Diet and Weight Gain in Pregnancy
We know very little about diet and weight gain in pregnancy. Sure, there is lots published on the topic. Many doctors, mothers, mother-in-laws, web sites and books have some very strong statements and opinions about the topic. Unfortunately, most of what you hear about the topic was made up, decades ago, and just passed on, year after year, generation after generation. The purpose of this page is to explain what you may really need to know for a healthy and manageable pregnancy.
The prenatal vitamin is good for you, and your baby, but not necessary. The published literature says that developing babies benefit from extra folic acid (400 mcg) in the three months before conception and in the first three months of pregnancy. The chance of certain birth defects of the brain and spine, like spina bifida, are lower in pregnancies supplemented with this does of folic acid.
The prescription prenatal vitamin is chock full of extra stuff, all of which is good for pregnant moms and unborn babies, none of which has been proven (in the peer reviewed published medical literature) to prevent birth defects or increase IQ. Many women suffer from constipation and stomach aches from the prenatal vitamin. For those women, taking a children’s chewable vitamin, with 400 mcg of Folic Acid is a good, safe, and appropriate alternative.
Don’t “eat for the baby.” Pregnant women should eat when hungry, and stop eating when feeling full. A common problem is eating too much, not eating too little.
During the first three months of pregnancy many women are nauseous and have a difficult time “eating right.” Don’t worry about your diet in the first three months, especially when you can barely tolerate most food, or even keep foods down. Heck, if all you can eat for a while is candy, crackers, and sips of water, then FINE.
What do you do if you are hungry all the time and/or gaining too much weight? Some pregnant women find that no matter what, 1-2 hours after a meal they are hungry again. Three full meals and three big snacks can be a lot of food, a lot of calories, and more weight gain than is necessary. Women who are hungry all the time will benefit from eating on a schedule, and eating six “half meals” instead of full meals and snacks. And stay away from candy. A half meal is just that, HALF of what you may have been planning to eat. Eat the other half 2 hour later. This way you get to eat all the time, but you keep your calories down.
If you eat it, it will stay on. The physiology of pregnancy causes extra weight gain when you eat extra, and more than would happen at other times. Therefore, pregnant moms need to be careful about overeating, because the weight can really go up. Too much weight gain is uncomfortable.
What about the “old school” recommendation for 30 lbs weight gain all pregnancy: 10 lbs in the first 20 weeks, and one pound per week until delivery. Those numbers were average weight gain for average women, 50 years ago. And, in those old days doctors thought there was a close relationship between mommy weight gain and baby growth. Over time, and with ultrasound baby measurement, we figured out that weight gain in pregnancy was NOT so predictive of baby size. And today, the starting weight of pregnant women is much higher than it used to be. In some patients with high body mass index (BMI, the relationship between height and weight that classifies obesity) no weight gain OR weight loss is preferable. Ultrasound has shown normal baby growth in such women.
Some women start out pregnancy with a very low BMI, like between 18 and 20. Friends and family often comment on how thin these women are, and may express concern about too little weight gain. The ultrasound at 20 weeks will confirm healthy baby growth, and uterus measurements and baby movement will confirm continued growth during the third trimester. Ultrasound can confirm good baby growth, when medically necessary.
Finally, when it comes to diet and weight gain, pregnant women should just focus on diet. If a patient is eating well and staying away from fast food and junk food, then her weight gain is set by nature, and we don’t need to worry extra.
There is a lot of information out there regarding what foods to eat, or not to eat, in pregnancy. Many people and organizations claim benefits from certain dietary supplements and vitamins. Here is a list of foods and food preparation issues related to mother’s and baby’s safety…[read more]