Safe weight gain during pregnancy

Managing your weight gain during pregnancy: MedlinePlus Medical Encyclopedia

Most women should gain somewhere between 25 and 35 pounds (11.5 to 16 kilograms) during pregnancy. Most will gain 2 to 4 pounds (1 to 2 kilograms) during the first trimester, and then 1 pound (0.5 kilogram) a week for the rest of the pregnancy. The amount of weight gain depends on your situation.

Overweight women need to gain less (15 to 25 pounds or 7 to 11 kilograms or less, depending on their pre-pregnancy weight).
Underweight women will need to gain more (28 to 40 pounds or 13 to 18 kilograms).
You should gain more weight if you are having more than 1 baby. Women having twins need to gain 37 to 54 pounds (16.5 to 24.5 kilograms).

A balanced, nutrient-rich diet, along with exercise, is the basis for a healthy pregnancy. For most pregnant women, the right amount of calories is:

1,800 calories per day in the 1st trimester
2,200 calories per day in the 2nd trimester
2,400 calories per day in the 3rd trimester

Much of the weight that you gain during pregnancy is not fat, but is related to the baby. Here is a breakdown of how 35 pounds (16 kilograms) adds up:

Baby: 8 pounds (3.5 kilograms)
Placenta: 2 to 3 pounds (1 to 1.5 kilograms)
Amniotic fluid: 2 to 3 pounds (1 to 1.5 kilograms)
Breast tissue: 2 to 3 pounds (1 to 1.5 kilograms)
Blood supply: 4 pounds (2 kilograms)
Fat stores: 5 to 9 pounds (2.5 to 4 kilograms)
Uterus growth: 2 to 5 pounds (1 to 2.5 kilograms)

Some women are already overweight when they get pregnant. Other women gain weight too quickly during their pregnancy. Either way, a pregnant woman should not go on a diet or try to lose weight during pregnancy.

It is better to focus on eating the right foods and staying active. If you do not gain enough weight during pregnancy, you and your baby may have problems.

Still, you can make changes in your diet to get the nutrients you need without gaining too much weight. Talk to your health care provider to get help with planning a healthy diet.

Below are some healthy eating tips to help you get started.

Healthy choices:

Fresh fruits and vegetables make good snacks. They are full of vitamins and low in calories and fat.
Eat breads, crackers, and cereals made with whole grains.
Choose reduced-fat dairy products. You need at least 4 servings of milk products every day. However, using skim, 1%, or 2% milk will greatly reduce the amount of calories and fat you eat. Also choose low-fat or fat-free cheese or yogurt.

Foods to avoid:

Naturally sweetened is better than foods and drinks with added sugar or artificial sweeteners.
Food and drinks that list sugar or corn syrup as one of the first ingredients are not good choices.
Many sweetened drinks are high in calories. Read the label and watch out for drinks that are high in sugar. Substitute water for sodas and fruit drinks.
Avoid junk-food snacks, such as chips, candy, cake, cookies, and ice cream. The best way to keep from eating junk food or other unhealthy snacks is to not have these foods in your house.
Go light on fats. Fats include cooking oils, margarine, butter, gravy, sauces, mayonnaise, regular salad dressings, lard, sour cream, and cream cheese. Try the lower-fat versions of these foods.

Eating out:

Knowing the amount of calories, fat, and salt in your food can help you eat healthier.
Most restaurants have menus and nutrition facts on their websites. Use these to plan ahead.
In general, eat at places that offer salads, soups, and vegetables.
Avoid fast food.

Cooking at home:

Prepare meals using low-fat cooking methods.
Avoid fried foods. Frying foods in oil or butter will increase the calories and fat of the meal.
Baking, broiling, grilling, and boiling are healthier, lower-fat methods of cooking.

Exercise:

Moderate exercise, as recommended by your provider, can help burn extra calories.
Walking and swimming are generally safe, effective exercises for pregnant women.
Be sure to talk to your provider before starting an exercise program.

If you have struggled with your weight in the past, it may be hard to accept that it is OK to gain weight now. It is normal to feel anxious as the numbers on the scale edge up.

