Here at Westchester Health, we get this question a lot from our moms who are expecting. Our answer? Yes, of course, you do need to eat extra calories for your growing baby, but it’s really not necessary to “eat for two.” In actual fact, the average pregnant woman needs only about 300 healthy calories more a day than she did before she was pregnant in order to gain the right amount of weight.
As well as gaining weight, there are a number of important steps you need to take in order to have a healthy pregnancy, including eating a balanced diet, exercising regularly, taking a vitamin and mineral supplement if recommended by your physician, and avoiding alcohol, tobacco and other harmful substances.
How much you should gain while pregnant, based on your body type
In general, you should gain about 2-4 pounds during the first three months (1st trimester) of the pregnancy and 1 pound a week during the rest of your pregnancy. Here’s what we recommend:
- A woman who was average weight before getting pregnant should gain 25-35 pounds
- Underweight women should gain 28-40 pounds
- Overweight women should gain only 15-25 pounds
- If you are expecting twins, you should gain 35-45 pounds
For twins, weight gain increases to 1½ pounds per week after the first three months. It’s particularly important to gain enough weight when you’re carrying twins because your weight directly affects the babies’ weight. In addition, because twins are often born before their due date, a higher birth weight is important for their health. With twins, you may need between 3,000 and 3,500 calories a day.
Where your extra weight goes during pregnancy
As well as asking how weight they should gain, our pregnant patients often ask us, “Where does all the weight I’m gaining actually go?” Here’s a general breakdown:
- 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
It’s not just eating more, it’s eating the right things
A balanced diet containing a variety of foods can provide pregnant women with enough nutrients for themselves and their developing baby. These should include:
- Whole grains: Bread, cereals, pastas and brown rice.
- Fruits: All types of fruits without added sugars.
- Vegetables: A variety of colorful vegetables with no added salt. Raw sprouts should be avoided.
- Lean protein: Choose lean protein from meat, poultry, fish, eggs, beans and peas, peanut butter, soy products and nuts. Avoid eating tilefish, shark, swordfish and king mackerel, and limit white (albacore) tuna to 6 ounces per week. Deli, luncheon meats and hot dogs should be reheated before eating, avoided altogether.
- Dairy: This includes milk, cheese, ice cream and yogurt. Unpasteurized milk and some soft cheeses that are made from unpasteurized milk should be avoided.
- Healthy fats: You can get these from foods such as avocados, nuts and seeds as well as vegetable oils including canola and olive oil.
- Folic Acid: Folic acid reduces the risk of birth defects that affect the spinal cord. That’s why pregnant women should consume at least 400 micrograms of folic acid each day. Sources of folate include legumes, green leafy vegetables and citrus fruits. Folate also can be obtained through fortified foods such as cereals, pastas and bread, as well as vitamin supplements.
- Iron: Maternal iron deficiency is the most common nutritional deficiency during pregnancy. Pregnant women need at least 27 milligrams of iron each day. Good sources of iron include red meat, chicken and fish, fortified cereals, spinach, beans and some leafy greens.
- Calcium: During pregnancy, it’s important to get enough calcium for the healthy development of a baby’s teeth, bones, heart, nerves and muscles. When a pregnant woman does not consume enough calcium, her body will take it from her bones for the baby. The recommended amount of calcium during pregnancy is 1,300 milligrams per day for adolescents 14-18 years old and 1,000 milligrams per day for women 19-50 years old. That equals at least 3 daily servings of calcium-rich foods such as milk, yogurt, cheese, broccoli or fortified cereals and juices.
5 tips for sensibly gaining weight while pregnant
- Eat 5-6 small meals a day rather than 3 large ones.
- Keep quick, easy snacks on hand, such as nuts, raisins, cheese and crackers, dried fruit, peanut butter and ice cream or yogurt.
- Spread peanut butter on toast, crackers, apples, bananas or celery. One tablespoon of peanut butter gives you about 100 calories and 7 grams of protein.
- Add healthy extras to your meal, such as butter, cheese, gravy, beans, tofu, sour cream, bananas or nuts.
- Avoid empty calories and added sugar from soda, candy, chips and fried snacks.
If you gain too much weight during pregnancy
If you have gained more weight than your doctor recommends, you’ll probably have to wait until after the delivery to lose the added weight. Here are some suggestions to slow your weight gain:
- Avoid fried foods such as french fries, onion rings, mozzarella sticks or breaded chicken patties.
- Cut out sweet or sugary drinks such as soft drinks, fruit punch, fruit drinks, sweetened iced tea, lemonade or powdered drink mixes. Choose water — it’s healthier and it contains no extra calories.
- Don’t add salt to foods when cooking. Salt causes you to retain water.
- Limit sweets and high-calorie snacks. Cookies, candies, candy bars, donuts, cakes, syrup, honey and potato chips have a lot of calories and little nutrition. Instead, choose lower-calorie snacks and desserts such as fresh fruit, yogurt, angel food cake with strawberries, or pretzels.
- Use fats in moderation. Fats include cooking oils, margarine, butter, gravy, sauces, mayonnaise, regular salad dressings, sauces, lard, sour cream and cream cheese.
- Cook food in a 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, biking or swimming is usually safe for pregnant women. Ask your healthcare provider what exercise would be right for you before getting started.
Concerned about your pregnancy weight gain? Please come see us.
If you are expecting a baby and have concerns about the amount of weight you’re gaining (or not gaining), please make an appointment with Westchester Health to see one of our OB/GYNs. We will help make sure you are neither overdoing nor underdoing it, and that your baby is getting the optimal amount of nutrients he/she needs to grow at a healthy rate.