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Exercise During Pregnancy for Smaller Baby

Moderate Exercise During Pregnancy Lowers Baby's Birth Weight, May Reduce Baby's Risk of Obesity

Written by Kathleen Doheny

April 5, 2010 -- Women who exercise moderately during pregnancy give birth to somewhat smaller babies, which may reduce the infants' obesity risk later, according to a new study.

The average birth weight of babies born to exercising mothers was lower but still very healthy.

The average birth weight of babies born to mothers who exercised was 7.5 pounds, compared to 7.8 pounds for mothers who did not exercise, says a team of researchers from New Zealand and the U.S. Babies born weighing 8.8 pounds or more are defined as high birth weight.

At the two-week checkup, the babies of exercising moms averaged 8.1 pounds; the babies of sedentary moms averaged 8.6 pounds.

"We would suggest this study support the recommendations of at least 30 minutes of moderate exercise daily and probably more," says study co-author Paul Hofman, MD, a researcher at the University of Auckland in New Zealand. The study is published in the Journal of Clinical Endocrinology & Metabolism.

The new research follows a recent study finding that three out of four pregnant women in the U.S. do not get enough exercise.

Exercise During Pregnancy: The Study

Hofman and his colleagues assigned 84 women pregnant with their first child to an exercise group or a control group. Women in the exercise group rode stationary bikes at home at a moderate intensity for 40 minutes, 5 times a week maximum, beginning at 20 weeks into the pregnancy and continuing until about week 36.

Women in the control group were instructed to continue their normal daily activities during the same time periods.

Women in both groups had, on average, a healthy body weight before pregnancy and were similar in other regards such as age and ethnicity.

Exercise During Pregnancy: Results

The babies born to the exercisers had a lower body weight and a lower body mass index or BMI.

There were no differences in the length of the babies, on average, between exercisers and non-exercisers. The exercise didn't affect the length of the pregnancy, either, or the mothers’ weight.

Exactly why the exercising mothers produced smaller babies isn't known, says study co-author Chris Baldi, PhD, an assistant professor of biological sciences at Northern Arizona University, Flagstaff.

Researchers initially believed the exercising mothers would become less insulin-resistant. Typically, Baldi says, a woman becomes more insulin-resistant during pregnancy, a normal occurrence within certain boundaries. "It has a lot to do with hormonal changes," he says. If a woman becomes too insulin-resistant, gestational diabetes can occur.

"It did not come out as we suspected," Baldi tells WebMD, with no substantial differences found in insulin resistance between the two groups.

The difference, says Baldi and Hofman, may be because of other factors, such as differences found in certain growth factors. Another possible explanation, Hofman says, is slightly reduced blood flow that occurs to the placenta during exercise and for several hours afterward.

Exercise During Pregnancy: Other Input

The finding of lower birth weights of infants of exercising mothers is not surprising to Linda May, PhD, an associate professor of anatomy at the Kansas City University of Medicine and Biosciences in Kansas City, Mo. , who has also researched the topic.

The finding that there was no change in insulin sensitivity between groups was surprising, she tells WebMD.

Her research has found that during pregnancy, more exercise [within recommended amounts for an individual] yields more benefits.

More study is needed on high-risk pregnant women, Hofman and May say. The women in the study, exercisers and non-exercisers, were not high risk.

For most healthy pregnant women, Hofman says, the research seems to support exercising at least 30 minutes a day moderately, and probably more. Some studies, he says, have demonstrated up to 60 minutes daily is generally safe.

the less the better?

9 months Mother and child

You can often hear from pregnant women that they are afraid to "feed" the baby and it is desirable that the weight of the baby be less before childbirth - so, they say, it will be easier to give birth, and there will be more chances not to break. But is it so unequivocally good if the baby weighs a little at the time of birth and what are the criteria for the normal weight of the child at birth?