Keep in mind that you need to gain weight for a healthy pregnancy. The extra pounds will come off after you have had your baby. However, if you gain a lot more weight than is recommended, your baby will also be bigger. That can sometimes lead to problems with delivery. A healthy diet and regular exercise are your best ways to ensure a healthy pregnancy and baby.

Prenatal care - managing your weight

Berger DS, West EH. Nutrition during pregnancy. In: Landon MB, Galan HL, Jauniaux ERM, et al, eds. Gabbe’s Obstetrics: Normal and Problem Pregnancies. 8th ed. Philadelphia, PA: Elsevier; 2021:chap 6.

Bodnar LM, Himes KP. Maternal nutrition. In: Resnik R, Lockwood CJ, Moore TR, Greene MF, Copel JA, Silver RM, eds. Creasy and Resnik's Maternal-Fetal Medicine: Principles and Practice. 8th ed. Philadelphia, PA: Elsevier; 2019:chap 12.

Updated by: John D. Jacobson, MD, Professor of Obstetrics and Gynecology, Loma Linda University School of Medicine, Loma Linda Center for Fertility, Loma Linda, CA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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Weight Gain During Pregnancy: How Much Is Normal?

Written by WebMD Editorial Contributors

Reviewed by Traci C. Johnson, MD on June 12, 2022

In general, you should gain about 2 to 4 pounds during the first 3 months you're pregnant and 1 pound a week during the rest of your pregnancy. If you are expecting twins you should gain 35 to 45 pounds during your pregnancy. This would be an average of 1 ½ pounds per week after the usual weight gain in the first 3 months.

It's especially important to gain the right amount of weight when you're expecting twins because your weight affects the babies' weight. And because twins are often born before the due date, a higher birth weight is important for their health. When carrying twins, you may need between 3,000 and 3,500 calories a day.

Where Does the Extra Weight Go During Pregnancy?

Baby: 8 pounds
Placenta: 2-3 pounds
Amniotic fluid: 2-3 pounds
Breast tissue: 2-3 pounds
Blood supply: 4 pounds
Stored fat for delivery and breastfeeding: 5-9 pounds
Larger uterus: 2-5 pounds
Total: 25-35 pounds

Is It Safe to Lose Weight When Pregnant?

If a woman is very overweight when they get pregnant, their doctor may want them to lose weight. They should only lose weight under their doctor's care. But in most cases, women should not try to lose weight or diet during pregnancy.

How to Gain the Right Amount of Weight During Pregnancy

If your health care provider wants you to gain weight while you're pregnant, try these tips:

Eat five to six small meals every day.
Keep quick, easy snacks on hand, such as nuts, raisins, cheese and crackers, dried fruit, and ice cream or yogurt.
Spread peanut butter on toast, crackers, apples, bananas, or celery. One tablespoon of creamy peanut butter gives you about 100 calories and 7 grams of protein.
Add nonfat powdered milk to mashed potatoes, scrambled eggs, and hot cereal.
Add extras to your meal, such as butter or margarine, cream cheese, gravy, sour cream, and cheese.

What if You Gain Too Much Weight During Pregnancy?

If you have gained more weight than your doctor recommended, talk to your doctor about it. In most cases, you'll want to wait until after delivery to lose weight.

Here are some tips to slow your weight gain:

