How much weight should I gain during pregnancy?
It’s clear that gaining the right amount of weight during pregnancy involves eating a healthy and balanced diet so that your baby is getting all the nutrients he or she needs and is growing at a healthy rate. In general, you will need to consume 100 to 300 more calories a day to meet the needs of your growing baby. You should gain about 2 to 4 pounds during your first three months of pregnancy and 1 pound a week for the remainder of your pregnancy.
Guidelines for weight gain during a singleton pregnancy are as follows:
- Underweight women (BMI < 18.5) should gain 28-40 pounds.
- Normal-weight women (BMI, 18.5-24.9) should gain 25-35 pounds.
- Overweight women (BMI, 25-29.9) should gain 15-25 pounds.
- Obese women (BMI, 30 or higher) should gain 11-20 pounds.
It is important to ask your health care provider how much weight you should gain during pregnancy. A woman of average weight before pregnancy should gain 25 to 35 pounds during pregnancy. Underweight women should gain 28-40 pounds during pregnancy. Overweight women may need to gain only 15-25 pounds during pregnancy.
The good news, in my experience, is that 95% of women will return to their normal body weight within 9 months of having their baby.
Where does all the weight gain go during pregnancy?
I find that some women in my practice have a difficult time pacing themselves as the pregnancy goes along on how much weight to gain and at what intervals. It’s a challenging time to see your body completely morph over a 9-month time period. I always remind women that this is a temporary time period when you need to allow your body to grow and develop in a healthy way. Once you are done with pregnancy and nursing you can have the body you once had before this wonderful journey began!
| Baby | 8 pounds |
| Placenta | 2-3 pounds |
| Amniotic fluid | 2-3 pounds |
| Breast tissue | 2-3 pounds |
| Blood supply | 4 pounds |
| Fat stores for delivery and breastfeeding | 5-9 pounds |
| Uterus increase | 2-5 pounds |
| Total | 25 to 35 pounds |
How much caffeine can I drink during pregnancy?
Caffeine can be consumed in a safe way in pregnancy. It was thought that moderate caffeine consumption > 200mg/day (12oz cup of brewed coffee) was thought to be a contributing factor in miscarriages and preterm labor. The good news for coffee drinkers is the studies currently do not show that drinking a 12 oz cup of coffee will lead to an increase miscarriage rate or affect your pregnant in the slightest way. It’s recommended to limit your caffeine intake to 1 cup of coffee or 2 cups of tea/day during pregnancy. Also know how much caffeine is contained in the foods and beverages you eat so you can keep the quantity under 200mg/day which is considered a safe amount before and during pregnancy.
The bottom line is all the medical research suggests that having a 12-oz cup of coffee or 2 cups of tea a day is safe for your growing baby.
| Table 1. Caffeine Content of Foods and Beverages | |
| Food and Beverages | Milligrams of Caffeine (Average) |
| Coffee (8 oz) Brewed, drip Instant |
137 76 |
| Tea (8 oz) Brewed Instant |
48 26–36 |
| Caffeinated soft drinks (12 oz) | 37 |
| Hot cocoa (12 oz) | 8–12 |
| Chocolate milk (8 oz) | 5–8 |
| Candy Dark chocolate (1.45 oz) Milk chocolate (1.55 oz) Semi-sweet chocolate (1/4 cup) Chocolate syrup (1 tbsp) |
30 11 26–28 3 |
| Coffee ice cream or frozen yogurt (1/2 cup) |
2 |
| U.S. Department of Agriculture, Agricultural Research Service, 2000. | |
What can I do for heartburn in pregnancy?
More than 60% of pregnant women have symptoms of severe heartburn beginning in the second trimester and continuing throughout the third trimester. Heartburn is also known as acid indigestion and feels like a burning sensation in the esophagus caused by reflux (comes back up) of the stomach contents. The reason heartburn in pregnancy occurs is due to the changing hormone levels which affect the muscles of the digestive tract. These muscles “relax” allowing stomach acids to splash back up into the esophagus. This action along with an enlarging uterus can crowd the abdomen pushing stomach acid upward resulting in heartburn.
To reduce heartburn during pregnancy you can do the following:
- Eat several small meals a day instead of three large ones
- Eat slowly.
- Avoid fried, spicy, or rich foods, or any foods that seem to cause relaxation of the lower esophageal sphincter and increase the risk of heartburn.
- Drink less while eating. Drinking large amounts while eating may increase the risk of acid reflux and heartburn.
- Don’t lie down directly after eating.
- Keep the head of your bed higher than the foot of your bed. Or place pillows under your shoulders to help prevent stomach acids from rising into your chest.
- Medications such as Tums or Maalox help coat the esophagus minimizing the burning sensation and are safe in pregnancy. Other over-the-counter medications that help with the symptoms include Zantac and Pepsid AC. These medications should be taken 30 minutes before each meal and before bedtime for optimal results. Rarely, prescriptive medications are needed to control severe heartburn symptoms. As always consult with your Obstetrician or health care provider.
- Wear loose-fitting clothing. Tight-fitting clothes can increase the pressure on your stomach and abdomen.
The good news is that heartburn usually disappears following childbirth
Should certain foods be avoided during pregnancy?
This is a common and important question. Food concerns during pregnancy include raw vegetables, unpasteurized juices, liver, and undercooked meat, poultry, or eggs. Food poisoning can occur when eating raw vegetables, unpasteurized juices, and undercooked meat, poultry, or eggs that can be linked with Salmonella and Escherichia coli bacteria.
