Dr. Jacqueline Gerhart: Too much weight gain during pregnancy has a few negatives

UW Health Family Medicine physician Dr. Jacqueline GerhartMadison, Wisconsin - UW Health Family Medicine physician Jacqueline Gerhart writes a column that appears Tuesdays on madison.com and in the Wisconsin State Journal. Columns are re-published here with permission.


Dear Dr. Gerhart: 


I'm 30 weeks pregnant and I have gained 40 pounds. My doctor said that I might be gaining too much weight. But I just crave food. Does gaining more weight hurt the baby? 


Dear Reader: 


Congratulations on your pregnancy! Being 30 weeks along is an exciting time. Chances are that you no longer have nausea or morning sickness that is usually associated with early pregnancy. You also may be finding it a bit more difficult to get around to do your normal tasks. The lack of nausea — and the ability to eat more — combined with the decreased desire to exercise may be contributing to the weight gain. 


Remember that the weight you gain during pregnancy is not only your baby. In other words, you won't be having a 40 pound baby! You are gaining weight to support the baby's placenta (which is baby's source of nutrients), and the fluid that the baby sits in (called the amniotic fluid). You are also gaining breast mass, increasing needed fat stores and expanding your blood volume. 


There is no steadfast rule regarding how much weight to gain in pregnancy. The ideal amount depends on your starting weight and body mass index (BMI). In general, I recommend that patients who are underweight pre-pregnancy gain between 30–40 pounds during pregnancy. Those who are normal weight I suggest gain about 25-35 pounds and those who are overweight should gain about 15-25 pounds. 

These estimates change and vary depending on both mom's health and baby's health. For example, having twins or having a history of low birth weight babies may change this estimate. 


Gaining too much weight in pregnancy is often uncomfortable. Some people notice leg swelling, back pain, or feel overheated. You also are more likely to develop high blood pressure or diabetes during pregnancy with excessive weight gain. High blood pressure may affect your blood flow to the placenta, which can lead to a more serious condition called preeclampsia, or could necessitate that you deliver the baby early to prevent complications to you or your baby. Diabetes may affect your baby's sugar metabolism, may cause a larger baby, or may necessitate that you need help pushing the baby out. (This can mean the person delivering your baby may need to use special tools, may make a cut in your vaginal area to allow more space, or may need to do a C-section ). Also, if you develop diabetes in pregnancy, both you and your baby are more likely to develop type 2 diabetes later in life. 


With all that being said, most people who gain more than their goal weight in pregnancy have healthy kids and remain healthy themselves. But if you want to reduce your risk, try this advice: Stick to eating about 300 calories more per day than what you did pre-pregnancy. Continue to include activity or exercise in your schedule, and try to lower your stress levels as much as possible. 


Congrats again, you are almost there! 



This column provides general health information and is not specific advice intended for any particular individual(s). It is not a professional medical opinion or a diagnosis. Always consult your personal health care provider about your concerns. No ongoing relationship of any sort (including but not limited to any form of professional relationship) is implied or offered by Dr. Gerhart to people submitting questions.


Date Published: 12/27/2011

News tag(s):  jacqueline l gerhart

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