Gaining the right amount of weight is important for fetal development and health. Gaining either too much weight, or not enough, is associated with increased risk to both mother and baby, and unfortunately, most moms-to-be are falling into one of these categories. According to a study by the Center for Disease Control and Prevention (CDC), 47% of people gain more than the recommended amount of weight during pregnancy, while 21% do not gain enough. That means only one-third of pregnant people are getting it right. While factors like genetics certainly play a role, so do factors that you have more control over—including exercise and proper nutrition. Read on to learn more about the specific guidelines and some tips to help you stay within them.
Healthy Weight Gain Guidelines
The official guidelines for weight gain during pregnancy are provided by the Institute of Medicine. The most recent guidelines (from 2009) are summarized in the table below.
Because only about 6-8lbs of weight goes to the actual baby, you may be wondering where all of the additional weight goes. The extra pounds are distributed throughout the body between the breast tissue, growing uterus, placenta, increased blood supply, and accumulation of extra maternal fat stores.
Note that weight gain throughout pregnancy will not be evenly distributed. While every individual is different, below are general guidelines for the additional calories needed and expected weight gain each trimester.
- What you need: No additional calories! That’s right. The increased caloric needs actually do not begin until the second trimester.
- What you can expect: Even though there is no increased caloric need, there is some weight gain due to increased blood volume and fluid, as well as changes in appetite due to nausea. The norm is around 3 – 5lbs, but some people do not gain, or may even lose weight if morning sickness is extreme. That’s ok, and can be balanced in the second trimester.
- What you need: Additional 300 calories per day–more if you’re exercising.
- What you can expect: Most of your weight gain occurs during this trimester
- What you need: Additional 450 calories per day – more if you’re exercising.
- What you can expect: Women continue gaining weight, but often may plateau around week 36 as the stomach becomes compressed from the large uterus.
Notice the increased calories needed are nowhere near the old saying of “eating for two” It equates to about 1-2 additional snacks per day, along with an addition of 1-2 oz of protein at meals. Now even though you shouldn’t eat for two, aiming to get “nutrition for two” is a fantastic goal! In other words, try to boost the nutritional value of everything you eat. Here are a few tips:
- Focus on “nutrient-dense” foods: Nutrient dense foods are those that pack the most vitamins and nutrients per calorie. Examples include organic eggs, avocados, dark leafy greens, sweet potatoes, blueberries, Greek yogurt, wild salmon, nuts, and quinoa.
- Eat more protein and higher fiber foods: Protein and fiber create a longer sense of fullness to help you avoid overeating. In addition, high fiber foods like fruits, vegetables, whole grains, and legumes help alleviate constipation, which is common during pregnancy due to increased progesterone loosening the intestinal walls.
- Eat smaller meals, regularly spaced throughout the day: Because your blood sugar is lower during pregnancy (since more of it goes to your growing baby!), it’s best to eat smaller meals, regularly spaced throughout the day to avoid large fluctuations in blood sugar levels. This also helps reduce indigestion.
- Drink plenty of water: Pregnant people need at least 3 liters of water per day for adequate hydration (more if they are exercising). Hydration aids digestion and elimination, fuels exercise and boosts metabolism. Plus, dehydration can induce feelings of hunger, and lead you to overeat. While juice hydrates, it also adds unnecessary calories and sugars (natural sugars are still sugar!), so keep a water bottle handy and sip throughout the day.
- Listen to your body: During pregnancy, your body will very likely “tell” you what you need. Listen to those “cravings” and consider the qualities or nutrients inherent in those foods. For example, craving orange juice? Maybe your body wants some Vitamin C, and you can opt for an orange instead, which provides some extra fiber and less sugar than a full glass of OJ. There is truth in the joke that pregnant people want burgers: Your body needs iron! So maybe you enjoy that burger one day (perhaps with a whole wheat bun and healthy condiments!), but then opt for other healthier red meat sources on other days.
- Exercise: Along with a myriad of other benefits, continuing to stay active can help keep excess weight gain in check while building muscle to help you with the demands of labor and motherhood. Incorporate both cardio and strength-training. Just don’t exercise on a completely empty stomach since your blood sugar is already low, and exercise further reduces blood sugar.
- Get plenty of sleep: More than ever now is the time to prioritize sleep: Getting enough sleep better enables your body to reap the benefits of nutrients and exercise.
- Limit sugar, processed foods, and other empty calories: Sugary snacks and beverages contribute calories and lack nutrients that you and your growing baby need. In addition, many processed and packaged foods have addictive qualities, due to the combination of high-fat content + salty, savory, or sweet flavors, which could also lead to overeating. Remember to listen to your cravings and, for the most part, try to find a healthy swap that can help satisfy that craving.
Think of your pregnancy as the optimal time to begin nourishing your growing baby (and your own body) in the best way possible. Do your best to up the nutritional value of everything you eat, but be kind to yourself, and do not stress if morning sickness in the first trimester makes the thought of leafy green vegetables seem repulsive. Eat what is appealing to you, and just focus on getting some calories in. You can make up for it in the balance of your pregnancy.
Nicole Silber, RD, CSP, CLC is a registered dietitian, board-certified specialist in pediatric nutrition, and certified lactation counselor. Nicole has worked with hundreds of children, mothers and families with chronic medical conditions, pre and post-natal nutrition, gestational diabetes, food allergies, picky eating, oral-motor and sensory processing disorders, infant nutrition, breastfeeding, gastrointestinal conditions, prematurity, underweight and obesity. Currently she manages her private practice and frequently teaches Tiny Tasters Workshop series. Prior to her current roles, she served as a clinical nutritionist at the Morgan Stanley Children’s Hospital at New York Presbyterian/Columbia, where she covered the antepartum and postpartum units, and at NYU Langone/Fink Children’s Ambulatory Care Center. Nicole lives in Westchester County with her husband and her daughters, Lily & Luna.