Tuesday, January 3, 2017

Pregnancy Weight Gain Management ~ My Top 5 Tips

Attitudes about pregnancy and pregnancy weight gain have certainly undergone a complete overhaul in the past decades. We went from pregnant women taking it easy and eating for two to pregnant women attending burn boot camps and being publicly criticized for either gaining too little or too much. It seems to me that there should be a happy middle ground!

I know not every woman is concerned about her weight during pregnancy. This post is not to say that you should be concerned. If you don't want to know what you weigh during pregnancy than don't weigh yourself! Your doctor will still weigh you, but you can tell them you don't want to know.

I'm not an expert on this topic. I didn't spend pregnancy in "the best shape of my life." I simply stayed active and was within the recommended guidelines for weight gain. I took nearly a year to lose my baby weight and started pregnancy #2 at the same weight as I did pregnancy #1. These are my top tips for managing weight gain and, most importantly, feeling good!

Current recommendations for weight gain...

If you start at an average weight (neither over nor under weight) the recommended weight gain is 25-35 pounds, or around 5 pounds in first trimester and 1 pound per week in second and third trimesters. The math part of this gave me a headache! Here's a breakdown:

First Trimester, Weeks 1-13: 5 pounds
Second Trimester, Weeks 14-27: 14 pounds
Third Trimester, Weeks 28-40: 13 pounds
Total: 32 pounds

With my first pregnancy, I gained 5 pounds first trimester, 16 pounds second trimester, and 14 pounds third trimester for a total of exactly 35 pounds.

With my second pregnancy, I have gained 2 pounds in first trimester and around a pound a week after that to be at 18 pounds gained at 28 weeks.

So where is this weight going...

Baby: 7-8 pounds
Enlarged uterus: 2-3 pounds
Placenta: 2-3 pounds
Amniotic Fluid: 2-3 pounds
Breast Enlargement: 2-3 pounds
Blood Volume: 5 pounds
Total: 20-25 pounds

The extra weight on top of that is Stored Fat, which is fine! Stored fat typically adds an additional 5-10 pounds. This is the only weight you have any control over. 

On to the Tips!

Tip #1 ~ Be Kind to Yourself
Avoid the comparison trap! Every woman carries differently. I'm 5'4 so my baby takes up a lot of my torso. A woman who is 5'10 is going to look much different carrying a baby. I think most of us would love that perfect "basketball" pregnancy look where you don't even look pregnant from the back, but that look is often a very unrealistic expectation! Also a woman carrying her third baby will look much different from one carrying her first. 

My bump was much bigger at 18 weeks with baby #2 than it was at 20 weeks with baby #1, even though I had gained less weight at that point:

20 Weeks - Baby #1
18 Weeks - Baby #2

I don't recommend setting a goal weight for time of delivery. You can't anticipate how your pregnancy will go. Diet or exercise restrictions could greatly effect your weight gain. Also don't put pressure on yourself! Control over your weight can sometimes feel very limited. It can seem that even if you watch what you eat and exercise that the scale is creeping up faster than you'd expected. If this happens and your doctor says you are doing great, then just smile and go with it. Your body knows best! 

Don't worry about clothing labels! Prenatal clothing sizes are definitely not standardized. For baby #2 I needed some additional long sleeve tops so I purchased some from Old Navy Maternity, a size larger than the ones I had for baby #1 - I was first to second trimester in winter last time and and this time I'm second to third trimester in winter. Imagine my surprise when the bigger size this year was the same size or even smaller than the tops I had from my previous pregnancy!

Tip #2 ~ Know What Works for You

Managing pregnancy weight gain is very similar to maintaining a steady weight when you are not pregnant. If you are successful in maintaining a weight that works for you, don't change up your formula just because you are pregnant! Keep doing what works for you, as long as it is safe and approved by your doctor. If you've struggled with maintaining your preferred weight in the past, you may want to consider talking to your doctor or a dietitian about some individualized strategies to help you manage your weight gain. 

Tip #3 ~ Eat Healthy, Whole Foods
Unless you are under weight or concerned you are gaining weight too quickly, there is no reason to count out adding an additional 300 calories to gain weight in your second and third trimesters. I've seen tons of recommendations on how to add snacks to get those extra 300 calories. Calorie counting in pregnancy is not fun and in most cases is unnecessary. Instead, simply eat healthy foods when you are hungry. Snacks can help to prevent nausea in first trimester and can be used to fill in between smaller meals once your uterus is compressing everything in second and third trimester. I recommend 3 meals and 3 snacks per day. Remember to drink a lot of water.

Any diet can be made to work for pregnancy, whether it's vegan, paleo, gluten-free, etc. Ask your doctor if you're concerned about your nutrition! I've tried a lot of different diets over the years, but during pregnancy have never put any restrictions on my diet. I find I need more carbohydrates to fuel me during pregnancy and operate on a philosophy of mostly whole foods

Eating at home is something that really helps me control my weight (whether I'm pregnant or not!). Restaurant meals are often much higher in calories than you would suspect and tend to contain a large amount of sodium. Eating out frequently can also lead to unpleasant bloating and constipation.

Here's an example of my daily diet...

