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Fit for Two

Tips for Pregnancy


INTRODUCTION

This publication is part of the Healthy Eating & Physical Activity Across Your Lifespan Series from the Weight-control Information Network (WIN). The series offers health tips for readers at various life stages, including adulthood, pregnancy, parenthood, and later life. The series is also available in Spanish.

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How can I use this publication?

This publication is one of several resources from WIN that may help you and your family. It gives you tips on how to eat better and be more active while you are pregnant and after your baby is born. Use the ideas and tips in this publication to improve your eating pattern and be more physically active.

These tips can also be useful if you are not pregnant but are thinking about having a baby! By making changes now, you can get used to new eating and activity habits and be a healthy example for your family for a lifetime.

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HEALTHY WEIGHT

Why is gaining a healthy amount of weight during pregnancy important?

Gaining too much or too little weight may lead to serious health problems for you and your baby.

Gaining the right amount of weight during pregnancy helps your baby grow to a healthy size. But gaining too much or too little weight may lead to serious health problems for you and your baby.

Too much weight gain raises your chances for diabetes and high blood pressure during pregnancy and after. If you are overweight when you get pregnant, your chances for health problems may be even higher. It also makes it more likely that you will have a hard delivery and need a cesarean section (C-section).

Gaining a healthy amount of weight helps you have an easier pregnancy and delivery. It may also help make it easier for you to get back to your normal weight after delivery. Research shows that a healthy weight gain can also lower the chances that you or your child will have obesity and weight-related problems later in life.

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How much weight should I gain during my pregnancy?

How much weight you should gain depends on how much you weighed before pregnancy. See the following box on "Weight Gain during Pregnancy" for more advice.1

TOOLS YOU CAN USE

Weight Gain during Pregnancy

General weight-gain advice below refers to weight before pregnancy and is for women having only one baby.

If you are You should gain about
underweight (BMI* less than 18.5) 28 to 40 pounds
normal weight (BMI of 18.5 to 24.9) 25 to 35 pounds
overweight (BMI of 25 to 29.9) 15 to 25 pounds
obese (BMI of 30+) 11 to 20 pounds

*The body mass index (BMI) measures your weight in relation to your height. See the Resources section for a link to an online BMI calculator.

It is important to gain weight very slowly. The old myth that you are "eating for two" is not true. During the first 3 months, your baby is only the size of a walnut and does not need very many extra calories. The following rate of weight gain is advised:

  • 1 to 4 pounds total in the first 3 months
  • 2 to 4 pounds each month from 4 months until delivery

Talk to your health care provider about how much weight you should gain during pregnancy.

Talk to your health care provider about how much weight you should gain. Work with him or her to set goals for your weight gain. Take into account your age, weight, and health. Track your weight at home or at your provider visits using charts from the Institute of Medicine. See Weight Gain During Pregnancy: Reexamining the Guidelines in the Resources section for a link to these charts.

Do not try to lose weight if you are pregnant. Healthy food is needed to help your baby grow. Some women may lose a small amount of weight at the start of pregnancy. Speak to your health care provider if this happens to you.


1 Institute of Medicine. Weight Gain During Pregnancy: Reexamining the Guidelines. Washington, D.C.: The National Academies Press; 2009.

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HEALTHY EATING

How much should I eat?

Eating healthy foods and the right amount of calories helps you and your baby gain the proper amount of weight.

In the first 3 months of pregnancy, most women do not need extra calories.

How much food you need depends on things like your weight before pregnancy, your age, and how fast you gain weight. In the first 3 months of pregnancy, most women do not need extra calories. You also may not need extra calories during the final weeks of pregnancy.

Check with your doctor about this. If you are not gaining the right amount of weight, your doctor may advise you to eat more calories. If you are gaining too much weight, you may need to cut down on calories. Each woman's needs are different. Your needs depend on if you were underweight, overweight, or obese before you became pregnant, or if you are having more than one baby.

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What kinds of foods should I eat?

A healthy eating plan for pregnancy includes nutrient-rich foods. Current U.S. dietary guidelines advise eating these foods each day:

„„
  • fruits and veggies (provide vitamins and fiber)
  • whole grains, like oatmeal, whole-wheat bread, and brown rice (provide fiber, B vitamins, and other needed nutrients)
  • fat-free or low-fat milk and milk products or non-dairy soy, almond, rice, or other drinks with added calcium and vitamin D
  • protein from healthy sources, like beans and peas, eggs, lean meats, seafood (8 to 12 ounces per week), and unsalted nuts and seeds

A healthy eating plan also limits salt, solid fats (like butter, lard, and shortening), and sugar-sweetened drinks and foods.

