Women who are overweight before they become pregnant should definitely not be eating for two, recommend new guidelines from the Institute of Medicine.
The guidelines suggest that women who are obese when they become pregnant may not need to gain weight during pregnancy at all, as long as they are eating healthy foods.
The recommendations on pregnancy weight are the first since 1990 from the IOM, which is a non-governmental organization that advises the U.S. on issues of medicine, and health.
The guidelines do not differ much from what obstetricians have recommended for more than a decade; the key difference is there is now an upper limit on how much weight obese women should gain in pregnancy.
The guidelines for weight gain are based on a woman's body mass index before she became pregnant. The guidelines recommend:
- Underweight: Gain 28-40 pounds
- Normal weight: Gain 25-35 pounds
- Overweight: Gain 15-25 pounds
- Obese: Gain 11-20 pounds
The guidelines for weight gain during pregnancy with twins recommend:
- Normal weight: Gain 37-54 pounds
- Overweight: Gain 31-50 pounds
- Obese: Gain 25-42 pounds
- Underweight: No weight gain guidelines are available because of insufficient data.
Underweight and normal-weight mothers should aim to put on a pound a week for proper fetal growth in the second and third trimesters. Overweight and obese women need about half a pound a week. Pregnancy is not a time to lose weight, the guidelines stress.
Researcher Dr. Yvonne S. Thornton says the most important message the guidelines confer is that pregnancy should not be a licence to overeat, and pregnancy should not lead to obesity.
The IOM says maintaining a healthy weight throughout pregnancy is healthiest for the mother, since it reduces the chance of pregnancy-related diabetes or high blood pressure and also reduces the need for a C-section.
It's also best for babies since those born to overweight mothers have a greater risk of premature birth or of later becoming overweight themselves, research has found.
The guidelines call for increased nutrition and exercise counseling during pregnancy, saying doctors or midwives may need to consult a dietitian to tailor a woman's care.
