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Shed /control weight during pregnancy without harming baby Category:   News ::  Health ::  Women's Health  

Shed /control weight during pregnancy without harming baby
Your health care provider will suggest a range of weight that you should gain, usually about 20 to 35 pounds. You will gain 20 pounds just by being pregnant as your breasts, uterus, and baby get bigger. The placenta, bag of waters (amniotic sac), and extra blood and body fluids also are included in this 20 pounds. An additional 5 to 10 pounds are needed for adequate nutrition for your baby.

On average you should expect to gain 10-12,5 kg by the end of your pregnancy. Starting with the 4th month of your pregnancy you will probably gain around 1,5-2 kg per month. Check your weight periodically and consult the doctor if you notice you are gaining less than 1 kg or more than 3 kg per month. Both too little and too much weight gain can adversely affect the health of you and your baby. Thus, make sure that you and your baby get enough calories, but do not overeat (especially sweets and fatty foods). Remember, “eating for two” does not mean “twice as much”. Just follow your appetite and the healthy eating.Avoid excess under- or overeating.

If too much weight is gained, multiple physical problems can result, causing excessive discomfort in a woman's back and legs from the added burden of carrying those extra pounds. The extra weight can also result in elevated blood pressure and an overload of work on a pregnant woman's heart. This can lead to dangerous situations both for the mother and baby. Finally, all of those extra pounds can result in a more difficult labor and delivery, and after the baby is born they are much more difficult to lose!

Significant weight gain during pregnancy may cause changes in breast tissue that increase susceptibility to breast cancer in later liferoughly equivalent to the risk of postmenopausal obesity.Gaining more than 50 pounds during pregnancy, and not losing the excess weight post-pregnancy, could triple a woman's risk of developing breast cancer after menopause.

Maternal weight gain during pregnancy is an important determinant of birth outcomes," says lead author Emily Oken, MD, MPH, instructor in the Department of Ambulatory Care and Prevention. "These findings suggest that pregnancy weight gain can influence child health even after birth and may cause the obstetric community to rethink current guidelines."

After the length of gestation, maternal weight gain accounts for the largest proportion of variation in birth weight; pregravid weight has the next largest effect. White and black women differ in pregravid weight and weight gain during pregnancy. The incidence of overweight is 1.8 times higher among black women than among white women (44 percent vs. 25 percent), and the incidence of severe obesity is almost twice as great (19 percent vs. 10 percent). Black women are more likely to be advised to restrict their weight gain, and to gain less during pregnancy. Data from national surveys showed that 26 percent of married white women were advised to limit their weight gain to 21 lb (9.5 kg), as compared with 34 percent of married black women. An actual gain of at least 21 lb occurred in 22 percent of white women and 33 percent of black women.Race may be a confounding factor between dietary intake, nutritional status, and the rate and pattern of weight gain during pregnancy and birth weight, preceding or compounding medical factors ultimately leading to very low birth weight.

There's no one-size-fits-all approach to pregnancy weight gain. How much weight you need to gain depends on various factors, including your pre-pregnancy weight and body mass index (BMI). Your health and your baby's health also play a role.Work with your health care provider to determine what's right for you. Consider these general guidelines for pregnancy weight gain from the American College of Obstetricians and Gynecologists:

* If your Pre-pregnancy weight is underweight ,28 to 40 pounds weight gain is recommended.
* If your Pre-pregnancy weight is normal weight ,25 to 35 pounds weight gain is recommended.
* If your Pre-pregnancy weight is Overweight ,15 to 25 pounds weight gain is recommended.
* If your Pre-pregnancy weight is Obese ,at least 15 pounds weight gain is recommended.

Using a body mass index (BMI) of 25.0 or higher as “overweight” and a BMI of 30.0 or higher as “obese.Generally, a pregnancy diet only requires an extra 200-300 calories a day during the last six months of pregnancy to achieve adequate weight gain. It is best to receive these extra calories from healthy foods.Young women less than 18 years old should try to gain weight at the upper limits of these ranges.

If you are overweight, you should not try to lose weight during pregnancy. This can be harmful to the baby. You should still gain 15 to 25 pounds during pregnancy. Overweight mothers may have larger babies and may be at higher risk for diabetes during pregnancy.

If you are more than 10% below the average weight for your height, you are more likely to have problems such as preeclampsia (blood pressure problems), premature delivery, and bleeding. High blood pressure, or hypertension, is a serious complication of pregnancy. It occurs in about 6 to 8 percent of pregnant women. In a small number of cases, it's present before pregnancy. It is important that you have your blood pressure checked often throughout your pregnancy.Very high blood pressure can occur, with a rapid weight gain, swollen ankles and protein in the urine. This disorder is knows as "toxemia of pregnancy" or "pre-eclampsia."

Preeclampsia can prevent the placenta (which gives air and food to your baby) from getting enough blood. If the placenta doesn't get enough blood, your baby gets less air and food. This can cause low birth weight and other problems for the baby.

Women who are of normal weight before pregnancy and who gain an amount that is within the range recommended usually return to their prepregnancy body-mass index without requiring intervention. Women who are overweight before pregnancy and who gain more than the recommended amount would benefit from prenatal and postnatal nutritional counseling.