What if I am a vegetarian?

A vegetarian eating plan during pregnancy can be healthy. Talk to your health care provider to make sure you are getting calcium, iron, protein, vitamin B12, vitamin D, and other needed nutrients. He or she may ask you to meet with a registered dietitian (a nutrition expert who has a degree in diet and nutrition approved by the Academy of Nutrition and Dietetics, has passed a national exam, and is licensed to practice in your state) who can help you plan meals. Your doctor may also tell you to take vitamins and minerals that will help you meet your needs.

Does your eating plan measure up? How can you improve your eating habits? Try eating fruit like berries or a banana with low-fat yogurt for breakfast, a salad with beans for lunch, and a lean chicken breast and steamed veggies for dinner. Think about things you can try. Write down your ideas in the space below and share them with your doctor.

 

 

 

 

 

 

 

For more about healthy eating, see the MyPlate links in the Resources section of this fact sheet. They include a link to the online program "Daily Food Plan for Moms." It can help you make an eating plan for each trimester (3 months) of your pregnancy.

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Do I have any special nutrition needs now that I am pregnant?

Yes. During pregnancy, you need more vitamins and minerals, like folate, iron, and calcium.

During pregnancy, you need more vitamins and minerals, like folate, iron, and calcium.

Getting the right amount of folate is very important. Folate, a B vitamin also known as folic acid, may help prevent birth defects. Before pregnancy, you need 400 mcg per day. During pregnancy and when breastfeeding, you need 600 mcg per day from foods or vitamins. Foods high in folate include orange juice, strawberries, spinach, broccoli, beans, and fortified breads and breakfast cereals.

Most health care providers tell women who are pregnant to take a prenatal vitamin every day and eat a healthy diet. Ask your doctor about what you should take.

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What other new eating habits may help my weight gain?

Pregnancy can create some new food and eating concerns. Meet the needs of your body and be more comfortable with these tips:

Make sure you eat enough high-fiber foods during pregnancy and drink plenty of water.

  • Eat breakfast every day. If you feel sick to your stomach in the morning, try dry whole-wheat toast or whole-grain crackers when you first wake up. Eat them even before you get out of bed. Eat the rest of your breakfast (fruit, oatmeal, whole-grain cereal, low-fat milk or yogurt, or other foods) later in the morning.
  • Eat high-fiber foods. Eating high-fiber foods, drinking plenty of water, and getting daily physical activity may help prevent constipation. Try to eat whole-grain cereals, vegetables, fruits, and beans.
  • If you have heartburn, eat small meals more often. Try to eat slowly and avoid spicy and fatty foods (such as hot peppers or fried chicken). Have drinks between meals instead of with meals. Do not lie down soon after eating.

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What foods should I avoid?

Talk to your doctor to find out the amount of nutrients you need during pregnancy.

There are certain foods and drinks that can harm your baby if you have them while you are pregnant. Here is a list of items you should avoid:

  • Alcohol. Do not drink alcohol like wine or beer. Enjoy decaf coffee or tea, non-sugar-sweetened drinks, or water with a dash of juice. Avoid diet drinks and drinks with caffeine.
  • Fish that may have high levels of mercury (a substance that can build up in fish and harm an unborn baby). You should eat 8 to 12 ounces of seafood per week, but limit white (albacore) tuna to 6 ounces per week. Do not eat tilefish, shark, swordfish, and king mackerel.
  • Anything that is not food. Some pregnant women may crave something that is not food, such as laundry starch or clay. This may mean that you are not getting the right amount of a nutrient. Talk to your doctor if you crave something that is not food. He or she can help you get the right amount of nutrients.

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PHYSICAL ACTIVITY

Should I be physically active during my pregnancy?

Almost all women can and should be physically active during pregnancy.

Almost all women can and should be physically active during pregnancy. Regular physical activity may

  • help you and your baby gain the right amounts of weight
  • reduce backaches, leg cramps, and bloating
  • reduce your risk for gestational diabetes (diabetes that develops when a woman is pregnant)

If you were physically active before you became pregnant, you may not need to change your exercise habits. Talk with your health care provider about how to change your workouts during pregnancy.

It can be hard to be physically active if you do not have child care for your other children, have not worked out before, or do not know what to do. Keep reading for tips about how you can work around these things and be physically active.

TIPS YOU CAN USE

How much physical activity do I need?

Most women need the same amount of physical activity as before they became pregnant. Aim for at least 30 minutes of aerobic activity per day on most days of the week. Aerobic activities use large muscle groups (back, chest, and legs) to increase heart rate and breathing.