Wake up 7 a.m.Hydrate! I start the day with 12 oz water mixed with 4 oz of orange juice. This curbs any intense hunger and I like the taste from adding in the orange juice.
Breakfast 8 a.m. - 1 cup yogurt with 1/2 cup granola or 1 egg and 1/2 avocado, 1/2 banana, Decaf tea latte (with milk and 1 tsp maple syrup)
Snack 10 a.m. - Piece of fruit, 1/2 avocado, or a homemade muffin
Lunch 12 p.m. - Baby spinach or kale salad with tomatoes, bell peppers, chickpeas/chicken/cheese/nuts (choose 1 or 2), olive oil and balsamic vinegar (dressing mixed at home)
Snack 2:30 p.m. - Carrots, apple, or cucumber with hummus or smoothie with 1 cup almond milk or coconut milk and frozen strawberries
Dinner 5:30 p.m. - Chicken and vegetable stir fry with brown rice
Snack 8 p.m. - Piece of fruit

My husband's family always ate fruit in the evening instead of having a post-dinner sweet dessert. Having an apple, orange, or bunch of grapes in the evening is hydrating and provides a refreshing, fiber-full, antioxidant-rich snack. If you are craving sweets in the evening, try a piece of fruit instead!

Tip #4 ~ Move Your Body
Find an exercise which you enjoy and which fits into your daily routine. It's important to find something you can fit into your daily schedule because you will be most successful in maintaining your workout regimen. If you already have a regular routine of going to a gym, keep it up! 

With my first pregnancy...I walked my dog for 30-45 minutes every morning, did cardio and stretching 4-5 days a week right after work, and attended yoga class on Saturdays. Sometimes I even did extra cardio and stretching on the weekends too.

Now with my second pregnancy...my dog gets 10-20 minutes walking if he's lucky. My prenatal insomnia has been worse this go around and I have more difficulty getting up in the morning. I have to wait to do cardio and stretching after dinner because I take care of my son between finishing my workday and when my husband gets home. I'm much less motivated to work out after dinner, and am managing 3-4 days per week.

Good cardio options include an elliptical machine, a stationary bike, or jogging. If you already have a routine of regular swimming or other pregnancy safe exercise - keep it up!

My Cardio Choice - I have a spinning bike in my home. I bought it many years ago and it sat collecting dust for great periods of time because I always preferred to mountain bike outdoors. But for pregnancy it has been wonderful! It is gentle on my joints and biking really loosens up my lower back and hips, preventing pain. It's easy to modify as my pregnancy advances by simply lowering the tension. I can also read while I bike which makes the time go by faster.

After cardio, you want to do some gentle stretching. If you are a yoga fan, this is a great time to incorporate a few yoga poses. 

I always preform the following sequence after my cardio workout (I am 29 weeks pregnant with baby #2 here):

Cat/Cow, breathing in for cat and out for cow for 10 breaths. When  you arch for cow, pull in your abdominal muscles.

Table Top Balance, extend an opposite leg (flex toes) and arm (stretch out through fingertips) and hold for 10 breaths, then switch and hold the balance on your other side for 10 breaths.

Modified Side Plank, hold for 10 breaths on each side. Rotate to the side so your hips are stacked on top of each other. If you can do a regular plank (feet stacked on top of each other) that is awesome! I'm not good at a regular plank even when I'm not pregnant so I do the modified version with my knee down.

Hip Circles, five in each direction. When circling only stretch forward as far as is comfortable for you, you're not trying to go into a plank/push up position.

Child's Pose, hold for 10 breaths. Focus on bringing your hips back, if your forehead can't touch the floor that's okay.

Here's a BabyCenter article on Prenatal Yoga.

In my first pregnancy, I also attended prenatal yoga classes once per week. I loved those classes until I shifted my pelvis (Sacroiliac or SI joint) out of place. I did not acquire the injury while doing yoga! But after a chiropractor shifted things back into place I had to be very careful about how I rotated my legs which made yoga classes impractical. Search for classes in your area and keep in mind that a lot of studios will let you take your first class for free, so make sure to ask! Here is also a useful article about common Pregnancy Back Ailments

A few cautions...exercise should not cause pain! Especially with yoga and stretching, be aware of what your body is feeling and do not push yourself as you might if you were not pregnant. If you feel like something is stretching too far, it probably is! Your ligaments are much looser during pregnancy which increases the chance for injury. Also beware of jarring motions, this isn't the time to take up plyometrics!

Inactivity can also lead to discomfort. If I do not get any exercise, my knees, hips, and back are all hurting within a few days. A gentle workout will loosen things up, allowing me to get back on track with my workouts.

Tip #5 ~ Indulge in Moderation
Similar to being kind to yourself, a little indulgence never hurts (unless your doctor has said absolutely not). I've definitely experienced food aversions during pregnancy, but never real cravings. Sure, I'd like to sit around and eat potato chips and ice cream, but let's face it, that's pretty much any day whether I'm pregnant or not!

The important thing to keep in mind with indulgences is moderation. Whether it's one small treat a day or one big treat a week, find what works for your weight management and what makes you happy

My best tip about moderation is to limit what you keep in your home. Keep healthy snacks and little treats on hand, but limit how much you buy and don't buy things you don't want to snack on. My solution for when I went into an office and had access to a vending machine was to never have change or single bills in my purse. I'd like to say I can just resist temptation...but not usually. I enjoy snacking and I want to snack even more during pregnancy so I always make sure to have healthy snack options on hand. It's easier to resist temptation while shopping than once you have the treats at home in your cupboard.

My #1 favorite pregnancy treat is a strawberry milkshake. At home, I'll make a very thick almond or coconut milk and frozen berry smoothie which can be a healthier substitute. But if we go out for burgers, you can bet I'm getting a milkshake. I want it more than I want the burger or the fries :-) 
Strawberry Milkshake!

Of all the above tips, the most important is #1. Remember to be kind to yourself every day. 

Please comment and share your tips!

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