No need to panic if your practitioner tells you that you're pacing ahead of your recommended pregnancy weight gain. There are plenty of steps you can take to get back on track. Don't diet, but focus on eating nutrient-dense foods in appropriate amounts, and stay active (with your health care practitioner's approval).
Read on for more tips and information about pregnancy weight guidelines.
How much weight should I gain during pregnancy?
In general, women with a "normal" pre-pregnancy BMI (18.5 to 24.9) are advised to gain between 25 and 35 pounds. Those who are underweight may need to gain more, while those who are overweight or have a BMI above 30 are advised to gain less.[1]
"I was bigger to begin with, so my OB only wants me to gain between 10 and 20 pounds," says What to Expect Community member Kay-Fay. "I've stocked up on fruits and veggies and made homemade popsicles and frozen yogurt with fruit in it, so hopefully I can stick with eating healthy."
While there's ongoing debate about using BMI to define “healthy” weight, it remains the standard used in research and by the National Academy of Medicine to set pregnancy weight gain guidelines. Still, it's important to remember that BMI isn't a perfect measure.
If you step on the scale and find you've gained more than expected, you're not alone. In fact, 48% of American moms gain too much weight during pregnancy. Keep in mind that gaining a little extra weight usually isn't a cause for concern. After all, weight gain is essential to support your baby's growth. Problems arise when weight gain significantly exceeds guidelines over the course of pregnancy.
Your practitioner is the best resource to assess your individual needs and recommend a healthy weight gain range throughout your pregnancy.
How do I get my pregnancy weight gain back on track?
If you’ve surpassed your target weight gain, you can still aim to stay within range for the rest of your pregnancy. These strategies can help:
- Talk to your practitioner. Your doctor or midwife can help you monitor your weight and may recommend working with a nutritionist.
- Skip dieting. Trying to lose weight during pregnancy isn't safe. Your baby needs a steady supply of nutrients, especially in the second and third trimesters. Avoid appetite-suppressing drinks or pills, which can be dangerous when you're expecting.
- Cut empty calories. The emphasis is on empty — you still need to eat enough of the right kinds of calories to keep your baby growing. Focus on nutrient-dense foods and make simple swaps — like low-fat milk instead of whole, fresh fruit instead of dried, or grilled chicken instead of fried.
- Watch portion sizes. A true serving is often smaller than expected. For example, a serving of meat or poultry is about the size of a computer mouse, and a serving of cheese is about the size of a 9-volt battery.
- Eat filling, lower-calorie foods. Choose vegetables (especially leafy greens), fruits with high-water content (like melon), lean proteins, and whole grains like oatmeal. Drink water instead of soda or juice.
- Prioritize healthy fats. About 25% to 35% of all your daily calories should come from healthy fats, such as those found in olive oil, canola oil, peanut oil, safflower oil, sesame oil, avocados, nuts, seeds, and fatty fish like salmon. Limit saturated fats, and avoid trans fats found in processed and fried foods.
- Curb late-night snacking. Try to eat balanced meals and snacks earlier in the day, and keep evening snacks small and nutritious if needed.
- Skip sugary drinks. Soda is the obvious beverage to eliminate, but juices and smoothies can also be high in sugar and calories. Limit intake and check labels on prepared drinks.
- Stay active. With your practitioner's okay, make regular exercise a part of your pregnancy. While joining a prenatal yoga or exercise class is a great way to get and stay motivated, small amounts of activity add up fast and all count toward your recommended 30 minutes of daily physical activity. So incorporate some movement into your everyday routines: Park a few blocks from your destination, and take the stairs instead of the elevator, for example.[2]
"I've just been a little more conscious on my carb intake and upped my activity level a bit with slightly longer walks, etc.," says Community mom ivfmiracle0830. "I've slowed the gain down with just those small tweaks."
Want help keeping your pregnancy weight gain on track? Download the What to Expect app to log your progress, track your symptoms, and get advice that’s tailored to your stage.
What are the risks of gaining too much weight during pregnancy?
Gaining more than the recommended weight during pregnancy puts you and your baby at risk for health problems both during pregnancy and after, including:[3]
- Less accurate ultrasound results. If you're overweight during pregnancy and have too much body fat, your practitioner may have a harder time looking at your baby (and diagnosing any problems that might require treatment) during your ultrasound exams. That may mean you'll have longer exams and possibly more ultrasounds.
- Increased physical discomfort. Let's face it, pregnancy isn't all that comfortable to begin with — and those discomforts tend to multiply with the pounds. Excess weight gain can result in or aggravate everything from backaches and pelvic pain to overall exhaustion, varicose veins, leg cramps, heartburn, hemorrhoids, and achy joints.
- High blood pressure. Having gestational hypertension, which is diagnosed in the second half of pregnancy, can lead to issues during delivery.
- Preeclampsia. Gaining too much weight can up your risk of preeclampsia. In turn, that condition can lead to liver and kidney problems for you as well as increase your risk of intrauterine growth restriction (IUGR), placental abruption, and other complications. If you gain more than three pounds in any one week in the second trimester, or if you gain more than two pounds in any week in the third trimester — especially if it doesn’t seem to be related to overeating or excessive intake of sodium — check with your practitioner, as it could be a sign of preeclampsia.
- Gestational diabetes. Being overweight or gaining too much weight during pregnancy puts you at risk of gestational diabetes.
- A large baby. The heavier you are, the more likely it is that you'll give birth to an overly big baby (macrosomia) at birth (which can also happen as a result of gestational diabetes). Macrosomia increases the odds that a vaginal delivery will require the use of forceps or vacuum extraction and ups your chances of delivering by C-section. Larger babies are also at greater risk of childhood obesity.
- Preterm labor. The higher your pre-pregnancy BMI and the more weight you gain during pregnancy, the more likely your baby is to be born prematurely. Preterm birth raises a baby's risk of a number of health issues depending on how premature the baby is, including breathing difficulties, eating challenges and, sometimes, developmental delays and learning problems later in life.
- Difficulty losing weight postpartum and a higher long-term risk of obesity. If you gain too much weight, you may have a harder time losing the weight after your baby is born. What’s more, women who gain excessively and don't lose the pounds in the six months to year after giving birth are at a higher risk of being overweight or even obese 10 years later, which comes with its own set of health challenges.
"I'm focusing on eating healthy as much as possible (and to forgive myself if I feel like enjoying a chocolate chip cookie) and taking daily walks to keep myself moving," says Community mom gililik. "I'm doing what I can to be healthy both physically and mentally."
It is possible to get your weight gain back on track with adjustments to your eating and activity habits. So don't be hard on yourself — just focus on making healthy choices.
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