When eating fast food, choose lower-fat items such as broiled chicken breast sandwich with tomato and lettuce (no sauce or mayonnaise), side salad with low-fat dressing, plain bagels, or a plain baked potato. Avoid foods such as French fries, mozzarella sticks, or breaded chicken patties.
Avoid whole milk products. You need at least four servings of milk products every day. However, using skim, 1%, or 2% milk will greatly reduce the amount of calories and fat you eat. Also, choose low-fat or fat-free cheese or yogurt.
Limit sweet or sugary drinks. Sweetened drinks such as soft drinks, fruit punch, fruit drinks, iced tea, lemonade, or powdered drink mixes have lots of empty calories. Choose water, club soda, or mineral water to skip extra calories.
Don't add salt to foods when cooking. Salt causes you to retain water.
Limit sweets and high-calorie snacks. Cookies, candies, donuts, cakes, syrup, honey, and potato chips have a lot of calories and little nutrition. Try not to eat these foods every day. Instead, try fresh fruit, low-fat yogurt, angel food cake with strawberries, or pretzels as lower-calorie snack and dessert choices.
Use fats in moderation. Fats include cooking oils, margarine, butter, gravy, sauces, mayonnaise, regular salad dressings, sauces, lard, sour cream, and cream cheese. Try lower-fat alternatives.
Cook food the healthy way. Frying foods in oil or butter will add calories and fat. Baking, broiling, grilling, and boiling are healthier preparation methods.
Exercise. Moderate exercise can help burn excess calories. Walking or swimming is usually safe for pregnant women. Ask your health care provider what exercise would be right for you before getting started.

When to Call Your Doctor

Talk to your doctor if you:

Want to know a good target weight gain for you
Think you are gaining too much weight
Are losing weight during the second or third trimester
Have an eating disorder that is keeping you from eating a healthy amount of food
Need help setting a good menu plan to gain a healthy amount of weight
Gain weight rapidly. This could be a sign of preeclampsia, pregnancy-related high blood pressure, a serious health issue

Health & Pregnancy Guide

Getting Pregnant
First Trimester
Second Trimester
Third Trimester
Labor and Delivery
Pregnancy Complications
All Guide Topics

Weight during pregnancy.

What increase is considered optimal?

Why is excessive weight gain during pregnancy particularly harmful? What should be the calorie content of the diet? How to build your diet so that you can eat varied (and tasty), but at the same time not gain too much? Let's figure it out.

What makes up weight gain during pregnancy?

An increase in the subcutaneous fat layer during pregnancy is a normal and natural process.

While the baby is growing inside you, he needs energy and external protection. But during pregnancy, weight increases not only and not so much due to the adipose tissue of the mother: there is more fluid in the body, the uterus grows, the fetus and placenta develop, and the breasts increase in preparation for the feeding process.

Interestingly, weight loss during the period of toxicosis can later provoke its increase: the body will try to regain what was lost.

Expectant mothers especially actively gain weight in the second trimester and the beginning of the third, but closer to childbirth, a pregnant woman can even lose 1-2 kilograms.

As long as the weight increases more or less evenly and does not go beyond the upper limit of the norm, there is nothing to worry about. But if your weight is rapidly going up, you should be wary.

How to correctly calculate the weight, and what increase is considered optimal?

In Russian obstetric practice, it is generally accepted that the total gain should not exceed 12 kg. for the entire pregnancy. Of these 12 kg. 5-6 accounts for the fetus, placenta, amniotic fluid, another 1.5-2 - for an increase in the uterus and mammary glands, and only 3-3.5 - for the fat mass of a woman.

But this is a general indicator, a kind of "average temperature in the hospital." The optimal increase is calculated individually and depends on the initial weight of the pregnant woman, her age, the number of fetuses and the size of the child (children), physical activity.

WHO recommends that optimal weight gain be calculated based on Body Mass Index (BMI).

It is determined by the formula: body weight (kg) / height squared (m).

BMI	Recommended weight gain
19.8-26 (normal body weight)	12.5-15 kg
26.1-29 (overweight)	11.5 - 14 kg
over 29 (obese)	7-9 kg

How to calculate the optimal weight gain?

To do this, use the following chart:

Calculate your BMI: divide your initial weight in kg. for height in meters squared.

For example, your "pre-pregnancy" weight was 60 kg with a height of 170 cm.

BMI = 60: (170 x 170) = 20.76.

A BMI of less than 18.5 indicates underweight. Indicators from 18.5 to 25 are within the norm, from 25 to 30 are above the norm, and a figure greater than 30 indicates obesity.
Now that you know your BMI, find the optimal weekly increase in the table and compare it with yours.

