The great baby weight debate

The weight is over, when it comes to debunking popular misconceptions about managing mom’s pounds before, during, and after pregnancy.

Dr. Grace Lau, assistant professor in the department of obstetrics and gynecology at New York University Langone Medical Center, says that it is important that every woman knows her baseline weight, so she can determine whether she is going through normal changes or something out of the ordinary.

“For someone of normal body mass index, the aim is to gain between 25 and 35 pounds total over the whole pregnancy, but if you are overweight or underweight or carrying a multiple gestation, your target weight gain is different, and you should check with your practitioner,” said Lau.

Do not believe the old saw about a positive pregnancy test giving you license to throw calorie counting out the door for the next nine months.

“We always hear that pregnancy is a time when you eat for two, but that does not equate to multiplying your daily caloric consumption by two, because the other person you are eating for is a small fetus,” said Lau.

If you follow the standard recommendations, you’ll enjoy a healthier pregnancy.

“In the first trimester, you do not need to increase your caloric intake much at all, but by the second trimester, you will increase by 300 calories a day to obtain that 25- to 35-pound weight gain,” said Lau.

The key is to strive for a well-balanced, low-fat, high-fiber diet.

“Consuming adequate protein is important, and fiber in your diet helps to prevent or reduce constipation and hemorrhoids,” said Lau. Exercise is the other half of the equation. “If you are healthy and have a normal pregnancy, you should get in 30 minutes or more of moderate exercise on most days. But before you start, just get the green light from your doctor.”

If you are not used to exercising, the American Congress of Obstetricians and Gynecologists advises beginning with as little as five minutes of exercise a day, and adding five minutes each week. The idea is that you stay active for 30 minutes a day — and something as simple as taking a walk can offer you health benefits and does not strain joints. Swimming is another great choice for pregnant women.

Whether you are wondering about diet or exercise, you should feel comfortable bringing any questions and concerns to your first prenatal visit, and it is highly encouraged that women maintain an open dialogue with their providers.

If you are obese, pregnancy is a poor time to attempt to lose weight. The American Congress of Obstetricians and Gynecologists states that because overweight and obese women have a higher risk of the complication of gestational diabetes than women who are at a normal weight, their healthcare providers may test them for gestational diabetes during the first three months of pregnancy. Sometimes modifications are made for obese women, because a vaginal delivery might be harder to achieve since it is can be a challenge to monitor the baby during labor.

Being obese increases the risk of some problems for the baby, including birth defects like heart defects or neural tube defects. It may be hard for the doctor to run tests, because if you have too much body fat, it can be more difficult to see certain problems with the baby’s anatomy on an ultrasound exam. Preterm birth and stillbirth rates are also higher if the mother has a high body mass index.

Obesity also puts the mother at risk for health problems, including high blood pressure, preeclampsia, and gestational diabetes. It is advised to do the best you can and work closely with your obstetrician, because despite the risks, it is still possible to have a safe pregnancy and healthy baby if you are obese.

It is normal to worry about how or if you will lose the baby weight after your pregnancy.

“I tell my patients not to stress about weight loss during the first six weeks postpartum,” said Lau.

Do not fall for fad diets — but, rather, try to ease back into an exercise program when your doctor deems you ready.

“Breastfeeding can help, too, as you can burn from 200 to 500 calories per day that way,” said Lau. “Weight loss should be slow and gradual, and if you are breastfeeding, you should not slash calories, because you need that energy for your milk supply.”

Jamie Lober, author of “Pink Power” (www.getpinkpower.com), is dedicated to providing information on women’s and pediatric health topics. She can be reached at [email protected]. © 2013 Jamie Lober

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