Weight gain during pregnancy is expected but.....

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Weight gain during pregnancy is expected, but piling on too much is risky for mother and baby, writes Meena Sreenivasan

GAINING weight is a natural part of pregnancy. It not only helps your baby grow and develop, but also prepares you for breastfeeding. But how much weight should a pregnant mum gain?

Being too heavy or obese isn’t just unhealthy for an expectant mother, it also puts her baby at risk for future health problems.

 “Women who are overweight need to reduce their weight before they become pregnant. They will have a much healthier baby as well as reduce problems associated with maternal obesity,” advises Pantai Hospital Kuala Lumpur  obstetrician and gynaecologist Dr M. Narayanan.  

He says that the management of weight in pregnancy must ideally start before pregnancy.

“If you are overweight and lose some weight before conceiving, it will not only help your pregnancy, but also fertility.

He said most patients tend to lose some weight during the first trimester because of morning sickness, nausea and vomiting.

ALLOWABLE RANGE
“If you are of normal weight, you are allowed to put on about 11 to 15kg during the course of your pregnancy. But if you are overweight, you must not put on more than 11kg.

 “If you are underweight, then you are allowed put on up to 18kg. In conditions like twin pregnancy, you will be expected to put on more weight — about 22 to 25kg,” he explains.

When a mother delivers her baby, the excess weight she puts on doesn’t disappear straightaway. After giving birth, she immediately loses about 6kg.

This includes the weight of the baby, the amniotic fluid, the placenta, the weight due to the increase in blood volume and the increase of uterine mass.

“If you have put on 15kg during pregnancy, you will have to work at losing the rest of the weight. And the more weight you gain, the more difficult it is to lose.

“People who are obese in pregnancy may face problems such as gestational diabetes and high blood pressure. They may end up with operative or instrumental delivery. Given that post-delivery obese people tend to move less, this in turn disposes them to deep vein thrombosis.                

“Gaining too much weight also raises your baby’s risk of health problems and childhood obesity. It is suggested that expectant mothers exercise during pregnancy.

“You can enrol in an ante-natal exercise class or exercise on your own by going for walks with your husband in the evenings.

“If you have the facilities, swimming is recommended. But make sure that you do not overdo it. Do only what your body can take. If you experience pain or undue tiredness, you are overdoing it,” adds Dr Narayanan.

OFF WITH THE BABY WEIGHT
How long a mother takes to shed the extra weight depends on how much weight she puts on during her pregnancy.

“It should not take too long, but one should aim to attain the original weight within three to six months. That’s a reasonable amount of time and it also depends on whether you gave birth normally or by surgery.

“Start exercising as soon as you can. Focus on abdominal exercises to tighten muscles. While most people think it’s enough to just control their diet, it’s a wrong notion. Combine it with a proper regime of diet and exercising which will show results,” says Dr Narayanan.

He adds that if mothers gain excessive weight during pregnancy and if they keep gaining extra kilos with every pregnancy, this can lead to long-term obesity and medical problems.

Shobie Malani, for instance, had problems getting pregnant. After two miscarriages due to polycystic ovary syndrome, she was advised to lose her weight a little to conceive. Soon after, she got pregnant.

By the time she found out that she had conceived, Shobie had already dropped a few kilos due to her healthier lifestyle.

“I was extra careful after my second miscarriage and was eating right. As such, I did not put on much weight and fortunately, did not suffer from morning sickness.

“Overall, I had a good pregnancy and stayed fit with yoga. But I was monitored for gestational diabetes. Generally, when you are much older — I was 35 years old when I got pregnant — I knew that I needed to take extra precautions.

“Luckily, I had no other medical problems because I stayed active and fit.”

PUTTING ON WEIGHT
But Shobie started putting on weight during her third trimester, just after seventh month of pregnancy.

“I was not overly worried about my weight because my doctor said it was normal. The only setback I had was the back pain I experienced due to the extra weight. I was blessed because I could eat anything. I had no cravings or dislike for any food. My doctor advised me to eat a proper diet, and eat enough by having smaller meals throughout the day,” says Shobie.

When she gave birth to her daughter Dheeiya, she fully breastfed her. Then seven months later, when she started to wean Dheeiya off and start her on semi-solids, Shobie realised that she had put on weight.

“Being a vegetarian, I tend to eat more. I was shocked when I found that within 1½ months, I had put on almost 5kg! I hired someone to look after me for a month during confinement, but since I had a Caesarean section, she could only do my bengkung (body wrap) in the third week. My wound had to heal first.

“By that time, I admit I had already gotten a bit lazy. Initially, she did the bengkung for me, but instead of wearing it the whole day, I took it off by lunchtime. I only wore it for three to four hours although it is recommended for seven to eight hours.

“My stomach muscles started to slacken and became wobbly. Then I decided to do something about it, and started on pilates and swimming four times a week to tone and strengthen my body. It also helped my back.”

Now, Shobie can feel her core muscles and abs getting stronger. She also makes sure that she eats more vegetables and fibre, with carbs in smaller portions.

“I am happy that I am getting back into shape and I give myself three months to get back to my ideal weight. The challenge I face is finding time to exercise, especially when I have to care for my toddler.”

Eat right
• It is a fallacy that you must eat for two.
• Eat adequate amounts and eat healthy food.
• Don’t binge on chocolates, ice cream and foods rich in calories.
• Eat plenty of fibre, a good serving of vegetables, fish and chicken.
• Try to reduce sugar and carbohydrates.
• Stay away from fried foods.
• If you are breastfeeding, your extra food intake should not exceed 200 to 250 calories a day.
• Engage in regular physical activity.

Problems associated with maternal obesity
•    Body mass index increases and this will lead to problems related to obesity.
•    The heart is doing extra work.
•    Maternal obesity also increases the risk of diabetes and blood pressure.
•    Overweight and obese pregnant women may also experience joint problems because of the excessive weight.

sumber : new straits times - health