August 27th, 2011 by Hasham

Weight Gain

Overview:

The appropriate amount of weight to gain during pregnancy is based on multiple factors, including the mother’s initial weight, trimester of pregnancy and number of fetuses. The Institutes of Medicine has updated their recommendations for pregnancy weight gain.

Mother’s Pre-Pregnancy Weight Consideration:

In general, the recommendation for pregnancy weight gain is 25 to 35 pounds. A woman who is considered to be underweight should gain more–about 28 to 40 pounds. Women who are overweight or obese, with a BMI greater than 25, should gain less weight–between 10 to 25 pounds over the course of the nine months.

Trimester Weight Gain:

During the first trimester of pregnancy, a woman’s weight gain is minimal, consisting of only about two to four additional pounds. During the second and third trimesters, weight gain increases more rapidly, to about one pound a week.

Weight Gain Recommendation for Multiples:

Women who are at a normal weight prior to pregnancy and who are carrying twins should gain between 37 and 54 pounds over the course of their pregnancy, according to the March of Dimes. Women with triplets should gain between 45 and 60 pounds. Women carrying more than three fetuses should add an additional ten pounds per baby. In multiple pregnancies, weight gain is most rapid during the second trimester, with many babies delivered prior to 38 weeks of gestation.

Where Does the Weight Come From?

Of the total amount of weight gained during pregnancy, the baby likely only contributes about seven to eight pounds. The remainder of the weight comes from the placenta and amniotic fluid, increase in breast and uterine tissue, increase in fat stores and an expansion of the blood supply.

The Dangers of Excess Weight Gain:

According to the Institutes of Medicine, mothers-to-be who gain excess weight during pregnancy face an increased risk for cesarean section due to babies of larger birth weight. They also may be at increased risk of retaining the weight after the pregnancy ends. Babies who are above normal birth weight risk premature birth, stunted growth and blood sugar issues.

First trimester:

Your primary weight-gain challenge now is nausea. You have nearly double the hormones that make singleton expectant moms queasy, so it’s quite possible that you’ll have more intense morning sickness (and it’s more likely it will last all day). The good news: For some women, eating small amounts of food can actually help calm the stomach. If you are one of these lucky ones, just try to make the most healthful choices that your cravings (and your queasiness) will allow and aim to gain about a pound a week through the first trimester. If you aren’t this lucky, relax. You can catch up later. Just be sure to take your prenatal vitamin (try switching brands if that makes you sick, too), sip fluids so you don’t get dehydrated, and tell your practitioner if you can’t keep any food or liquid down.

Second trimester:

If you’re lucky, your nausea will have subsided around the 12-week mark (for some it’s more like week 16, or even 20). Now’s your chance to really load up on the nutrition your babies need to grow. If you gained no weight during the first trimester (or if you lost weight due to your nausea and vomiting) your practitioner may want you to gain one and a half to two pounds per week during this period. (If you’ve been gaining steadily through the first trimester, aim for one and a half pounds a week.) If you need to catch up, it’s time to supercharge your pregnancy diet with extra servings of protein, calcium, and whole grains. Whole milk (with powdered milk mixed in, for an extra calcium kick), cottage cheese, beef, and turkey are good options to get the nutrients you need.

Third trimester:

Your goal now is to continue the one-and-a-half-to-two- pound-per-week gain through your seventh month. By 32 weeks, your twins may be four pounds each. (Think about it: That adds up to eight pounds of babies alone, which is as much baby weight as most moms of singletons ever have to carry to term.) That doesn’t leave much room for food, which is why heartburn and indigestion are all-too common among in the last stage of multiple pregnancies. But don’t give up on your healthy eating plan. Your babies are really bulking up now, and they need the nutrition a well-balanced diet provides. Expect to gain a pound a week or less in the eighth month, and just a pound or so total during the ninth. (This makes more sense when you remember that most multiple pregnancies don’t make it to 40 weeks.)