Women's Wellness: What's healthy pregnancy weight gain?

Like it or not, eating for two isn't a license to eat twice as much as usual. Use healthy lifestyle habits to manage your pregnancy weight gain, support your baby's health and make it easier to shed the extra pounds after delivery.

There's no one-size-fits-all approach to pregnancy weight gain. Appropriate weight gain for you depends on various factors, including your pre-pregnancy weight and body mass index (BMI). Your health and your baby's health also play a role. Work with your health care provider to determine what's right for you.

When You're Overweight

Being overweight before pregnancy increases the risk of various pregnancy complications, including gestational diabetes, high blood pressure disorders of pregnancy, such as preeclampsia, and the need for a C-section.

Work with your health care provider to determine what's best in your case and to manage your weight throughout pregnancy.

When You're Underweight

If you're underweight before pregnancy, it's essential to gain a reasonable amount of weight while you're pregnant. Without the extra weight, your baby might be born smaller than expected.

When You Gain Too Much

Gaining too much weight during pregnancy can increase your baby's risk of health problems, such as being born significantly larger than average (fetal macrosomia). You might also be at increased risk of pregnancy-related hypertension, gestational diabetes, prolonged labor, and the need for a C-section or delivery before your due date. Excessive weight gain during pregnancy can also increase your risk of postpartum weight retention and increases your risk of blood clots in the postpartum period.

Where Does Pregnancy Weight Gain Go?

Your baby might weigh in at 7 or 8 pounds (about 3 to 3.6 kilograms). That accounts for some of your pregnancy weight gain. What about the rest? Here's a sample breakdown:

• Larger breasts: 1 to 3 pounds (about 0.5 to 1.4 kilogram)
• Larger uterus: 2 pounds (about 0.9 kilogram)
• Placenta: 1 1/2 pounds (about 0.7 kilogram)
• Amniotic fluid: 2 pounds (about 0.9 kilogram)
• Increased blood volume: 3 to 4 pounds (about 1.4 to 1.8 kilograms)
• Increased fluid volume: 2 to 3 pounds (about 0.9 to 1.4 kilograms)
• Fat stores: 6 to 8 pounds (about 2.7 to 3.6 kilograms)

Putting On The Pounds

In the first trimester, most women don't need to gain much weight - which is good news if you're struggling with morning sickness.

If you start out at a healthy or normal weight, you need to gain only about 1 to 4 pounds (0.5 to 1.8 kilograms) in the first few months of pregnancy. You can do this by eating a healthy diet - no extra calories are necessary.

Steady weight gain is more important in the second and third trimesters - especially if you start out at a healthy weight or you're underweight. According to the guidelines, you'll gain about 1 pound (0.5 kilogram) a week until delivery. An extra 300 calories a day - half a sandwich and a glass of skim milk - might be enough to help you meet this goal. For women who are overweight or have a BMI of 30 or higher, the guidelines suggest a weight gain of about 1/2 pound (0.2 kilogram) a week in the second and third trimesters. Try adding a glass of low-fat milk or an ounce of cheese and a serving of fresh fruit to your diet.

Working With Your Health Care Provider

Your health care provider will keep a close eye on your weight. A dietitian also can help. Do your part by eating a healthy diet and keeping your prenatal appointments. To keep your pregnancy weight gain on target, your health care provider might offer suggestions for boosting calories or scaling back as needed.

©2020 Mayo Foundation for Medical Education and Research
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