Week of pregnancy	Underweight before pregnancy (BMI less than 18.5)	Normal pre-pregnancy weight (BMI 18.5 to 24.9)	Overweight before pregnancy (BMI over 30)
4	0-0.9 kg	0-0.7 kg	0-0.5 kg
6	0-1.4 kg	0-1 kg	0-0.6 kg
8	0-1.6 kg	0-1.2 kg	0-0.7 kg
10	0-1.8 kg	0-1.3 kg	0-0.8 kg
12	0-2 kg	0-1.5 kg	0-1 kg
14	0.5-2.7 kg	0.5-2 kg	0.5-1.2 kg
16	up to 3.6 kg	up to 3 kg	up to 1.4 kg
18	up to 4.6 kg	up to 4 kg	up to 2. 3 kg
20	up to 6 kg	up to 5.9 kg	up to 2.9 kg
22	up to 7.2 kg	up to 7 kg	up to 3.4 kg
24	up to 8.6 kg	up to 8.5 kg	up to 3.9 kg
26	up to 10 kg	up to 10 kg	up to 5 kg
28	up to 13 kg	up to 11 kg	up to 5.4 kg
30	up to 14 kg	up to 12 kg	up to 5.9 kg
32	up to 15 kg	up to 13 kg	up to 6.4 kg
34	up to 16 kg	up to 14 kg	up to 7.3 kg
36	up to 17 kg	up to 15 kg	up to 7.9 kg
38	up to 18 kg	up to 16 kg	up to 8.6 kg
40	up to 18 kg	up to 16 kg	up to 9. 1 kg

Recently, doctors are increasingly talking about an individual approach and urge not to panic if the increase is slightly beyond the normal range. When assessing the state of health of a pregnant woman, the doctor focuses not only on weight, but also takes into account the results of tests and examinations and other important indicators.

Why is excessive weight gain dangerous?

Gaining extra pounds can lead to gestational diabetes, hypertension, preeclampsia, or cause a caesarean section.

In addition, excessive weight gain during pregnancy may increase the risk of obesity and associated cardiovascular disease.

What can I do to keep my weight within normal limits during pregnancy?

First of all, consult a nutritionist. If there is no such doctor in the antenatal clinic, it makes sense to contact a specialist on a commercial basis. He will develop an individual diet, which will contain all the useful elements, and will offer to keep a food diary. It will also tell you how to eat right and weigh yourself.
To prevent excessive weight gain during pregnancy, it is enough to follow simple rules of a healthy diet:

Eat often and in small portions;
Always keep a “healthy snack” on hand: fresh apple wedges, unsweetened crackers, dried fruit, or sugar-free yogurt;
Refuse soda, chips, sausages and sausages;
Minimize sweets;
Avoid fast food;
Limit the use of condiments, especially salt, which retains water in the body;
Choose steamed dishes;
Eat more fiber-rich foods such as whole grain bread, bran, vegetables;

The diet of a pregnant woman should be varied. Include grains, vegetables, fruits, dairy products, meat and fish, legumes, or nuts.

It must be remembered that expectant mothers should never starve and adhere to extreme diets.

How many calories per day do you need during pregnancy?

It is difficult to calculate the energy value per day on your own, and then strictly adhere to a certain number of calories, and it is not necessary, unless it is recommended by a nutritionist or endocrinologist. On average, you can aim for 2000-2500 calories per day, but it is important to understand that the need for calories depends on many factors: age, initial weight, health status and level of physical activity.

When should I be on the alert?

Strictly speaking, it is better for a pregnant woman not to worry and entrust her condition to a doctor who will control the development of pregnancy, analyzes and monitor weight. It is important to take tests to determine the level of fasting blood glucose once a trimester. The appearance of glucosuria, an increase in fasting blood glucose (more than 5.5 mmol / l) or an hour after a meal (more than 7.7 mmol / l) indicate the possible development of "diabetes in pregnancy", in connection with which the doctor will prescribe appropriate treatment . In addition, a sharp increase in body weight can cause preeclampsia.

These and other diseases can be dangerous, which is why you need to carefully monitor the body weight during the gestation period, but remember that pregnancy is not the time for strict diets.