Baby on Board:
Healthy Eating for Two

For some women finding out they are pregnant can be a green light to overindulge. Why not have that double scoop of ice cream or that large order of fries? After all, how many pregnant women have heard, "You're eating for two now!" While no one wants to suggest that woman be denied every famous mom-to-be craving, pregnant women need to be reminded of the importance of a healthy diet. Gaining too much or too little weight can be harmful to mom, her baby, or both. Pregnant women need to eat a well-balanced diet and remain active.

Weight Matters

Gaining the right amount of weight is important. Women who gain too little weight increase their risk for having a low weight baby, which can put the baby at risk for mental and physical disabilities. Gaining too much weight can put the mother at risk for developing pre-eclampsia (a dangerous condition resulting in high blood pressure during pregnancy), or needing a caesarean section. For women who begin their pregnancy already overweight the risks are even higher for serious complications. Gaining too much weight also increases the possibility of the mother retaining excess pregnancy weight and the possibility of the baby being overweight later in life.

Another potential risk is gestational diabetes. This happens when the body is not able to make and use all the insulin it needs for pregnancy. Gestational diabetes affects about 4% of all pregnant women. According to the American Diabetes Association , there are 135,000 reported cases each year. Untreated or poorly controlled gestational diabetes can harm a baby. High glucose (sugar) levels can cause the baby's pancreas to make extra insulin to get rid of the blood glucose. Since the baby is getting more energy than it needs to grow and develop, the extra energy is stored as fat. Babies with excess insulin become children who are at risk for obesity and adults who are at risk for type 2 diabetes. Many women who have gestational diabetes also go on to develop type 2 diabetes.

The amount of weight a woman should gain depends on her weight before pregnancy and her height. For a woman who is average weight before getting pregnant, she should gain between 25 and 35 pounds. Underweight women should gain 28 to 40 pounds; an overweight woman, 15 to 25 pounds and obese women 15 pounds or less. Most women don't realize that in the first trimester they only need an additional 150 calories each day. That's the equivalent of a container of low fat yogurt and a small piece of fruit.

Beginning in the fourth month of pregnancy, only an additional 300 calories each day is recommended. That is no more than a container of low fat yogurt, a small piece of fruit and a slice of plain bread. In general, an average weight pregnant woman should gain about two to four pounds total during her first three months of pregnancy and one pound a week for the remainder of her pregnancy. For a mom expecting twins she should gain about a pound and a half a week in the last two trimesters.

Menu Please

During pregnancy many women experience a change in their eating habits. Some foods or smells may be more appealing than others. Here are some tips to share with the women you see.

To maintain a healthy pregnancy weight:

• Eat three meals and several small snacks OR five to six small meals each day
• Avoid second helpings or large portions
• Drink plenty of water
• Choose healthy snacks such as fruit, a cup of carrots or yogurt
• Cut down on greasy foods and sweets

To slow weight gain (if gaining too fast):

• Watch portion size when eating out; ask for half your meal to be boxed to take home and choose lower fat items
• Avoid whole milk products. While at least four servings of milk products are recommended each day use skim or 1% milk and choose low-fat or fat-free yogurt and cottage cheese
• Limit sweet or sugar drinks
• Do not add salt to food when cooking since it causes the body to retain water
• Prepare meals using low-fat cooking methods such as broiling and grilling

If a pregnant woman craves non-food items (clay, dirt, ice, coffee grounds, etc.) this can be a sign of a low level of iron in the blood which can be corrected. Providers should ask the pregnant women they see if they experience these cravings.

Along with a healthy diet, pregnant women need to be reminded to exercise. Mom doesn't need to train for a triathlon, but she needs to keep moving. Before starting any physical exercise she should always check with her doctor first. If she's healthy with no complications, she should exercise three to five times a week. Walking and swimming are excellent and safe options during pregnancy. Incorporating exercise in her daily routine can help pregnant women sleep better, reduce back pain, boost energy levels, help prevent too much weight gain, make her stronger for labor and get her back in shape once the baby is born.