Pregnant? Take weight off your mind - ditch the diet

Once, pregnancy was seen as giving women a green light to overindulge regardless of the consequences. But the health implications of carrying excess weight before and during pregnancy have put paid to the eating-for-two myth, with issues such as high blood pressure and gestational diabetes making pregnant women think twice before reaching for another biscuit.

Now a study suggests that even accepted levels of weight gain during pregnancy may increase the risk of having an overweight toddler.

Women in the study at America's Harvard Medical School who gained the recommended amount of weight ran four times the risk of having a child who was overweight at the age of three, compared to those who gained less than the advised amount.

One in three children in Scotland is overweight; widespread confusion about food, what to eat and how much, could be starting in the womb, says Sue Jacob, a midwife and spokeswoman for the Royal College of Midwives.

"Bigger mums-to-be who consume too many calories could be laying down the foundations for their baby to overindulge later in life," she warns. "Excess blood sugar, saturated fat and hormones can all result in negative biofeedback mechanisms to the baby."

Quality, not quantity, counts during pregnancy, she continues, and women need not consume more calories when they are having a baby. "It is a myth that you are eating for two. You don't need to increase your portions or calories although you may crave certain food that your body needs for iron and proteins," she says.

"But unless you are under- nourished, like the women we see in war-torn areas or living in extreme poverty, most of us are already carrying enough weight to sustain a healthy baby."

Until recently, expectant mothers would be weighed at every antenatal check, but doctors have realised this makes many women anxious, and they now rely on body mass index (BMI) tests at the start and end of pregnancy.

Midwives are also mindful not to cause a pregnant woman stress about her weight, adds Jacob. "We don't want women to get paranoid about how much they eat and how much they gain or don't. While underweight mothers risk having a small baby, larger mums are more likely to have heavier babies. But both can be equally dangerous to a baby's health."

Every woman will gain different amounts of weight, but this should not be more than 10-12kg or 22-28lbs during the pregnancy, says a spokeswoman from the Food Standards Agency. "If you gain too much weight this can affect your health and increase your blood pressure," she adds.

"But equally, it's important that you don't try to diet when you are pregnant. If you are concerned about your weight, talk to your GP or midwife. The agency continues to keep a watching brief on the evidence base on issues relating to diet and pregnancy."

But Melanie Doherty, a GP and mother of two from Ayrshire, admits she piled on 19kg (three stone) with her first child, Duncan, now five. "I was a healthy eater before becoming pregnant, then I suffered terrible morning sickness which was only abated by snacking on crisps, biscuits and pizza," she says.

"It wasn't within my control to eat healthily during pregnancy, simply because good things like fruit made me feel so ill. Duncan was a big baby, at 9lb 12, (4.5kg) but at no point was he ever overweight, and when he was a toddler he was actually slightly underweight for his height." With her second son, Bryn, now aged three, Mrs Doherty put on no more than the recommended amount and he was born slightly heavier than his brother.

"The last thing women should do is worry about their weight and diets when they are pregnant," she adds. "There is already enough pressure on women over weight issues the rest of the time. The message should simply be to eat as healthily as you can."

Whether you overindulge or not, it is important that pregnant women realise they are going to put on weight during pregnancy. The muscle layer of the uterus grows dramatically, and weighs an extra 2lb (1kg); the placenta weighs 1.3lb (0.6kg); breasts weigh an extra 0.9lb (0.4kg); blood volume increases and weighs an extra 2.6lb (1.2kg); amniotic fluid around the baby weighs 5.7lb (2.6kg); and fat which is laid down to give you extra energy for breastfeeding comes in at 5.5lb (2.5kg).

Without forgetting the baby, which weighs on average 7.3lbs (3.3kg), a woman can expect to gain 25.3lbs (1.8 stone; 11.5kg) more than she did before she was pregnant. The amount of weight gained may depend on how heavy she is before becoming pregnant, or her BMI.

British doctors agree with their American colleagues that women with a high BMI before pregnancy should try to limit the weight they gain. The impact of weight upon breastfeeding can also be misunderstood, says Heather Welford, a breastfeeding spokeswoman for the National Childbirth trust. "There is no evidence that not putting on much weight can compromise breastfeeding," she says. "There is a wide range of normal weight gain during pregnancy, but your ability to breastfeed has nothing to do with that. You don't need to have stockpiled pounds. Some people find they can lose weight quickly by breastfeeding, but research shows that it only makes a significant difference if done for at least six months."

The normal calorie intake for a woman is 2000 a day, and during breastfeeding this need only increase by another 500 to 750 extra calories.

But breastfeeding itself is a sedentary activity that can also leave women feeling hungry and reaching for the biscuit tin. It can result in many women finding it a struggle to lose excess weight after giving birth.

Anne Marie McGarry, 37, put on more than the recommended weight during all three of her pregnancies, culminating in an extra five stone (31.8kg) before the birth of her third baby in June 2005.

"I can't do skinny pregnant," admits the bank customer services officer from Cumbernauld, who is mother to Gillian, 13, Daniel, three, and Matthew. "I knew I was going to put weight on anyway and rather than feel deprived and watch everything I ate I decided to enjoy myself."

Mrs McGarry joined Scottish Slimmers to help her shed the excess weight afterwards, and she does not believe the extra pounds she gained adversely affected the weight of her children either before or after they were born.

She says: "They were all big, healthy babies, but all my children are lean now and more tall than they are heavy. If I'd thought my weight would be an issue for the children's health I would have been more careful not to put too much on. But I wasn't weighed during my last pregnancy, and at no point was I made to feel overweight."

After the event: how to lose the post-baby bump

Cravings, weight and how to shed excess pounds are among the most discussed topics on pregnancy and parenthood website forums. But the expert advice is not to fret about how much you are putting on, or to consider a diet while pregnant; both are likely to make a pregnant woman worry even more. Sensible healthy eating and gentle exercise remain the best way to lose weight once the baby is born. It takes nine months to get to full-term size, so women should not expect to return to their pre-pregnancy weight immediately afterwards. During the birth, women who have gained the recommended amount shed 12 to 14 pounds, leaving the same again to disappear during the post partum period.

If weight gain during pregnancy was normal, a woman should be able to return to her pre-pregnancy weight within eight months of giving birth. But those who have put on more weight should expect to take longer to lose it. Breastfeeding can help, but in most cases a woman needs to breastfeed for at least six months for it to have an impact on stored calories. Women breastfeeding should not expect to lose inches from their bust until they have weaned their baby off their breast.

The fastest and most effective way to lose weight after pregnancy is to introduce exercise. This, combined with a healthy diet, will not affect the quantity or quality of breast milk and will speed up weight loss and help avoid post natal depression.