For most women, pregnancy weight gain comes easily. But for others, the problem isn’t gaining too much weight — it’s not gaining enough. Here’s how to get your pregnancy weight gain on track, and when it’s time to see your doctor.
Why am I not gaining weight during pregnancy?
A number of factors can contribute to not gaining enough weight when you’re expecting. Causes of slow or no weight gain in pregnancy include:
- A fast metabolism
- Morning sickness
- Appetite loss
- Concerns over body image
- Other medical reasons
What is considered too little weight gain during pregnancy?
During the first trimester of pregnancy, you don’t need to gain any weight at all. You may even lose a few pounds. That’s usually perfectly okay, as long as you make up for it later on in pregnancy.
Your pregnancy weight gain should pick up in earnest, however, by the second trimester. The least amount of weight you should gain during pregnancy depends on how much you weighed before you conceived, among other factors. If you had a higher body mass index (BMI) before pregnancy, you typically need to gain less weight than if you started out pregnancy with a lower one.
By the second trimester, you should aim to gain the following:
- Underweight (BMI under 18.5) before pregnancy: About 1 pound per week (for 28 to 40 total pounds during pregnancy)
- Normal BMI (18.5 to 24.9) before pregnancy: Less than 1 pound per week (for 25 to 35 pounds total during pregnancy)
- Overweight (BMI 25 to 29.9) before pregnancy: About 0.6 pounds per week (for 15 to 25 pounds total during pregnancy)
- Obese (BMI 30 or more) before pregnancy: About 0.5 pounds per week (for 11 to 20 pounds total during pregnancy)
If you’re carrying twins, you need to gain roughly 50 percent more weight (give or take, again depending on your pre-pregnancy weight).
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What happens if you don’t gain enough weight during pregnancy?
Not gaining enough weight over the course of your pregnancy can put you and your baby at greater risk of complications. Babies whose mothers gain too little weight during pregnancy are more likely to:
- Be born prematurely
- Be small for their gestational age
- Suffer growth restriction in the uterus
Some babies who are born small may have trouble breastfeeding and be at greater risk for illnesses and missing developmental milestones.
A lack of weight gain is usually perfectly normal in the first trimester. Tiny fetuses have tiny nutritional needs.
The same isn’t true if you’re falling short of your recommended weight gain by the second trimester. As your baby gets bigger, calories and nutrients will be increasingly in demand. To keep up, you'll need to increase your weight at a steady pace.
How to gain more weight during pregnancy
It sounds obvious, but it's worth repeating. If you're eating the recommended calories during pregnancy and you're not gaining weight fast enough, you should eat more.
It’s easier said than done, but try not to stress if you’re not gaining the advised weight. Your doctor or a registered dietitian can help create a meal plan for you.
In the meantime, here are a few tips to help you put on more weight during pregnancy:
Choose nutrient-dense foods
If you’ve lost your appetite, focus on high-quality calories in small packages filled with healthy fats, protein and fiber. Nutrient-rich options include:
- Avocados
- Nuts and nut butter
- Fatty fish (like salmon)
- Olive oil
- Beans
- Peas
- Whole grain bread, cereal and pasta
- Oatmeal
- Brown rice
- Lean meat or poultry
- Plain Greek yogurt
- Dried fruit
- Eggs
- Cheese
Add a caloric punch to your dishes
Try dosing your dishes with an extra tablespoon of calorie-dense olive oil, butter, cream cheese, sour cream or cheese. Or toss a couple of scoops of powdered milk in hot cereal or scrambled eggs.
Some research suggests that adding protein supplements to your meals can help you gain weight. Talk to your doctor to make sure you get the right amount, since overdoing it on protein may limit a baby’s growth.
Eat strategically
It’s important to drink plenty of water during pregnancy to stay hydrated. And fruits and vegetables are a staple of a healthy pregnancy diet. They provide your baby with folic acid, a vitamin that helps form healthy cells and reduces the risk of birth defects like spina bifida.
That said, both beverages and calorie-light dishes can put a damper on your appetite. Instead of starting your meal with a salad or big glass of water, save the beverages and greens for after your main course.
Don’t turn to junk foods
While it might be tempting to fill the caloric gap with doughnuts, try to resist the urge. Processed, sugary or greasy foods will add weight but not nutrition. Right now, you and your baby need both.
Eat more often
Try not to skip meals, even if you’re feeling nauseous. Instead of eating three large meals a day, try having six smaller snack-sized bites every two hours or so. Eating smaller, frequent meals also helps combat morning sickness.
Don't feel like eating? Make yourself a thick smoothie and fortify it with wheat germ.
Compensate for exercise
Have a regular exercise routine? Exercise during pregnancy is excellent for your health and your baby’s in most cases. Just be sure to check in with your practitioner on your fitness program and make sure you’re eating enough to hit your caloric goals.
To make up for a sweat session, eat at a nutrient-dense snack around the time you exercise. It’s especially important if your workout involves high-intensity exercise or lasts longer than 45 minutes.
When to see the doctor
Sometimes, severe and continuous nausea and vomiting can keep you from gaining weight during pregnancy. If you’re among the 1 to 3 percent of women who develop hyperemesis gravidarum, your baby may not be getting the vital nutrients and vitamins he needs to grow. You may also be dehydrated, which can be a problem for both you and your baby.
Be sure to let your doctor know if your morning sickness is severe. Signs of hyperemesis gravidarum include not being able to keep food or liquids down and losing weight. Your practitioner may prescribe lifestyle changes or medication to help you manage the condition.
Finally, if you’ve struggled with an eating disorder in the past, it can be challenging to accept pregnancy weight gain. Speak honestly with your practitioner about past or present disordered eating. He or she may recommend seeing a registered dietitian with expertise in eating disorders for extra guidance. Building a supportive team can make it easier to ask for help when you need it. Remember that gaining weight is essential for your baby’s growth and health.
If you’re struggling with pregnancy weight gain by your second trimester, talk to your doctor. Your practitioner or a registered dietitian can offer tools to help you maintain a healthy amount of weight gain.
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