“If I were a queen,” the third girl said, “I would give birth to a hero for the father-king,” these lines of the classic are still relevant today. The first question asked by happy dads and grandparents after giving birth: “What is the weight and height?” Moreover, “heroic” parameters are always perceived as an indisputable merit of the mother and a sign of the baby’s health, and the modest size of the newborn disappoints the male half of the family. Newly-made grandmothers and aunts also ask about the baby’s weight, but their reaction to the heroic data of a new family member is usually the opposite: they express sympathy for the mother and clarify whether everything is fine with her and the baby’s health after such “heroic” childbirth. If the newborn turns out to be miniature, the female half of the family sincerely rejoices for him and for his mother and congratulates him on an easy birth!

So, among mothers - both experienced and future - there is a strong opinion that the lower the weight of the child, the better for childbirth. Let's try to figure out how true this is, whether low weight is always a sign of the baby's health and a guarantee of easy childbirth, what determines the weight of the fetus at the time of the onset of labor and whether it can be influenced, how the weight of the baby affects the various stages of childbirth and what is more important in assessing the size fetus - weight or other factors?

Does “less” always mean “better”?

In fact, low birth weight - just like a large newborn - is not in itself a criterion for a baby's health. And it does not necessarily guarantee an easy birth.

►Often, low weight is the result of a lack of nutrition of the fetus during fetal development. If the mother is healthy, lives in normal conditions and eats normally, there can be only one reason for malnutrition of the child: reduced transport of nutrients in the blood due to impaired blood circulation between mother and baby at the level of placental vessels. And then, in addition to low weight, the crumbs may have another problem - chronic hypoxia , a long-standing and prolonged lack of oxygen: after all, the baby receives both oxygen and nutrients in the same way - they come to him from the mother's body through the placental blood flow. That is why doctors monitor the baby's weight gain and assess the compliance of its size with the norms for the gestational age at each ultrasound examination: a lag in growth and weight may be the first indication of a deterioration in placental circulation and the development of fetal hypoxia.

►Another problem of low birth weight is related directly to the process of childbirth itself: births with small fetuses are often quick and even rapid, since a small child encounters less resistance from the walls of the birth canal. And this, oddly enough, is the problem: fast, and especially rapid, births are often accompanied by significant ruptures of the soft tissues of the birth canal, since they simply do not have time to stretch with its rapid progress. It's dangerous for a baby0015 birth injuries , and for the mother - bleeding from tears and severe pain of contractions : when the intensity of contractions necessary for the birth of a child increases in three hours instead of twelve, the nervous system of the woman in labor simply does not have time to adapt to increased pain.

Is it possible to feed the baby?

►How often the mother of a “hero” has to hear from those around her: “Well, mommy, apparently she ate well - she fed the baby so much!” The essence of this popular statement boils down to the fact that the abundant nutrition of the mother directly affects the large weight of the child (large fetus) at the time of birth. It turns out that the mother herself is “to blame” for the heroic size of her child and the reason for the large weight of the newborn is malnutrition during pregnancy. In this sense, the statement is incorrect: there is no direct digestive tube between the body of the mother and the baby. The food consumed by a pregnant woman decomposes in the digestive tract to proteins, fats and carbohydrates, and even from these end products only what the body needs for energy metabolism is absorbed, because our body must spend a lot of energy on processing and assimilation of nutrients, and it extremely economical and will not waste energy in vain! Those micro- and macro-elements from the food received by the mother, which the baby really needs, are absorbed into the mother's bloodstream and delivered to the baby through the vessels of the placenta and umbilical cord. Surplus food is ejected from the mother's body through the intestines, some is deposited in the form of "rainy day reserves" in adipose tissue.

how to help them develop?

The birth of a small child is not uncommon today. Often, such babies are born on time or a little earlier, but due to a lack of weight, they can significantly lag behind their peers in development. Pediatricians and neuropathologists closely monitor the child's condition, because a child's body weight deficiency is a risk factor for changes in the neurological status, functional disorders of the cardiovascular and autonomic nervous systems. But because of their weakness, underweight children do not eat well, and the rate of weight gain in children born with low body weight determines their further physical and psychomotor development and the formation of the immune system.

How much should a newborn gain in weight?

