Current recommendations for pregnancy weight gain were established by the Institute of Medicine in 1990. They recommend that
A review looked at the evidence for these guidelines, especially those for obese women.1
The review was prompted by concerns that many women gain more than the recommended guidelines, overweight and obesity levels among women of childbearing women have risen dramatically, pregnancy complications that are associated with obesity are rising, and overweight levels in preschool children have risen.
More than 2/3 of US adults are overweight. One third are obese. More than 10% of children and adolescents are too heavy.2
Obesity can have serious complications for pregnancy. If you are obese and not yet pregnant, consider postponing pregnancy until you achieve a healthier weight level. (See Thinking About Getting Pregnant? Think About Your Weight)
The review supported current weight recommendations for normal weight and overweight women. They found that weight gains below these levels had a strong association with women with low birthweight babies. Low birthweight infants are more likely to have problems breathing than normal infants. They may have more problems breastfeeding and have a higher risk of other, more serious complications.
Women who were obese and gained less than the 15 pounds recommended by the guidelines were not more likely to have low birth weight babies – however the researchers noted that the evidence to assert
this was weak.
This review did not address the quality of diet. In practice there is a significant difference between women who eat a healthy diet and women who eat a poor diet. Until there is further research, talk to your doctor about learning to eat a healthy diet during pregnancy and not being overly concerned about a moderate weight gain if it comes from healthy food. Babies (and their mothers) need to be well nourished.
Women who do not eat a healthy diet may not be getting adequate nutrients to their babies. If you are
losing weight during your pregnancy, keep a food diary for a few days to make sure that you are really eating enough healthy food to nourish your baby.
The review also addressed the area of post partum weight retention. Women who gained more than the recommended guidelines retained more weight than those who gained the recommended amount. Women who gained weight quickly (regardless of the total amount gained) had more problems with
retaining weight after birth.
Regardless of your choices, your body plans to breastfeed. At times, your baby will need more calories than you can take in with a healthy diet. Nature knows this so adds a cushion of a few pounds. Women who breastfeed often use this stored energy, and breastfeeding can help reduce obesity in women. There is also evidence that babies who are breastfed are less likely to be obese as children (and probably as adults).
Be careful of extremely low fat diets during pregnancy. Fat soluble vitamins are important to baby’s growth and development. Chose healthy fats (such as avocados, nuts, small amounts of butter
or olive oil). Moderate amounts of seafood can be very beneficial. Avoid trans-fats, which are usually found in highly processed foods.
What if you are gaining faster than the recommendations? Evaluate your diet. Cut out empty calories. Add daily exercise. Decrease the grain category a small amount. Choose slightly smaller portions. Continue to include a wide variety of foods in reasonable amounts. Pregnancy is not a time for severe dieting.
Weight gain is only one measure of nutritional intake. However, it can be an important part of your health and your baby’s future health. Not sure what to eat during pregnancy? Unless your doctor tells
you otherwise, use our checklist.
1. Siega-Riz A.M, Viswanathan M et.
al. A systematic review of outcomes of maternal weight gain according to the Institute of Medicine recommendations: birthweight, fetal growth, and postpartum weight retention. Am J of Obstetics and Gynecology. October 2009 p 339e1-339e14
2. Flegal KM, Carroll MD, Ogden CL, Curtin LR. Prevalence and trends in obesity among US adults,
1999-2008.
3. JAMA 2010; DOI: 10.1001/jama.2009.2014. and Ogden CL, Carroll MD, Curtin LR, et al. Prevalence of high body mass index in US children and adolescents, 2007-2008. JAMA 2010
This section contains articles and guidance for healthy eating whether you are working on becoming pregnant, expecting or have a new baby. Articles cover information including what to eat, controlling nausea, breastfeeding and vitamins.