More Articles on A Healthy Pregnancy

Thinking About Getting Pregnant?
Congratulations on Your Pregnancy! (for those who are newly pregnant)
What is a healthy pregnancy weight gain?
Can I continue to eat a vegetarian diet during pregnancy?
A Pregnancy Menu For You and Your Baby
Treating Nausea and Vomiting
What About Seafood?
Don't Eat That!
Pregnancy and Cholesterol
Wash Those Veggies!
Breastmilk, the Healthiest Diet for Babies
What DOES that Broccoli Do for My Baby?
Vitamin D Supplements in Pregnancy and Breastfeeding
New Research Affirms Individualized Vitamin D Supplementation for Pregnant Women
Breastfeeding: Developing a Future Gourmet
What to Do About The Flu
Gestational Diabetes
Decreasing the Risk of Gestation Diabetes
Keeping and Storing Breastmilk
Pregnancy Weight Gain Guidelines – Do We Need New Ones?
Breastfeeding: A Woman's Health Issue
Eating During Labor
Probiotics and a Decreased Risk of Gestational Diabetes
Pregnancy - a Time to be Active!
Clearing the Air : Quit Smoking for You and Your Child
What is a Healthy Pregnancy Diet for Obese Women?
Does Iron Intake Matter?
One Fish, Two Fish... Full Term Birth?
Folic acid in pregnancy and language development
A Mediterranean Diet, Pre-Pregnancy
There is No Substitute for a Healthy Diet
Honest Healthy Diets for Babies
Exercise for New Moms
A Healthy Pre-Pregnancy Diet and Gestational Diabetes
Vitamin D and Gestational Diabetes
Great News About Breastfeeding
Peanuts and Pregnancy
Fried Foods and Gestational Diabetes
Iodine supplements - should you take them?
Prevent Gestational Diabetes with a Mediterranean-style diet
FDA Updates Recommendations for Fish Consumption in Pregnancy

About Faith Bontrager, RN, BSN

Faith Bontrager, RN, BSNFaith's passion in nursing is to help people find the options they need to discover their personal path to optimum health. Ask her friends and they will tell you that their appreciation of nutritious food has grown through Faith. About Faith Bontrager, RN, BSN


A Healthy Pregnancy

Pregnancy Weight Gain Guidelines: Do We Need New Ones?

Current recommendations for pregnancy weight gain were established by the Institute of Medicine in 1990. They recommend that

  • Underweight women gain 28-40 pounds
  • Normal weight women should gain 25-35 pounds
  • Overweight gain 15-25 pounds
  • Obese women gain at least 15 pounds

A recent 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.

Obesity is a huge (no pun intended) problem in our nation. 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.

I have seen obese women eat a healthy diet during pregnancy and actually lose a little weight initially. This is usually because their pre-pregnancy diet consisted of too many soft drinks, sweets, or processed foods. They weren't focused on weight loss; they simply were making better choices and their weight became more "normal." This kind of eating pattern allowed them to continue a sustainable weight loss after the baby is born. 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.

I would have liked to see the impact of breastfeeding on retained weight gain. 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.

Nourish yourself and your child!

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