The aerobic activity should last at least 10 minutes at a time and should be of moderate intensity. This means it makes you breathe harder but does not overwork or overheat you.

If you have health issues like obesity, high blood pressure, diabetes, or anemia (too few healthy red blood cells), ask your health care provider about a level of activity that is safe for you.

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How can I stay active while pregnant?

Even if you have not been active before, you can be active during your pregnancy by using the tips below:

  • Go for a walk around the block, in a local park, or in a shopping mall with a family member or friend. If you already have children, take them with you and make it a family outing.
  • Get up and move around at least once an hour if you sit in a chair most of the day. When watching TV, get up and move around during commercials. Even a simple activity like walking in place can help.

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How can I stay safe while being active?

For your health and safety, and for your baby's, you should not do some physical activities while pregnant. Some of these are listed below. Talk to your health care provider about other physical activities that you should not do.

TIPS YOU CAN USE

Safety Dos and Don'ts

Follow these safety tips while being active.

DO...

  • Choose moderate activities that are not likely to injure you, such as walking or aqua aerobics.
  • Drink fluids before, during, and after being physically active.
  • Wear comfortable clothing that fits well and supports and protects your breasts.
  • Stop exercising if you feel dizzy, short of breath, tired, or sick to your stomach.

DON'T...

  • Avoid brisk exercise outside during very hot weather.
  • Don't use steam rooms, hot tubs, and saunas.
  • After the end of week 12 of your pregnancy, avoid exercises that call for you to lie flat on your back.

Make a plan to be active while pregnant. List the activities you would like to do, such as walking or taking a prenatal yoga class. Think of the days and times you could do each activity on your list, like first thing in the morning, during lunch break from work, after dinner, or on Saturday afternoon. Look at your calendar or planner to find the days and times that work best, and commit to those plans.

Make a plan to be active while pregnant and commit to it.

ACTIVITY WHEN

 

 

 

 

 

 

 

 

 

 

 

 

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AFTER THE BABY IS BORN

How can I stay healthy after my baby is born?

After your baby is born start out with physical activity done at a moderate intensity.

After you deliver your baby, your health may be better if you try to return to a healthy weight. Not losing weight may lead to overweight or obesity later in life. Returning to a healthy weight may lower your chances of diabetes, heart disease, and other weight-related problems.

Healthy eating and physical activity habits after your baby is born may help you return to a healthy weight faster and give you energy.

After your baby is born

  • keep eating well. Eat foods from all of the food groups. See MyPlate in the Resources section for advice to help you stay healthy and fit.
  • check with your health care provider first, then slowly get used to a routine of regular, moderate-intensity physical activity, like a daily walk. This type of activity will not hurt your milk supply if you are breastfeeding.

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How may breastfeeding help?

Breastfeeding may or may not make it easier for you to lose weight because your body burns extra energy to produce milk. Even though breastfeeding may not help you lose weight, it is linked to other benefits for mother and child.

Benefits of Breastfeeding

Breastfeeding your baby

  • gives him or her the right mix of nutrients in a liquid (breast milk) that is easier to digest than formula
  • helps boost his or her immune system
  • helps protect your baby from common problems, like ear infections and diarrhea

Many leading health groups advise breastfeeding only for the first 6 months of the baby's life. This means that you should feed your baby only breast milk during this time—no other foods or drinks. Experts suggest that women breastfeed at least until the baby reaches 12 months. In months 6 through 12, you may give your baby other types of food in addition to breast milk.

Calorie needs when you are breastfeeding depend on how much body fat you have and how active you are. Ask your doctor how many calories you need.

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What else may help?

Try joining a group for moms and newborns.

Pregnancy and the time after you deliver your baby can be wonderful, exciting, emotional, stressful, and tiring—all at once. These feelings may cause you to overeat, not eat enough, or lose your drive and energy. Being good to yourself can help you cope with your feelings and follow healthy eating and physical activity habits.

Here are some ideas that may help:

  • Sleep when the baby sleeps.
  • Watch a funny movie.
  • Ask someone you trust to watch your baby while you nap, bathe, read, go for a walk, or go grocery shopping.
  • Explore groups that you and your newborn can join, such as "new moms" groups.

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RESOURCES

Additional Reading from the Weight-control Information Network

The following publications are available online at http://www.win.niddk.nih.gov/publications and also by calling WIN toll-free at 1–877–946–4627:

Better Health and You: Tips for Adults helps adults plan steps toward eating healthier and being more physically active.

