Being Pregnant
UK Freak Out Over Pregnancy Diet Recommendations
Over in the UK, headlines are telling pregnant women they can no longer eat “for two” and should head to the gym between pregnancies. The story is spinning out of new guidelines from National Institute for Health and Clinical Excellence (NICE) that are intended to help reduce obesity-related risks in pregnancy and childbirth.
I was, like this blogger, a little confused by the media coverage so I read the NICE guidelines. And I must say, they’re pretty reasonable.
Most of the recommendations are for women with a body mass index BMI over 30–a 5.8″ woman who is 200 lbs has a BMI of 30+. They’re directed mainly at healthcare workers and include evidence-based strategies for talking about nutrition, healthy eating, weight loss and exercise.
The idea that a woman needs to “eat for two” in pregnancy has been out of currency for quite some time. If there’s a number cited for optimal weight gain, it’s usually around 25-35 lbs. But for a long time, we’ve been told that underweight women need to gain more, overweight less. The NICE guidelines acknowledge the problems with generalizations:
“Many pregnant women ask health professionals for advice on what constitutes appropriate weight gain during pregnancy. However, there are no evidence-based UK guidelines on recommended weight-gain ranges during pregnancy. The amount of weight a woman may gain in pregnancy can vary a great deal. Only some of it is due to increased body fat – the unborn child, placenta, amniotic fluid and increases in maternal blood and fluid volume all contribute.”
The NICE advice for postpartum women who are obese or very overweight focuses on slow-paced, realistic weight loss goals– they mention the importance of recognizing what hard work it is caring for a baby, Â and talk about how support is necessary from family. Then they go into a whole thing about how mom-friendly exercise programs need to be available with free childcare or ways to involve the baby. Â The language they use emphasizes the need for healthcare workers to be sensitive and respectful to their patients on this topic.
Finally, NICE recommends breastfeeding for all women to help with weight reduction and obesity prevention in children. Michelle Obama’s “Let’s Move” anti-obesity task force is pushing breastfeeding, too.
Who knows how the NICE guidelines will play out– whether conversations with well-intentioned healthcare providers about the myths of pregnancy weight gain will make a difference. Or make people more stressed out. Or be misinterpreted and average weight women will not eat enough. I can see that after so much has been written about the risks of obesity and pregnancy, one would expect the “healthcare authorities” to develop some kind of strategy. I wonder how things will change over here…
Photo: Ewedistrict/Flickr
- If Mom’s Pre Pregnancy Weight is High, Kids are More Likely to Be Overweight
- Pregnant Women Should Gain Less Weight (Easy For You To Say, New York Times)
- Big Mommies Make Big Babies: Greater Pregnancy Weight Gain = Higher Birth Weight
- Too Much Pregnancy Weight Gain Linked To Future Health Risks
- Bethenny Frankel: Skinny Girl or Skinny Bitch?
Tags: BMI in pregnancy, calories in pregnancy, health, NICE, obesity and pregnancy, pregnancy diet Ôªø
5 Comments
Lyn Lomasi commented on Jul 29 10 at 4:10 pmSounds like the guidelines are fairly reasonable. It’s not exactly necessary to eat 4 servings at dinnertime, for instance. I ate a ton when I was pregnant with my first – and gained 70 pounds. Luckily, I lost most of it soon after. What I kept, I needed to keep. I didn’t feel the need to eat as much in subsequent pregnancies. My appetite was larger, but not even close to what it was the first time. I think by following the body’s natural cues and taking proper care of themselves, women will do just fine. Seems like that’s more what these guidelines are about. But I’ll have to read them closer.
Kellie Glass RD, LD commented on Aug 01 10 at 12:51 pmIt’s extremely important for pregnant women to make healthy choices before, during and after pregnancy. They can help set the example for their child by making healthy lifestyle changes in nutrition, exercise, stress management and sleep. For more information, visit http://www.thefriedchickendiet.com
Rosana commented on Aug 02 10 at 11:12 amIt is a matter of using common sense. We all know when we are eating too much and while breastfeeding for both of my kids for a year each I have only felt very hungry a few times so I did not feel the need to eat more all the time.
Hetty Fauxvert commented on Aug 04 10 at 3:34 amIt is important for mothers of multiples (twins or more) to make sure they get enough protein and calcium early on in the pregnancy, since oftentimes later in the pregnancy it becomes difficult to eat much, because of your stomach (and lungs!) being squished by the babies. Not all healthcare providers are aware of the special requirements of multiple fetuses in the womb. It is better to have to lose weight after, than have your babies be born at low weight. Our twins were born at 6 lbs and 4.5 lbs, nearly singleton weight, and it was obvious they got a better start because of it.
nutterbutter commented on Aug 04 10 at 10:11 amBeing a mother of multiples my thoughts were exactly those of Hetty’s on reading this article. My twins were born at 38 weeks, each over 5lbs and agpars of 9 and 10. Dr Barbara Luke (if my memory isn’t completely shot by now) is the “go to” on maximising healthy outcomes for multiples and she strongly advocates early healthy weight gain for multiples because as Hetty explained…it’s very hard to eat when there is no room to put food. At 6 mths I was diagnosed with gestational diabetes and was frustrated by the seeming lack of understanding of diabetes practitioners about the calorie/nutritional requirements for a multiple birth. Whilst I followed the diet I ignored the calorie restriction somewhat. The negative response was frustrating and not helped by weight estimtes that said my babies were already 7lbs EACH. Which raises my other concern, that ultrasound specialists and their ways of estimating weight don’t seem to get the feedback of actual results with which to see how accurate they are. A 4lb OVER estimate which would have had me under eating. My total weight gain was about 30lbs.
Ceridwen Morris is a writer, mother and childbirth educator. She is co-author of It's All Your Fault and 
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Danielle Elwood is a Connecticut Mother to two boys, Camden, and Benjamin, and wife to William Volunteer Firefighter, and Veteran Marine. She is expecting her third
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