To assess the development of your child and the compliance with the norm of the main indicators (height, weight), you can contact a pediatrician or independently - according to existing tables. In the first months, the child is actively growing, adding up to 25-60 grams per day. Small children with adequate nutrition can increase body weight more intensively than their peers. For the first month of life, children should gain up to 1.3-1.7 kg. After 5-6 months of life, the intensity of weight gain decreases somewhat - in 30 days, the increase can be only 400-700 grams.

The length of the child's body during the first month increases by 4-7 cm, and after 5-6 months of life, growth is added less intensively - by 2-3 cm. But parents should understand that these figures are approximate. Each child is individual. Its weight and height depend on many factors: heredity, the quality of the mother's nutrition, the state of health of the newborn, the severity of childbirth.

Why is the child not gaining weight well?

The main cause of underweight in the neonatal period is the baby's refusal to breastfeed. Small children have poor appetite and spend most of the day sleeping. Often, parents have to wake up the child for a long time, and after a few minutes of sucking on the breast or a bottle of formula, the newborn falls asleep again. Children are especially sleepy, in whom pronounced physiological jaundice was observed in the first days of life.

As a result, after the next weighing, the doctor can tell the mother that the newborn has not gained weight at all or the increase is insignificant. If the situation does not improve for several months, the mother and baby may be hospitalized for a comprehensive examination and tube feeding in a hospital setting.

Sometimes the cause of low weight gain lies in non-compliance with breastfeeding tactics. Pediatricians recommend applying the baby to only one breast during feeding so that it sucks out the "hind" milk, which is of particular energy value and rich in nutrients. Due to their inexperience, mothers offer both breasts to newborns. In this case, the child sucks the upper milk without making any effort and quickly falls asleep, slightly satisfying his hunger.

If the baby has had an infectious disease, has been ill for a long time, suffered from a high temperature or an intestinal disorder, then the monthly weight gain may be significantly less than usual. In this case, the timing of the introduction of complementary foods is also shifted, and during the period of illness, in general, many children practically refuse to eat, which is reflected in their weight. Parents should actively communicate with the pediatrician, if necessary, ask him questions of interest and adhere to all recommendations.

How to help a child gain weight and catch up with their peers in their development?

If you are breastfeeding, pay special attention to your diet. Drink as much liquid as possible: low-fat milk, compotes, hypoallergenic juices. Your diet must include boiled or baked meat. Take extra vitamins (as advised by the doctor). Breastfeed your baby immediately after waking up, when he is active, in a good mood and does not want to sleep.

But sometimes women's milk is produced in insufficient quantities or the baby does not have enough strength to suck it out. In this case, it is necessary to start supplementing with special infant formula as soon as possible. For children prone to allergic reactions, special hypoallergenic products are intended, which can be bought at a pharmacy, having previously discussed the mixture option with a pediatric nutritionist or pediatrician. Small babies are not adapted to intensive sucking, so the nipple on the bottle must be soft and pliable so that the child can fill up without problems.

In addition, in order to increase the rate of weight gain and, accordingly, for the proper growth and development of the child, it is recommended to give courses of preparations containing L-carnitine (levorcarnitine), an essential vitamin-like substance that has anabolic properties and has proven itself to normalize body weight in case of its deficiency. In addition, by increasing the secretory and enzymatic activity of gastric and intestinal juices, appetite and digestion improve. One of these drugs is Elkar, containing an aqueous solution of L-carnitine. Elkar is included in the "National program for optimizing the feeding of children in the first year of life" as a means of correcting malnutrition of the II degree.

In children, in contrast to the adult body, where levocarnitine is among the substances produced, the synthesis of this compound covers only 1% of the required amount. Of course, the required amount of L-carnitine is found in breast milk, but if natural feeding is impaired or impossible, the drug must be added to the diet.

In underweight children, psychomotor development is often retarded, which can subsequently manifest itself in the form of speech defects, instability of the nervous system. Elcar improves the energy supply of brain activity, which will help to avoid or reduce the degree of development of functional failure in various areas of the child's neuropsychic response (motor, emotional-motivational, vegetative, cognitive spheres).

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