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Weight gain while pregnant

Weight gain in pregnancy recommendations have changed over the years. Used to be the that doctors told patients "you are eating for two" and gave encouragement to gain lots of weight. We now know that excess weight gain can increase risks of Cesarean section, maternal obesity, diabetes, preeclampsia and possible diabetes or obesity in offspring. The recommendation now is to gain a set amount of weight based on your pre-pregnancy BMI with lower BMIs gaining more weight. If you are underweight (BMI < 18.5) then the recommendation is to gain 28 - 40 lbs total for the entire pregnancy. For normal weight (BMI 18.5 - 24.9), weight gain recommendation is 25 - 35 lbs. For overweight patients (BMI 25.0 - 29.9) then limit to 15 to 25 lbs. And for obese patients (BMI >or= 30) then the limit is 11 to 20 lbs. And the recommendation may be less for the extremely obses maternal patient. These recommendations are for singleton pregnancies so multiples would be expected to gain more. In general it is recommended 1/2 to 1 lb weight gain per week in the second and third trimester. In the first trimester, some women may not gain much weight. Weight gain should definitely be limited to 1 lb per week in the first trimester. 

On average the weight gain is distributed to: 
- fetus 7-8 lbs
- increase blood volume, body fluid, body fat 11 - 15 lbs
- amniotic fluid 2 lbs
- breast enlargement 1 - 3 lbs
- increase uterine volume 2 lbs
- placenta 1.5 lbs
Most calories should come from protein, fruits and vegetables. IN the second and thirs trimester, most women need to increase their daily calories by about 350 calories. If there is poor weight gain, your doctor may order a growth ultrasound to check on the baby's weight gain. If the baby is growing appropriately then there is less concern about lack of maternal weight gain Sometimes women lose some weight in the first trimester due to nausea or changing to a more healthy lifestyle. In general dieting to lose weight is not recommended in pregnancy. However, exercise is definitely recommended and encouraged.
Author
Rachel Shepherd Dr Shepherd is a native of East Texas. She trained at Brown University and is happy to be back in Texas

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