Sunday, March 14, 2010

Diet, Exercise, Weight Gain

So, I get asked all the time "How much weight should I gain with pregnancy?" The answer is slightly different depending on your starting weight, so here goes. If you are a normal weight and BMI (body mass index) when you become pregnant, you should gain about 25-35 lbs. If you are overweight or obese meaning a BMI greater than 26, you should gain no more than 20 lbs. If you are underweight BMI less than about 21 you should gain about 28-40 lbs. Weight gain is something I believe is so important in growing a healthy baby. If you are not gaining enough weight, you risk a small for gestational age baby or a growth restricted baby. You also increase your risk of preterm birth (which although you may not care to be pregnant anymore, this is extremely dangerous for the baby). On the flip side of this, if you gain too much weight during pregnancy you risk a baby that is large for gestational age and the baby may have difficulty regulating blood sugars. Further a large baby (usually 9 + lbs is considered large) is at greater risk of birth trauma from shoulder dystocia (meaning we get the head delivered and the shoulders get stuck). This can result in Erb's palsy which causes the affected arm to be permanently numb (some are can be temporary) and can also result in death if we are unable to get the baby delivered rapidly. It also increases your risk of more severe vaginal and/or rectal lacerations :(
Okay, so now you know the risks, what can you do to prevent them? Try to eat healthy diet full of fresh vegetables, fruits, proteins, and complex carbohydrates. Try to avoid excess sugar, soda pop, and juices. Typically if you can include a small amount of protein with each meal, you will keep your blood sugars more stable and will not have rapid drops in sugar levels which make you crave more of the unhealthy sugars that contribute to some of the above problems. Protein is found in meats, fish, beans, nuts, peanut butter, tofu, yogurt, and cheese. I find if I tell patients that are feeling episodes of dizziness to include a small amount of protein with each meal, they tend to do better.
The other thing is exercise. Although I'm not a believer that you should be out running marathons or anything too strenuous, a little bit of exercise will help you maintain a normal weight gain with pregnancy and can help you be in shape for delivery. I would recommend walking, swimming, light aerobics, light weight lifting (no greater than about 10 lbs), yoga or pilates. Exercise also increases your brains natural endorphins such as serotonin and norepinephrine making you less depressed and moody.
Well, all of that being said, genetics do play a role in the size of your baby and some other conditions that you may not have total control of. So don't beat yourself up if you have a baby less than 6 lbs or over 9 lbs, you may not have been able to help it. I'm only suggesting ways to try and have the healthiest pregnancy and birth experience for you and your baby....
Good luck!

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