Cooking properly and thoroughly kills bacteria in the majority of foods. The proper temperature can be determined by a meat thermometer, although cooking until well done is safe for most meat. If you are not sure what “well done’ means here are the exact temperature settings: Ground beef should be cooked to at least 160°F, roasts and steaks to 145°F, and whole poultry to 180°F. Eggs should have a firm yolk and white after cooking. Eggnog and hollandaise sauce have raw or partially cooked eggs and are not considered safe. Liver can contain extremely high levels of vitamin A and is probably safe, but it should be eaten in moderation.
Can I eat sushi during pregnancy?
Eating raw fish, such as sushi, has not been recommended in pregnancy since it can carry certain bacteria and parasites. However, no conclusive evidence in the published literature that eating sushi in pregnancy has an adverse effect on the pregnancy or that pregnant women have more complications after eating sushi. There are few published reports on an adverse association between sushi and bad pregnancy outcomes.
How much fish can I eat during pregnancy?
There are specific fish known to being exposed to the naturally occurring compound methylmercury, levels of which have been increasing in the waters because of industrial pollution. Mercury is very toxic and can cause problems to the fetus and to the newborn nursing infant. Fish, such as shark, swordfish, king mackerel, and tilefish, have increased mercury levels and cause the most concern for consumption by pregnant women.
A pregnant woman can safely eat 12 ounces per week of varieties of fish thought to be low in mercury if they eat a variety of cooked, smaller fish. The safest fish that are low in mercury are shrimp, canned light tuna, salmon, Pollock, and catfish. Specifically, albacore (white) tuna has more mercury than light tuna. So, pregnant women should eat only up to 6 ounces (one average meal) of albacore tuna per week. In addition, the Environmental Protection Agency (EPA) also recommends that pregnant women and young children limit their consumption of freshwater fish caught by family and friends to no more than one meal per week and to follow all local advisories as to fish safety. The EPA specifies no more than 8 ounces of uncooked fish per week for adults. (see the table below)
The bottom line is ask your health care provider/obstetrician if you have questions about what you are consuming during pregnancy or while nursing your infant.
What foods should be eaten in limited amount?
- Caffeine-Consuming less than 200mg of caffeine a day is considered a safe amount for a growing baby. This translates to a 12-ounce cup of coffee or 2 cups of tea a day.
- Fish-Limit your white (albacore) tuna intake to 6 ounces a week.
- Sodium-The Dietary Guidelines for Americans recommend limiting your sodium intake to less than 2,300mg a day. Read the food labels!
- Processed, fried, fatty, sugary, and refined grains.
What foods should be not be eaten in pregnancy?
- High mercury containing fish-Avoid fish that have are higher in mercury such as Shark, swordfish, king mackerel or tilefish
- Unpasteurized milk and foods made with unpasteurized milk, including soft cheeses such as feta, queso blanco, queso fresco, Camembert, brie, or blue-veined cheeses unless the label says “made with pasteurized milk.”
- Raw and undercooked seafood (sorry no sushi!), beef, pork, poultry and eggs.
How does alcohol use during the first 4-8 weeks of pregnancy affect an embryo?
No amount of alcohol is safe or recommended during pregnancy. A recent study published in Pediatrics found the following on the hazards of alcohol consumption during all stages of pregnancy. “Specifically, first trimester drinking (vs no drinking) produces 12 times the odds of giving birth to a child with FASD [fetal alcohol spectrum disorder], first and second trimester drinking increases FASD odds 61 times, and drinking in all trimesters increases the FASD odds 65 times.” This same study showed that 1 in 10 women still drink alcohol during pregnancy.
Drinking alcohol during pregnancy also puts you at risk for miscarriage, stillbirth, prematurity and sudden infant death syndrome (SIDS).
Is it safe for pregnant women to occasionally have an alcoholic drink?
There are some doctors that say occasional light drinking is probably safe during pregnancy and will not cause any harm to your baby. In the medical literature no amount, even light drinking, has not proven to be safe. A recent study done by the CDC found that “1 in 8 pregnant women in the US reported drinking at least one alcoholic beverage in the past month”. Some experts believe that even drinking a small “light amount” of alcohol can cause harm to your baby because every woman breaks down alcohol at different speed so it can circulate in your body along with your babies. Since the studies aren’t sure what affect that has on your baby who wants to take the risk. We know that heavy alcohol drinking can cause impaired brain development and functioning. What if we find out in 10 years that light alcohol drinking increased your risk of having a child with Attention Deficient Disorder or speech and language delay, would you still want to take a chance?
Is it safe for pregnant women to occasionally take a few sips of an alcoholic drink?
I suspect that some obstetricians may allow their pregnant patients to have a glass of wine or champagne during those special occasions. A rare alcoholic beverage probably would not cause any significant harm to the baby but often 1 or 2 glasses of alcohol can lead to 3 or 4 quickly. I think once the door is open allowing an occasional glass of wine or two, the boundaries start to become more blurred and less certain. It is this uncertainty and blurred boundaries that can increase the risk of problems to your unborn baby.
Some experts believe that even drinking a small “light amount” of alcohol can cause harm to your baby because every woman breaks down alcohol at different speed so it can circulate in your body along with your babies. Since the studies aren’t sure what affect that has on your baby who wants to take the risk.
Plus, when you make the rules of alcohol clear and saw it is not recommended to drink any alcohol in pregnancy, there is no room for misinterpreting what is said between doctor and patient.
How much alcohol is safe in pregnancy?
The fact is there is no safe amount (according to the medical studies) of alcohol to use during pregnancy
