Pregnancy Nutrition and Weight Gain

Many of our patients are concerned with finding out what is an appropriate amount of weight gain during pregnancy. Did you know that “eating right for two” depends not just on the types of foods you are eating, but on how much weight you gain?

Read on to find out what you need to know about changing your normal eating habits and how many extra calories you should be consuming.

Different guidelines for weight gain depend on pre-pregnancy weight. Underweight patients will need to eat more than patients who are overweight to begin with. You can easily determine what your weight expectations are for your height by using an online body mass index (BMI) calculator. Simply plug in your height and pre-pregnancy weight. (If you are athletic and particularly muscular, these calculators may not be as accurate.) For overweight or obese patients, weight loss prior to pregnancy can help to reduce risks of problems such as diabetes or high blood pressure in pregnancy and their associated complications.

Weight Category Appropriate weight gain (pounds)
Underweight BMI < 18.5 28-40
Normal weight BMI = 18.5-24.9   25-35
Overweight BMI = 25-29.9 15-25
Obese BMI = 30 or more 11-20

Approximately 300 extra calories a day are recommended to achieve a normal weight gain in a patient with a normal weight. This should be adjusted accordingly up or down depending on the desired weight gain. Your physician can help you to determine what is right for you.

It may be difficult to gain weight in early pregnancy due to nausea. Some patients even experience weight loss. If you are unable to hold down food, vomit more than 2-3 times a day, or have significant nausea that interferes with everyday activities, you should discuss with your doctor whether a medicine for nausea should be prescribed. Ginger can be soothing, and small frequent meals throughout the day are usually easier to digest. Bland foods and carbohydrates may be easier to tolerate early on. It may be difficult to maintain adequate nutrition, since vegetables and protein sources may be less appealing. A prenatal vitamin will help fill in some of the missing gaps. Your physician can help you find a prenatal vitamin that you may be able to tolerate. Some prescription vitamins appear to be more tolerable for some patients. Liquid, chewable and gummy forms are also available. Meal supplement shakes may contribute to overall nutrition, and these may be especially helpful for underweight patients when used as in-between meals snacks.

If you already have a healthy diet – an extra snack or so a day will easily provide 300 extra calories. In order to stabilize blood sugar levels, try spreading out your calories into smaller, more frequent meals. Eating more protein and avoiding overly sweet foods, or foods that are very high in carbohydrates will also help to minimize the “up and down” feelings that may be more common during pregnancy.

Nutritional choices should include each of the food groups, including whole grains, fruits, vegetables and lean protein. Overly-processed foods, excessive sodium and saturated fats should be avoided. Adequate dairy intake can help to provide the extra calcium your developing baby needs. Folic acid is an important B vitamin that is found in green leafy vegetables, beans, nuts, peas and fortified breakfast cereals. It has been shown to reduce neural tube defects, (such as spina bifida) and should be consumed regularly both before and after conception – especially during the early developmental stages of pregnancy. Prenatal vitamins contain folic acid. Certain prescription prenatal vitamins now contain folic acid that may be more readily absorbable for certain patients. Iron-rich foods such as lean red meat, spinach and fortified whole grains and cereals can help to prevent anemia, which is common during pregnancy. Fiber and water should be increased when increasing iron to avoid constipation, and stool softeners can be taken when needed. Vegans need to especially concentrate on making sure that protein and calcium intake is adequate. This can be accomplished by incorporating beans, nuts, leafy greens and vegetables and considering food choices like tofu and soy milk.

Seafood should be limited to less than 12 ounces weekly due to potential for mercury exposure. Certain fish, such as tilefish, swordfish, shark and mackerel should be completely avoided. Fish, however, do contain beneficial omega-3 fatty acids which have been found to promote healthy brain and spinal cord development. This is why DHA, an omega-3 fatty acid which is found in fish oil has been recommended daily in pregnancy. Fish oil is processed to eliminate mercury, and therefore can be safely consumed during pregnancy (there are plant sources of DHA available as well). Fish and shellfish that tend to contain lower mercury levels include salmon, shrimp, clams, pollock, catfish and tilapia.

Avoid unpasteurized food products, which may include certain kinds of milk, juices, apple cider, deli meats and soft cheeses. Refer to product labels which usually provide this information. Doing so can reduce the risk of listeriosis, a significant bacterial illness. When in doubt, heating these items can reduce this risk. Wash vegetables and produce thoroughly and avoid uncooked or undercooked seafood, meat and fish. Avoid alcohol completely and limit caffeine to 1-2 six to eight ounce servings or less daily. Water is always the healthiest beverage choice and 6-8 eight ounce glasses daily will help to avoid dehydration that can commonly occur in pregnancy. Dehydration is a common well-known cause of preterm contractions.

Let us know if you have questions about your nutritional requirements in pregnancy. We are here to help!