Diet and Weight Gain
One of the foremost concerns a patient has about pregnancy, other than having a healthy baby, is her weight gain. Let me be blunt…You will gain weight during pregnancy! We try to focus more on eating a healthy diet instead of counting every pound.
MyPyramid
U.S. Department of Agriculture Guidelines for Nutrition During Pregnancy: The Pyramid Poster (pdf)
Average Pregnancy Weight Gain
The average weight gain during pregnancy is 30-40 pounds. Many women gain more than 50, and some up to 100 pounds (yes, this does happen). If a woman starts pregnancy at a normal weight, my opinion is that 25 pounds is a great weight gain, although a difficult target to achieve, as most women will gain more than this. Please keep in mind that 6 weeks after a normal delivery, weight loss is about 15 to 20 pounds from the final pregnancy weight, so even if pregnancy weight gain is just 25 pounds, there is still 5 to 10 pounds to lose to reach the pre-pregnant weight.
Nutrition
There is really no magic diet that one should eat while pregnant. A common-sense balanced diet is the key. Proteins, carbohydrates, fruits and vegetables – you should eat some of each every day. Vitamins and supplements can be beneficial (see ahead). Three servings per day of dairy can provide enough calcium. Non-meat eaters can get sufficient protein from nuts, eggs, fish and dairy. Weight gain can be reduced by cutting down on high-fat foods such as chips, fried foods, salad dressings, cheeses and sweets. Minimize fruit juices (very high sugar content).
Eating Pattern
I recommend that pregnant women try to eat 6-7 times per day. Food should be eaten about every
2½ to 3 hours. Try not to let yourself get too hungry. The blood sugar can drop causing unpleasant symptoms such as irritability, cravings for junk food, even lightheadedness. A good snack combines carbohydrates and protein, such as peanut butter and bread, cheese and cracker, milk and bran muffin, nuts, protein bars, cottage cheese and fruit. Have vegetables with meals. Carrots by themselves would not be a good snack item.
1st trimester
Many patients experience varying degrees of pregnancy sickness. In turn, this can affect their weight. Frequent vomiting may cause weight loss in the first trimester (see Chapter 11). Frequent nausea, without much vomiting, may lead to low food intake and limited weight gain. Alternatively, many find that only high-calorie, carbohydrate and fatty foods (so-called “comfort foods) help them to quell the nausea resulting in weight gain during the first trimester, despite the presence of nausea (not fair!). If the appetite is not normal, focus on protein-rich foods, soft fruits and easy-to-digest vegetables. It might be better to minimize salads and high-fiber.
Goal: Gain 0 to 10 lbs. during the whole first trimester.
2nd trimester
For many women, the appetite comes roaring back. This is the trimester of rapid weight gain. It is possible to eat 6-7 meals a day and still get hungry between meals. And food seems to taste so good! One way to balance the weight gain is to increase calorie-burning activities. Walk every day, swim, do something aerobic.
Goal: Gain about 3-4 lbs. per month during the second trimester.
3rd trimester
Patients tend to get full more easily, especially the last 1-2 months. However, water retention may occur, causing the weight to go up despite not eating as much. Water weight gain will come off after delivery, but this can take weeks.