Changing Your Habits: Steps to Better Health explains how you can take small steps to become more physically active and eat healthier foods.

Energize Yourself and Your Family! describes how being healthy and active can help you gain the energy you need to keep up with the demands of your busy life. Tips suggest how you can take better care of yourself to be there for the people who depend on you.

Just Enough for You: About Food Portions explains the difference between a portion and a serving and offers tips to help readers eat healthy portions.

The World Around You provides tips on how to use the world around you, no matter who you are or where you live, to stay healthy and fit.

Additional Resources

2008 Physical Activity Guidelines for Americans
U.S. Department of Health and Human Services (HHS)
http://www.health.gov/paguidelines

Academy of Nutrition and Dietetics
http://www.eatright.org  Exit Disclaimer

Aim for a Healthy Weight
National Heart, Lung, and Blood Institute
http://www.nhlbi.nih.gov/health/public/heart/obesity/lose_wt

American Congress of Obstetricians and Gynecologists
http://www.acog.org  Exit Disclaimer

Dietary Guidelines for Americans, 2010
HHS and U.S. Department of Agriculture (USDA)
http://www.health.gov/dietaryguidelines

Eunice Kennedy Shriver National Institute of Child
Health and Human Development

http://www.nichd.nih.gov

Food and Nutrition Information Center
USDA
http://www.nal.usda.gov/fnic

March of Dimes
Phone: 1–888–MODIMES (1–888–663–4637)
http://www.modimes.org  Exit Disclaimer

MyPlate
USDA
http://www.choosemyplate.gov

National Diabetes Education Program
http://www.yourdiabetesinfo.org  Exit Disclaimer

National Kidney Disease Education Program
http://nkdep.nih.gov

Office on Women's Health
http://orwh.od.nih.gov

Online Body Mass Index Calculator for Adults
http://www.nhlbi.nih.gov/guidelines/obesity/BMI/bmicalc.htm

U.S. Government's Food Safety Website
http://www.foodsafety.gov

Weight Gain During Pregnancy: Reexamining the Guidelines
Institute of Medicine
http://iom.edu/Reports/2009/Weight-Gain-During-Pregnancy-Reexamining-the-Guidelines  Exit Disclaimer

Inclusion of resources is for information only and does not imply endorsement by NIDDK or WIN.

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LIFESPAN TIP SHEET FOR PREGNANCY

  • Talk to your health care provider about how much weight you should gain during your pregnancy. Track your progress on a weight-gain graph.
  • Eat foods rich in folate, iron, calcium, and protein. Ask your health care provider about prenatal supplements (vitamins you may take while pregnant).
  • Eat breakfast every day.
  • Eat foods high in fiber and drink plenty of water to avoid constipation.
  • Cut back on "junk" foods and soft drinks.
  • Avoid alcohol, raw or undercooked fish, fish high in mercury, undercooked meat and poultry, and soft cheeses.
  • Be physically active on most, or all, days of the week during your pregnancy. If you have health issues, talk to your health care provider before you begin.
  • After pregnancy, slowly get back to your routine of regular, moderate-intensity physical activity.
  • Return to a healthy weight slowly.

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BODY MASS INDEX TABLE

To use the table, find the appropriate height in the left-hand column labeled Height. Move across to a given weight (in pounds).
The number at the top of the column is the BMI at that height and weight. Pounds have been rounded off.

  Normal Overweight Obese Extreme Obesity
         
BMI 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54
Height
(inches)
    Body Weight
(pounds)
 
