The early weeks of pregnancy are fragile—and confusing. Here, the answers to your questions.
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Whether you’re planning a pregnancy, entering your second trimester with your first baby, or contemplating having a third baby, you’ve likely thought about the weight gain—and looming struggle to get it off afterwards—at least a few times. And, if you’re starting out with even a few extra pounds on your frame from the last pregnancy, as many moms already are, the physical and emotional toll on your body can be a daunting one.
The latest weight gain recommendations for pregnancy from the Institute of Medicine were released in 2009 and can be found here. “Every woman should gain a certain amount of weight in order to sustain the pregnancy, but throughout the entire pregnancy, you only need an extra 300 calories a day for one baby,” says Celeste Durnwald, MD, assistant professor of Obstetrics and Gynecology at the Hospital of the University of Pennsylvania.
You’ve probably heard that too much weight gain during pregnancy can lead to an increased risk of developing gestational diabetes, but you’re also more at risk for hypertensive disorders of pregnancy—which could be gestational hypertension or a preexisting condition called preeclampsia. In its most severe form hypertensive disorders of pregnancy can lead to earlier delivery, says Dr. Durnwald.
Excessive weight gain during the pregnancy can ultimately lead to a bigger baby, whether that’s a ‘large for gestational age baby’ (measuring over the 90% percentile) or fetal overgrowth, says Dr. Durnwald. “Oftentimes women don’t feel a large baby (over 8.8 pounds) is a major problem, but if you have a large baby it could alter the mode of delivery…and put the baby at risk for other problems.”
Dr. Durnwald says larger infants may have problems with low blood sugar or other metabolic abnormalities after delivery, and it can lead to a longer stay in the hospital. “Our pediatric colleagues say that babies who are born larger and have more fat mass are at an increased risk for childhood metabolic problems like type 2 diabetes and obesity.”
So what’s a reasonable rate to gain each week? Helain Landy, MD, professor and chair, Department of Obstetrics & Gynecology, and fellowship director, Division Director at MedStar Georgetown University Hospital
in Washington, D.C., says she recommends the common sense approach. “For normal-weight patients, ideally they should gain 25-35 pounds, and for 40 weeks in a pregnancy, that’s usually a pound or a half pound per week.
“Pregnancy is a time when women want to do the right thing for the developing baby. And when they are a mother they want to do the best thing,” says Dr. Landy. It’s a good time to hit home important components, like restricting alcohol, taking your vitamins, developing a balanced diet, and getting regular exercise if you’re able to.