful. The body needs sufficient calories and important nutrients during pregnancy, which is why, for example, a low-calorie diet is not recommended.

It may be enough to increase physical exertion for at least 30 minutes about three to four days a week. Suitable sports can be, for example, gymnastics, swimming, cycling or walking (brisk walking). However, if there is an increased risk of premature birth, exercise is usually not an option at all. If in doubt, it is best to ask your gynecologist for advice.

How can pregnant women with underweight gain enough weight? Information about $CMS_IF( ! tt_headline.isEmpty)$$CMS_VALUE(tt_headline.toText(false).convert2)$$CMS_END_IF$

If a woman becomes pregnant while underweight and finds it difficult to gain weight, it is best to discuss this with her health care provider or midwife. Studies also suggest that dietary counseling can help gain weight and reduce the risk of preterm birth.

Protein supplements can help some underweight women gain weight. This reduces the risk of low birth weight of the child and also the risk of miscarriage. But beware: high protein supplements with more than 25% protein do not seem to have any benefit. In addition, there is evidence that these very high-protein remedies can interfere with the baby’s growth. Therefore, it is important to pay attention to a balanced mix of nutrients. "A lot helps a lot" is not the right strategy.

Can stretch marks be avoided by watching your weight? Information about $CMS_IF( ! tt_headline.isEmpty)$$CMS_VALUE(tt_headline.toText(false).convert2)$$CMS_END_IF$

There is no clear answer to this question yet. While there are many theories about what causes stretch marks and what might help. But none of these are supported by good research.

Whether a woman gets stretch marks depends not only on how much she gains weight. For example, very sudden and large weight fluctuations can cause more stretch marks than a gradual gain. However, it is unclear whether you can prevent stretch marks by keeping your weight down.

Weight loss after birth information on $CMS_IF( ! tt_headline.isEmpty)$$CMS_VALUE(tt_headline.toText(false).convert2)$$CMS_END_IF$

For many mothers, it takes a while to get back to about the weight they were before pregnancy. For some women, breastfeeding and taking care of the baby is enough to make the weight gained during pregnancy melt away: apparently, they can use the stored reserves to get through the first weeks and months of motherhood well.

However, most women do not return to their previous weight until about six months after giving birth. Women who do not lose weight or even gain weight may be at increased risk for health problems. These problems may be exacerbated during the next pregnancy.

The best way to lose weight is a combination of dietary changes and additional physical exercise. Exercise alone probably has little effect. Programs to change eating and lifestyle habits try to achieve weight loss. In the studies of such programs, women started one to two months after giving birth, sometimes later. Immediately after birth, women need adequate nutrients for breastfeeding – this is not an opportune time to try to lose weight specifically.

Excessive or all too sudden weight loss can have disadvantages. Possible adverse effects of a diet that is too strict or one-sided after the birth of a child include breast milk becoming less or containing fewer nutrients.

How do women feel about their weight during pregnancy and after?? Information on $CMS_IF( ! tt_headline.isEmpty)$$CMS_VALUE(tt_headline.toText(false).convert2)$$CMS_END_IF$

Women are constantly confronted with (usually additionally edited) images of models as an ideal of beauty. This ideal is also followed by pictures of pregnant women. This makes it difficult for many women to be happy with their figure, and it can affect their self-image and enjoyment of their own bodies. Media reports about how quickly stars and celebrities have regained their pre-pregnancy figure can put additional pressure on pregnant women and mothers to. However, every woman must gain weight during pregnancy – and none can expect to regain her old weight just a few weeks after giving birth.

On the other hand, for many women, pregnancy is a time to simply enjoy their belly, their curves, and the growing life inside them – and take a break from constantly worrying about their dress size. This can be one of the really pleasant aspects of pregnancy.

At most, a problem arises when a woman moves very far away from her normal weight and eating habits: then it can be difficult to return to her healthier "pre-baby" weight and lifestyle. Women who do not become more overweight during pregnancy will probably find it easier to return to their normal weight later on. However, women do not have to be thin to be happy and healthy and to have a healthy baby.

Amorim Adegboye AR, Linne YM. Diet or exercise, or both, for weight reduction in women after childbirth . Cochrane Database Syst Rev 2013; (7): CD005627.

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