Q: I just got pregnant. I am thrilled about the baby but worried about notbeing able to lose the weight afterwards. How much am I supposed to gain?How can I get back to my pre-pregnancy weight?
Answer from Kimra Hawk, R.D., L.D. Outpatient Dietitian, Providence St.Vincent Medical Center: Today we can give very good advice on pregnancy and weight. A generation or two ago, medical people advised women to gain only 15-20 pounds; then they realized too many babies were being born with health problems related to low birth weight.
If you weighed a healthy amount when you became pregnant, you should put on 25-35 pounds. That may sound like a lot, but the recommendation is based on medical studies that looked at newborns and the number of pounds their mothers gained. The healthiest babies were born to women who had gained 25-35 pounds.
Underweight women should gain 30-40 pounds, with at least five pounds in the first three months. Overweight women should gain 15-25 pounds, with very little of that gain in the first three months.
It's wise to keep an eye on the scale. Women who gain too much are at greater risk of diabetes, preeclampsia (a hypertensive disorder that affects both baby and mother) or an overly large baby, which increases the odds of needing a C-section.
Sugar, spice, puppy tails and what else? If the typical baby weighs seven pounds, what's all that extra weight about?
Placenta: 1-2 pounds
Amniotic fluid: 2 pounds
Uterine enlargement: 2 pounds
Maternal breast tissue: 2 pounds
Maternal blood flow: 2 pounds
Fluids in maternal tissue: 4 pounds
Maternal fat stores: 7 pounds
The March of Dimes offers a chart for tracking your weight gain and comparing it to the ideal pace.
In terms of gaining weight during pregnancy, I find my clients often encounter two particular pitfalls. Many switch to fruit juice after giving up soda, alcohol and caffeine. But juice is high in calories. Stop at eight ounces per day, preferably a calcium-fortified orange juice. Water is a great beverage and three daily glasses of nonfat or one percent fat milk.
The other is cravings. Keep your cravings in control if they involve foods high in calories and low in nutrition, such as sweets, chips, fast foods and fried foods. The occasional small portion is fine, but remember: Your baby is counting on you to maximize the nutrient value of the foods you eat.
If your pre-pregnancy diet was wholesome, add extra protein, calcium and whole grains, in small portions. If you don't have a healthy diet, now is the time to revamp it.
And don't even think of low carbs when pregnant. Carbohydrates, especially grains fortified with iron and folic acid, are a great source of energy, which will help with pregnancy fatigue.
Hello bright eyes; goodbye, weight
Now you have an idea of how much to gain. How do you keep those pounds from becoming permanent residents? Based on studies that track the weight of women through pregnancy and after delivery and other knowledge, we can give pointers for shedding those pounds:
What goes on, must come off. Do not gain any more than the recommended range for your body type.
Stay active. In consultation with your obstetrician or midwife, exercise 30 minutes a day, most days of the week, during your pregnancy and afterwards. Good pregnancy choices: pool exercises; lap swimming; brisk walking.
Breastfeed. It takes more calories to make breast milk than to make a baby about 500 a day. While individual women can have different experiences, in general the research shows that women who breastfeed exclusively, at least three to six months, lose their pregnancy weight more quickly and easily than women who do not breastfeed.
Your pediatrician will likely review the American Academy of Pediatrics' breastfeeding recommendations with you: breast milk as baby's sole food for approximately the first six months, with iron-enriched solid foods gradually added to a breast milk diet at six months to 12 months; ideally, continuing breastfeeding until at least 12 months; thereafter, as long as mutually desired.
Breastfeeding: a natural calorie burner
I want to make an important point here: You must eat a healthy diet, with enough calories, to enable your body to produce a proper supply of breast milk. Most women, as they breastfeed, tend to slowly and steadily lose weight as a result of the calorie demands from making milk. It's a wonderful circle of nature.
During baby's first six months, if you are breastfeeding, beware of trying to lose weight by cutting calories. Inadequate calories can cause your breast milk supply to drop which, for many women, discourages them from continuing with breastfeeding.
Let's do the math. If you gain 35 pounds, you have perhaps 15 to 20 pounds to lose after birth. Besides the baby, the weight of amniotic fluid, the enlarged uterus, extra blood and extra fluids are lost with delivery or shortly thereafter. When baby is six months old, assess how much pregnancy weight remains, then aim to lose a half-pound per week through a combination of diet and exercise.
With four key strategies – appropriate weight gain during pregnancy; moderate exercise during pregnancy and after delivery; a healthy diet; and exclusive breastfeeding for three-to-six months (and ideally, breastfeeding for at least 12 months) chances are you'll be back in your old jeans by the time baby turns into toddler.
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