How much weight should I gain during pregnancy?

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Weight gain pregnancy scales
We've all heard the phrase 'eating for two' - but now doctors are concerned that some pregnant women are taking this too far and are putting their babies at risk, according to a health watchdog.

The National Institute for Health and Clinical Excellence have released new guidelines to encourage women to be healthy during their pregnancies, as obesity can cause complications and problems for unborn babies.

The guidelines include advising women to try and reach a healthy weight before they get pregnant - and not to eat for two once they're pregnant.

Why do we need new guidelines?

Nearly half of all women at childbearing age are now overweight or obese - and many women find advice on weight gain during pregnancy confusing. The new guidelines are to help doctors make advice easier to follow.

Being overweight during pregnancy can put your baby at increased risk of complications like pre-eclampsia, gestational diabetes, miscarriage and stillbirth. Obese women are also more likely to need a Caesarean.

What should I do if I think I'm overweight during pregnancy?

It's natural to 'feel fat' during pregnancy, but talk to your doctor or midwife if you're concerned about your weight, as they'll be able to give you advice.

However, dieting is not recommended during pregnancy as it could harm your baby. Instead, women are advised to eat healthily and do regular, gentle exercise like swimming and brisk walking.

The old saying that you need to 'eat for two' just isn't true - you don't need to eat any extra calories until the last 3 months of your pregnancy - and even then, you only need around an extra 200 calories per day.

Keeping healthy during pregnancy will benefit you and your baby - and will help you to get back to healthy weight after birth

How much weight will I actually gain?

When you see your midwife at your antenatal appointment, she'll make a note of your weight and height, from which she can work out your BMI (Body Mass Index). The normal range is 20-25. Women who are considerably under or overweight may have additional risks, such as diabetes, high blood pressure or premature labour, and will probably need closer antenatal care.

The average weight gain during pregnancy is 9kg to 13.5kg (20-30lbs). In the first 12 weeks, most women don't gain much, if any, weight; by 20 weeks they've put on 25% of their total weight gain; by 30 weeks another 25%; and the remainder in the last 10 weeks. So, if you weigh 10 stone at the start of your pregnancy, you're likely to weigh between 11.4 - 12.1 stone by the end. However, there are lots of factors affecting weight gain during pregnancy, and everyone is different, so it's hard to predict how much you'll gain.

You must eat a healthy, balanced diet. Some mums-to-be have no appetite in the first three months of pregnancy because of morning sickness, but others say they're always hungry. You may feel better eating little and often, but make sure your diet is rich in vitamins and minerals.

Is my bump too big?

Women often compare their bumps with each other and then worry that theirs is 'too big' or 'too small'. The size is dictated by many things, not just how big or small your baby is. It may be the position in which he's lying, how tall you are, how many babies you've had before and, obviously, how many you're carrying!

We don't all have average-sized babies. By talking with other pregnant women, you'll discover that you're all secretly preoccupied with each other's bumps

What if my baby is too large?

Few babies are too big to push out. Babies tend to grow to 'fit' their mum's pelvis, but if they're genuinely too big to come out vaginally, your midwife will pick up on signs during labour. Sometimes babies have a 'deflexed head' during labour. This is when their chin isn't tucked onto their chest but is looking slightly up, which increases the dimension that has to go through the pelvis.

With good, strong contractions, however, the position can change. If your baby is 'too big' - a condition called cephalopelvic disproportion (CPD) - you'll need a caesarean section.

How will I know if my bump is the right size?

At each ante-natal appointment, your midwife will feel your abdomen and measure the distance from the top of the uterus to your pubic bone. Each week of pregnancy will measure about 1cm (1/2 in) on your bump.

If she feels that your baby isn't growing as well as he should be, she may send you for a scan to measure the growth or for a consultant opinion. If your baby feels significantly larger than expected, she'll do a blood test to rule out diabetes (glucose load test). But remember, not all babies are average size, and there will always be some that are bigger and some that are smaller.

What can affect the growth of my baby?

The source of nutrition and oxygen for your baby is the placenta, so if
this isn't working as efficiently as it should be, it can slow down the
growth. High blood pressure or pre-eclampsia can affect the placenta, as can smoking and malnutrition.

Continued below...

Diabetes in the mum-to-be can also affect a baby's growth, either slowing it
down or, more commonly, causing it to become large before term. But diabetic mums will have close antenatal care and regular scans monitoring their baby's growth, development and wellbeing.

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Christine Taylor

When I had my second baby I did over eat during the pregnancy and after she was born I had a lot of difficulty getting the weight off and my baby had an unhealthy eating disorder. Some people think it was due to her being bossed by her older sister but I think it could have been because of my eating far too much.

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