Dear Dr. Gerhart: I’m 30 weeks pregnant and I
have gained 40 pounds. My doctor said that I might be gaining too
much weight. But I just crave food. Does gaining more weight hurt
the baby?
Dear Reader: Congratulations on your pregnancy!
Being 30 weeks along is an exciting time. Chances are that you no
longer have nausea or morning sickness that is usually associated
with early pregnancy. You also may be finding it a bit more
difficult to get around to do your normal tasks. The lack of nausea
— and the ability to eat more — combined with the decreased desire
to exercise may be contributing to the weight gain.
Remember that the weight you gain during pregnancy is not only
your baby. In other words, you won’t be having a 40 pound baby! You
are gaining weight to support the baby’s placenta (which is baby’s
source of nutrients), and the fluid that the baby sits in (called
the amniotic fluid). You are also gaining breast mass, increasing
needed fat stores and expanding your blood volume.
There is no steadfast rule regarding how much weight to gain in
pregnancy. The ideal amount depends on your starting weight and
body mass index (BMI). In general, I recommend that patients who
are underweight pre-pregnancy gain between 30–40 pounds during
pregnancy. Those who are normal weight I suggest gain about 25-35
pounds and those who are overweight should gain about 15-25
pounds.
These estimates change and vary depending on both mom’s health
and baby’s health. For example, having twins or having a history of
low birth weight babies may change this estimate.
Gaining too much weight in pregnancy is often uncomfortable.
Some people notice leg swelling, back pain, or feel overheated. You
also are more likely to develop high blood pressure or diabetes
during pregnancy with excessive weight gain. High blood pressure
may affect your blood flow to the placenta, which can lead to a
more serious condition called preeclampsia, or could necessitate
that you deliver the baby early to prevent complications to you or
your baby. Diabetes may affect your baby’s sugar metabolism, may
cause a larger baby, or may necessitate that you need help pushing
the baby out. (This can mean the person delivering your baby may
need to use special tools, may make a cut in your vaginal area to
allow more space, or may need to do a C-section ). Also, if you
develop diabetes in pregnancy, both you and your baby are more
likely to develop type 2 diabetes later in life.
With all that being said, most people who gain more than their
goal weight in pregnancy have healthy kids and remain healthy
themselves. But if you want to reduce your risk, try this advice:
Stick to eating about 300 calories more per day than what you did
pre-pregnancy. Continue to include activity or exercise in your
schedule, and try to lower your stress levels as much as
possible.
Congrats again, you are almost there!
This column provides general health information and is not
specific advice intended for any particular individual(s). It is
not a professional medical opinion or a diagnosis. Always consult
your personal health care provider about your concerns. No ongoing
relationship of any sort (including but not limited to any form of
professional relationship) is implied or offered by Dr. Gerhart to
people submitting questions.
