Happy, Healthy and Heavier
When talking to a lot of my patients about their weight problems, one of the most common remarks is ‘My weight problems started during pregnancy.’
The best time to try and combat this effect is to aim at a healthy weight before conceiving. This can go a long way to helping you be happy and healthy during your pregnancy and postnatal period.
Approximately 50% of Australian women who become pregnant are overweight (BMI 25-29.5) or obese (BMI over 30). Most women of these women have a straightforward pregnancy and delivery, resulting in healthy babies. However, being overweight can increase the risk of complications. The most widely known are:
- Increased maternal blood pressure
- Gestational diabetes
- Miscarriage or premature labour
- Assisted birth or caesarian
- Blood clots
Postnatal complications can also include difficulties with breastfeeding as it can be challenging to accurately position your baby to feed correctly.
The Institute of Medicine’s suggested guidelines for weight gain in a single baby pregnancy are:
- 5-18 kg if your starting BMI is less than 18.5 (underweight)
- 5-16 kg if your starting BMI is 18.5 to 24.9 (normal)
- 7-11kg if your starting BMI is 25- 29.9 (overweight)
- 5-9 kg if your starting BMI is over 30 (obese)
Importantly, a recent study in the American Journal of Obstetrics and Gynaecology concluded that weight loss in pregnancy, or failure to gain 5kgs is associated with an increased risk of a small baby, decreased neonatal fat mass, decreased lean mass and a small head, even when Mum’s starting BMI is over 30.
This means that if you are overweight at the start of pregnancy, weight loss is not recommended. To decrease the risk of complications, it is advised that you attend all your antenatal appointments so that your obstetrician and midwife can keep a close eye on you and your baby and can respond well to any problems if they arise. However, weight loss between pregnancies results in decreased adverse effects in the next pregnancy.
A steady weight gain in pregnancy is normal and it is best to try and keep it within the recommended levels. This can be done by regular exercise, eating a variety of non-processed foods from across the food groups, and avoiding ‘eating for two’.
What should I eat during pregnancy?
- Plenty of vegetables of different types and colours with legumes/beans – 5-7 serves/day
- Grain (cereal) foods mainly wholegrain 8-8½ serves/day
- Lean meat, poultry, fish (beware of those that may contain a high level of mercury such as shark/flake, marlin, swordfish, deep sea perch, catfish).
- Reduced fat milk or yoghurt
- 14-20g/day of unsaturated spreads and oils for cooking, or nuts and seeds.
- Salt in food and drinks and don’t add salt at the table
- Food and drinks containing added sugars
To prevent Listeria infection, avoid:
- Soft cheeses and pate,
- Preserved and sandwich meats
- Pre-prepared salads
To prevent Salmonella, avoid:
- Raw eggs
Remember to drink plenty of water every day. During pregnancy and breastfeeding our need for water increases, so make sure you add a glass of water with each meal and another whenever you breastfeed.
- A lot depends on how active you were pre-pregnancy, and the most important piece of advice is to always follow how your body feels.
- Activities such as walking/swimming are good. If you don’t have a history of exercise, start with short sessions (10-15 mins) 3 x week, and gradually increase to 30 minute sessions.
- Exercise doesn’t have to be strenuous to be beneficial. You should be able to hold a conversation as you exercise in pregnancy.
- If you do develop any complications in the pregnancy then always follow the advice of your doctor regarding the amount of exercise to do.
- After delivery you can start exercise as soon as you are given the go ahead by your doctor, often after 6 weeks. Just remember to keep up your water intake and nutrition.
Losing weight after delivery:
- Many people start returning to their pre-pregnancy weight after delivery. However, this isn’t always the case – your body is going through significant changes, and lack of sleep and increased stress can make it particularly challenging for some mums.
- Slowly adopting healthy exercise habits and making sure your diet is rich in fresh foods, will go along way to helping you return to your pre-pregnancy weight over-time. Just don’t put too much pressure on yourself – remember, losing weight takes time and so focus on healthy habits more than weight loss.
- We don’t recommend anyone consider dieting for at least 8 weeks post delivery and only then with the agreement of your doctor. During the first 6 months of breastfeeding you need slightly more energy intake than you did in the latter stages of your pregnancy so work in close cooperation with your GP.