If you gain too much weight, you may be overeating or eating the wrong types of foods. If you are not overeating and are eating the right types of food, the extra weight is usually extra water. Extra water can be caused by too much salt in your diet.If you gain too much weight, you may have trouble losing the extra pounds after the baby is born.If you're a relative exercise newbie, start with Pregnancy Exercise for Beginners. You can enjoy low-impact exercise such as walking, swimming, and low-impact aerobics.

With overweight and obesity (defined as a body-mass index >=25) affecting about 50 percent of women in the United States,6 there is a need for prevention of excessive gestational weight gain and effective treatment for women who gain excessive amounts of weight during pregnancy. Clearly, the diet-and-exercise program of Lovelady et al.1 was successful in achieving accelerated weight loss in lactating women. However, the women's reactions to the program, such as hunger, fatigue, irritability, and psychosocial stress, should have been evaluated.In another study of women who were 8 weeks post partum, an energy deficit of approximately 500 kcal per day for 10 weeks resulted in weight loss of 4.8 kg, with no apparent effect on milk production, but a third of the women dropped out of the study.

Most women who are obese can safely exercise and diet to lose weight during pregnancy, according to a small pilot study conducted by Saint Louis University researchers.

"Doctors hadn't encouraged pregnant women who were obese to limit their weight gain or have them lose weight because they were afraid it would hurt the baby," says Raul Artal, M.D., principal investigator and chair of the department of obstetrics, gynecology and women's health at Saint Louis University."We found that obese women do not have to gain any weight, and, in fact, can lose weight and it won't hurt the baby. Pregnancy is an ideal time to start an exercise and fitness program, particularly for women who are obese.

You also may find that getting used to following a healthy diet and exercising while pregnant makes it easier to continue that pattern once your baby's born. If you're gaining weight too fast and are worried about it, or if you discover once the baby's born that you can't seem to lose the added pounds, talk to your doctor or a dietitian who can evaluate your eating habits and help you make your calories count.

Obese pregnant women can avoid weight gain or even lose some weight without harming their babies, a small study suggests.In fact, researchers found, obese women who maintained their weight or shed pounds during pregnancy were more likely to have a normal-weight newborn than those who gained pregnancy pounds.

The notion that it's all right for obese women to avoid weight gain during pregnancy is fairly controversial, said Dr. Raul Artal, an obstetrician at St. Louis University and the lead author of the new study.

In the U.S., he told Reuters Health, most obstetricians follow guidelines devised in 1990 that recommend obese women gain about 13 pounds during pregnancy. That's far less than the 25 to 35 pounds recommended for normal-weight women, but still a substantial amount of weight for women who are already heavy.

Those guidelines deserve a second look, Artal argued. For obese women, he said, weight maintenance or even modest weight loss may not only do no harm to mother and child, but might benefit them.For their study, Artal and his colleagues followed 96 obese pregnant with gestational diabetes -- a form of diabetes that emerges during pregnancy.

Fifty-seven of the women enrolled in a diet program, while the rest began a diet-and-exercise program. Both groups received help devising a healthy, lower-calorie eating plan, while women in the exercise group had supervised, moderate workouts, such as treadmill walking, once a week. Exercisers were also encouraged to walk or perform other low-impact activities on their own every day.

In the end, Artal's team found, women who dieted and exercised gained less weight than women who only changed their eating habits.

Moreover, women who shed pounds or maintained their weight -- regardless of the group they were in -- were less likely to have a larger-than-normal newborn. There was no evidence that weight loss increased the risk of pregnancy complications or harmed fetal growth, the researchers report in the journal Applied Physiology, Nutrition, and Metabolism.

Because it's so difficult for obese women to shed pounds gained during pregnancy, Artal said, preventing the weight gain could bring longer-term health benefits."Pregnancy is not a state of confinement," he said, and overweight women should not be afraid of moderate physical activity."All we're talking about is a brief walk after each meal," Artal noted.

That said, he advised that pregnant women still talk to their doctors before taking up an exercise routine, to make sure they have no conditions that preclude physical activity. Women should also get advice from a nutritionist on how to make healthy diet changes.

Losing weight during pregnancy may improve the health of babies born to obese women with gestational diabetes.Gestational diabetes is diabetes that occurs during pregnancy in a woman who didn't have diabetes before pregnancy; it usually goes away after pregnancy.

Study suggested that women who either maintain weight in pregnancy or lose weight -- and exercise -- have fewer complications than those on diets alone," Artal tells WebMD. "We definitely see these women deliver normal-size babies, which means that this plays a role in fewer complications."

Artal says. "When we talk exercise, we talk about just walking -- a safe form of exercise. If obese, pregnant women can engage in walking at a moderate pace, it is probably more beneficial. And maintaining a lower-calorie diet is beneficial."

It would be easy to add calories to your diet with candy bars and potato chips, but this won't give your baby the nutrients he or she needs. It's more important to avoid overeating and make nutrient-rich choices. Consider these suggestions:

# Trade white bread and pasta for the whole-grain variety.
# Switch from 2 percent milk to skim.
# Eat sliced fruit instead of a cookie.
# Top your salad with soy nuts or black beans and drop the breadsticks or dinner roll.
# Choose juices fortified with calcium and other nutrient



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