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.

Healthy Weight

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

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.

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

Weight Gain during Pregnancy

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

*The body mass index (BMI) measures your weight in relation to your height. See the Additional Links 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. 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 for more Information.

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.

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.

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.

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.

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 online program "Daily Food Plan for Moms ." It can help you make an eating plan for each trimester (3 months) of your pregnancy.

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.

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.

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.

What other new eating habits may helps 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:

• 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.

What foods should I avoid?

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.

Physical Activity

Should I be physically active during my 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.

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.

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.

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.

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.

After the Baby is born

How can I stay healthy after my baby is born?

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 Additional Links 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.

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.

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.

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

What else may help?

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.

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.

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.

Body Mass Index Table 1 of 2

Body Mass Index Table 2 of 2

Other publications in the Lifespan Series include the following:

• Health Tips for Pregnant Women

• Helping Your Child: Tips for Parents

• Health Tips for Adults

• Health Tips for Older Adults

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

• Consejos para la futura mamá

• Cómo ayudar a su hijo

• Cómo mejorar su salud: consejos para adultos

• Sugerencias para personas mayores

References

Clinical Trials

The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) and other components of the National Institutes of Health (NIH) conduct and support research into many diseases and conditions.

What are clinical trials, and are they right for you?

Clinical trials are part of clinical research and at the heart of all medical advances. Clinical trials look at 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. Find out if clinical trials are right for you .

What clinical trials are open?

Clinical trials that are currently open and are recruiting can be viewed at www.ClinicalTrials.gov .