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Pregnancy Weight Gain

The Institute of Medicine (IOM) today issued new guidelines on how much weight to gain during pregnancy. But actually, those guidelines begin before pregnancy.

The IOM wants women of childbearing age at a healthy weight before getting pregnant, for the sake of the health of mother and baby alike. And the IOM wants women to be offered preconception counseling about weight, diet, physical activity — and contraception, if they’re overweight or obese, so that they can lose extra weight before pregnancy.

Then, once a woman gets pregnant, she’s supposed to keep her weight gain within certain limits, based on her BMI (body mass index) before pregnancy.

Here are the IOM’s weight gain allowances for a woman carrying one child: If she’s underweight, she should gain 28-40 pounds. If she’s at a normal weight, she should gain 25-35 pounds. If she’s overweight, she should gain 15-25 pounds. And if she’s obese, she should gain 11-20 pounds.

Does that sound doable to you? Or did you figure that since you’re “eating for two,” you can double your calories — especially if you’re having cravings or feeling hormonal?

Don’t go there, says Melissa Goist, MD, a clinical assistant professor of obstetrics and gynecology at the Ohio State University Medical Center.

A normal-weight woman would need only 300 extra calories per day to maintain a healthy pregnancy with one baby — that’s one-sixth of her prepregnancy calorie budget and roughly the amount of calories in a Snickers bar, Goist says.

Of course, Goist isn’t recommending that pregnant women get their extra pregnancy calories from candy bars — a healthy, balanced diet is the way to go.

Goist says it can be tough to talk to pregnant patients about weight, like her patient who was 8 pounds heavier each month that Goist saw her. Keeping that pace for nine months would put her way over the IOM’s recommended weight gain. Plus, Goist says that patient wasn’t following her dietary advice — she was feasting on carbohydrates.

Goist, and the experts who wrote the IOM’s new guidelines, say the public hasn’t gotten the message that pregnancy isn’t a time to ignore weight or eat with abandon.

What do you say? If you’ve been pregnant, how much weight did you gain, and did your doctor talk to you about it? How hard was it to lose the weight after the baby was born, and would you gain more or less weight if you had to do it all over again?

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