58 91 96 100 105 110 115 119 124 129 134 138 143 148 153 158 162 167 172 177 181 186 191 196 201 205 210 215 220 224 229 234 239 244 248 253 258
59 94 99 104 109 114 119 124 128 133 138 143 148 153 158 163 168 173 178 183 188 193 198 203 208 212 217 222 227 232 237 242 247 252 257 262 267
60 97 102 107 112 118 123 128 133 138 143 148 153 158 163 168 174 179 184 189 194 199 204 209 215 220 225 230 235 240 245 250 255 261 266 271 276
61 100 106 111 116 122 127 132 137 143 148 153 158 164 169 174 180 185 190 195 201 206 211 217 222 227 232 238 243 248 254 259 264 269 275 280 285
62 104 109 115 120 126 131 136 142 147 153 158 164 169 175 180 186 191 196 202 207 213 218 224 229 235 240 246 251 256 262 267 273 278 284 289 295
63 107 113 118 124 130 135 141 146 152 158 163 169 175 180 186 191 197 203 208 214 220 225 231 237 242 248 254 259 265 270 278 282 287 293 299 304
64 110 116 122 128 134 140 145 151 157 163 169 174 180 186 192 197 204 209 215 221 227 232 238 244 250 256 262 267 273 279 285 291 296 302 308 314
65 114 120 126 132 138 144 150 156 162 168 174 180 186 192 198 204 210 216 222 228 234 240 246 252 258 264 270 276 282 288 294 300 306 312 318 324
66 118 124 130 136 142 148 155 161 167 173 179 186 192 198 204 210 216 223 229 235 241 247 253 260 266 272 278 284 291 297 303 309 315 322 328 334
67 121 127 134 140 146 153 159 166 172 178 185 191 198 204 211 217 223 230 236 242 249 255 261 268 274 280 287 293 299 306 312 319 325 331 338 344
68 125 131 138 144 151 158 164 171 177 184 190 197 203 210 216 223 230 236 243 249 256 262 269 276 282 289 295 302 308 315 322 328 335 341 348 354
69 128 135 142 149 155 162 169 176 182 189 196 203 209 216 223 230 236 243 250 257 263 270 277 284 291 297 304 311 318 324 331 338 345 351 358 365
70 132 139 146 153 160 167 174 181 188 195 202 209 216 222 229 236 243 250 257 264 271 278 285 292 299 306 313 320 327 334 341 348 355 362 369 376
71 136 143 150 157 165 172 179 186 193 200 208 215 222 229 236 243 250 257 265 272 279 286 293 301 308 315 322 329 338 343 351 358 365 372 379 386
72 140 147 154 162 169 177 184 191 199 206 213 221 228 235 242 250 258 265 272 279 287 294 302 309 316 324 331 338 346 353 361 368 375 383 390 397
73 144 151 159 166 174 182 189 197 204 212 219 227 235 242 250 257 265 272 280 288 295 302 310 318 325 333 340 348 355 363 371 378 386 393 401 408
74 148 155 163 171 179 186 194 202 210 218 225 233 241 249 256 264 272 280 287 295 303 311 319 326 334 342 350 358 365 373 381 389 396 404 412 420
75 152 160 168 176 184 192 200 208 216 224 232 240 248 256 264 272 279 287 295 303 311 319 327 335 343 351 359 367 375 383 391 399 407 415 423 431
76 156 164 172 180 189 197 205 213 221 230 238 246 254 263 271 279 287 295 304 312 320 328 336 344 353 361 369 377 385 394 402 410 418 426 435 443

Source: Adapted from Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults. The Evidence Report. NIH Publication No. 98–4083: National Heart, Lung, and Blood Institute; 1998.

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Why should I participate in clinical trials?

Clinical trials are research studies involving people. Clinical trials look at safe and effective new ways to prevent, detect, or treat disease. Researchers also use clinical trials to look at other aspects of care, such as improving the quality of life for people with chronic illnesses. To learn more about clinical trials, why they matter, and how to participate, visit the NIH Clinical Research Trials and You website at http://www.nih.gov/health/clinicaltrials. For information about current studies, visit http://www.ClinicalTrials.gov.

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Weight-control Information Network
1 WIN Way
Bethesda, MD 20892–3665
Phone: 202–828–1025
Toll-free number: 1–877–946–4627
Fax: 202–828–1028
Email: win@info.niddk.nih.gov
Internet: http://www.win.niddk.nih.gov

Like WIN on Facebook:
http://www.facebook.com/win.niddk.nih.gov

The Weight-control Information Network (WIN) is a national information service of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), part of the National Institutes of Health (NIH). WIN provides the general public, health professionals, and the media with science-based, up-to-date, culturally relevant materials and tips. Topics include healthy eating, barriers to physical activity, portion control, and eating and physical activity myths.

Publications produced by WIN are carefully reviewed by both NIDDK scientists and outside experts. This fact sheet was also reviewed by Suzanne Phelan, Ph.D., Associate Professor of Kinesiology, California Polytechnic State University and Linda Van Horn, Ph.D., R.D., Professor of Preventive Medicine, Northwestern University Feinberg School of Medicine.

This publication is not copyrighted. WIN encourages you to copy and share as many copies as desired.

The Lifespan Series includes the following publications:

Spanish-language publications in the Lifespan Series include the following:

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U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES
National Institutes of Health

NIH Publication No. 06–5130
November 2009
Updated June 2013


To contact WIN, call toll free 1–877–946–4627; fax: 202–828–1028; email: win@info.niddk.nih.gov;
or write Weight-control Information Network, 1 WIN Way, Bethesda, MD 20892–3665.

Last Modified: December 11, 2013

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