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<< Previous   of   Next >>   ADVERTISEMENT   CONTACT THE HERALD Do you have a news tip? newstips@heraldnet.com | 425.339.3400   Published: Friday, May 29, 2009 Don't 'eat for two,' experts tell pregnant women By Lauran Neergaard Associated Press WASHINGTON -- New guidelines are setting how much weight women should gain during pregnancy -- surprisingly little if they're already overweight. The most important message: Get to a healthy weight before you conceive, says the Institute of Medicine in the first national recommendations on pregnancy weight since 1990. It's healthiest for the mother -- less chance of pregnancy-related high blood pressure or diabetes, or the need for a C-section -- and it's best for the baby, too. Babies born to overweight mothers have a greater risk of premature birth or of later becoming overweight themselves, among other concerns. Meeting the guidelines could be a tall order, considering that about 55 percent of women of childbearing age are overweight, that preconception care isn't that common and about half of pregnancies are unplanned. Once a woman's pregnant, the guidelines issued Thursday aren't too different from what obstetricians already recommend, although about half of women don't follow that advice today. Among the new recommendations: A normal-weight woman, as measured by BMI or body mass index, should gain between 25 and 35 pounds during pregnancy. A normal BMI, a measure of weight for height, is between 18.5 and 24.9. An overweight woman -- BMI 25 to 29.9 -- should gain 15 to 25 pounds during pregnancy. For the first time, the guidelines set a standard for obese women -- BMI of 30 or higher: 11 to 20 pounds. An underweight woman -- BMI less than 18.5 -- should gain 28 to 40 pounds. What if a mom-to-be has gained too much? On average, overweight and obese women already are gaining five more pounds than the upper limit. But pregnancy is not a time to lose weight, stressed guidelines co-author Dr. Anna Maria Siega-Riz of the University of North Carolina, Chapel Hill. "It's not, 'Hey you gained enough, now you need to stop,"' Siega-Riz said. "Let's take stock of where you're at and start gaining correctly." Underweight and normal-weight mothers should put on a pound a week for proper fetal growth in the second and third trimesters, the guidelines say. The overweight and obese need about half a pound a week. The guidelines call for increased nutrition and exercise counseling during pregnancy, saying doctors or midwives may need to consult a dietitian to tailor a woman's care no matter her starting weight. Also, providers should discuss whether a woman plans to breastfeed, which not only is optimal for the baby but helps the new mother shed pounds, too. Obstetricians, who have struggled with how to advise heavier women as U.S. obesity rates have soared over the past two decades, welcomed the guidelines -- especially the recognition that babies born too large tend to grow into overweight children at risk for their own health problems. Not too many years ago it was rare to see a 9-pound, or larger, newborn. "Pregnant women should not be eating for two," said Dr. Ellen Landsberger, who specializes in high-risk pregnancies at New York's Montefiore Medical Center. "You want a healthy baby? On both ends, you have to eat the right amount." But is it realistic for obese women to gain as little as 11 pounds? "We think it's possible. We also think it will be a challenge," said Cornell University nutrition specialist Dr. Kathleen Rasmussen, who chaired the Institute of Medicine committee. READER COMMENTS Be the first to comment. You must be a registered user and verify your e-mail address to post comments to blogs or articles on HeraldNet. To register, click here. To read other terms and conditions, click here. Log out

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