Eating for Appropriate Weight Gain During Pregnancy
Some women may think of pregnancy as their ticket to eat anything they want, indulging any and all cravings and leaving portion control by the wayside. Put aside the thought you are eating for two. It may sound ideal, but that kind of thinking is not an ideal way to approach nutrition when making food choices during pregnancy.
Both inadequate weight gain and excess weight gain during pregnancy pose risks to both mother and child. A balanced diet can help you maintain a healthy weight and provide the best nutrition for you and your unborn baby. The following guidelines can help you find a nutrition balance for your pregnancy.
Guidelines for Weight Gain
Exactly how much weight gain to aim for will vary among women and depends on several factors, including the mother’s pre-pregnancy weight, height, age, and health status, as well as whether or not the pregnancy will involve twins, triplets, or more. See your doctor to determine the best weight gain goal for you.
In general, the following Institute of Medicine and National Research Council guidelines are used for women with a single-baby pregnancy:
- Women beginning pregnancy at a normal weight (defined as body mass index [BMI] of 18.5-24.9) are advised to gain 25-35 pounds during pregnancy.
- Underweight women (BMI 18.4 or less) are advised to gain 28-40 pounds.
- Overweight women (BMI 25-29.9) are advised to gain 15-25 pounds.
- Obese women (BMI 30 and over) are advised to gain 11-20 pounds.
Of course, everyone is different. Here are some common problems if you stray too far off the recommended weight range.
Risks of Too Little or Too Much Weight Gain
The correct weight gain is one of many factors that may help ensure a healthy pregnancy. Keep in mind this is not the time to try a new fad or extreme diet to control weight gain. It can be harmful to you and your child.
Risks to the Mother
Gaining too little weight can increase the risk for:
- Delivering a low birthweight baby
- Preterm birth
Gaining too much weight can increase the mother’s risk for conditions, such as:
- Pregnancy-induced high blood pressure called preeclampsia
- Gestational diabetes—which can lead to baby with high birthweight
- Preterm birth
- Longer labor and labor complications
- Cesarean delivery
Gaining too much weight during pregnancy can also make it harder to lose the weight afterward. Women who gain the suggested weight during pregnancy tend to lose most of it once the baby is born and the rest in the months following the birth.
Risks to Your Baby
Low birthweight or preterm birth is associated with:
- Poor growth
- Developmental problems
- Higher risk of jaundice
- Lung and breathing problems
- Systemic infection—neonatal sepsis
- Infant mortality
Gaining too much weight can increases the risk of having a larger than average baby at birth. Risks for your baby (which may continue into adulthood) include:
- Injury during birth, such as shoulder dystocia
- Low blood sugar after birth
- Metabolic syndrome—elevated blood sugar, blood pressure, cholesterol, and excess body fat, which can lead to diabetes and heart disease
- Type 2 diabetes
Small changes in your diet will benefit both you and your baby through pregnancy and even after birth.
Maximizing Nutrition Without Maximizing Calories
The approach to healthful eating during pregnancy is two-fold: You want to eat for an appropriate weight gain, but you also want to make sure you and your unborn baby get all the nutrients needed. Tips to help you do this include:
- Make sure your diet is high in healthy foods with lots of nutrition. This includes plenty of vegetables, fruits, and whole grains.
- Limit intake of foods high in sugar, saturated and trans fats (fried foods, whole dairy products, red meats).
- Avoid foods that are high in calories and little nutrition (cookies, cakes, chips, and soda).
It is not always easy to stay away from foods you are used to eating. Start slowly. Gradually substitue healthier options in place of less healthy foods. Talk to your doctor about ideal nutrition goals. Certain foods like low-fat dairy may be ideal additions to your diet. You can monitor your menu with an individualized food plan at the Department of Agriculture Supertracker website. If you are having a hard time planning meals, talk to a registered dietitian for suggestions.
In addition to proper nutrition, you may need to increase or change certain vitamins and minerals during your pregnancy. Ask your doctor about prenatal vitamins.
Keep in mind that physical activity also plays a role in pregnancy weight gain. Getting regular exercise during pregnancy may help you achieve your recommended weight gain goal and relieve some discomforts of pregnancy. Be sure to check with your doctor before embarking on any exercise program during pregnancy.
A Note About Food Safety
A discussion of healthful eating during pregnancy would be incomplete without a mention of food safety. While it is important to eat a variety of foods and get adequate nutrients, it is also important to avoid certain foods that could pose a risk to you or to your unborn baby.
Here are some recommendations to avoid potential food-borne illness:
- Do not eat or drink any raw or unpasteurized milk or milk products
- Do not eat raw or partially cooked eggs
- Avoid shark, swordfish, king mackerel, tilefish because of high mercury levels
- Limit white albacore tuna to 6 ounces a week or less (because of possible mercury content)
- Eat only deli, luncheon meats, or hotdogs that have been fully cooked or properly heated (if you are at high risk, you should avoid these foods completely)
Be aware of E. Coli 0157:H7. This bacterium may be found in raw and undercooked meat and unpasteurized milk. Be sure to cook all meats to appropriate temperatures and avoid cross-contamination by using separate cutting boards for raw and cooked foods.
If you start early, it will be easier to make the switch to a more healthful diet. Make the most of what is available to you so you can enjoy a healthy pregnancy and faster recovery.
ChooseMyPlate—Department of Agriculture
The American Congress of Obstetricians and Gynecologists
Women's Health Matters
Listeriosis in pregnancy. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated February 26, 2016. Accessed August 3, 2016.
Nutritional needs during pregnancy. ChooseMyPlate—Department of Agriculture website. Available at: http://www.choosemyplate.gov/nutritional-needs-during-pregnancy. Accessed August 3, 2016.
Nutrition in pregnancy. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated April 10, 2016. Accessed August 3, 2016.
Overcash RT, Lacoursiere DY. The clinical approach to obesity in pregnancy. Clin Obstet Gynecol. 2014;57(3):485-500.
Rasmussen KM, Catalano PM, Yaktink AL. New guidelines for weight gain during pregnancy. Curr Opin Obstet Gynecol. 2009;21(6):521-526.
Rooney BL, Schauberger CW. Excess pregnancy weight gain and long-term obesity: One decade later. Obstet Gynecol. 2002;100(2):245-252.
Thorsdottir I, Torfadottir JE, Birgisdottir BE, Geirsson RT. Weight gain in women of normal weight before pregnancy: complications in pregnancy or delivery and birth outcome. Obstet Gynecol. 2002;99(5 Pt 1):799-806.
Weight gain in pregnancy. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated July 8, 2016. Accessed August 3, 2016.
2/5/2009 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Cheng YW, Chung JH, Kurbisch-Block I, Inturrisi M, Shafer S, Caughey AB. Gestational weight gain and gestational diabetes mellitus: perinatal outcomes. Obstet Gynecol. 2008;112(5):1015-1022.
Hillier TA, Pedula KL, Vesco KK, et al. Excess gestational weight gain: Modifying fetal macrosomia risk associated with maternal glucose. Obstet Gynecol. 2008;112(5):1007-1014.
Last reviewed August 2016 by Michael Woods MD Last Updated: 8/3/2016