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It can be challenging to stick to the guidelines for pregnancy weight gain, especially if you've never craved carbohydrates so much in your life and it seems like everywhere you turn, people encourage you to eat for two.
But gaining too much weight while pregnant can raise your risk for birth complications like c-section delivery and premature birth. And even if you start pregnancy overweight or obese – like more than half of American women – sticking to the recommended range of weight gain can significantly reduce your risk of health problems like gestational diabetes and preeclampsia.
Below, doctors and nutritionists offer 10 important – and achievable – tips for healthy pregnancy weight gain.
1. Start pregnancy at a healthy weight if possible
"The most important thing you can do before getting pregnant, in addition to taking prenatal vitamins, is to start your pregnancy at a healthy weight," says Lauren Hyman, an ob-gyn in West Hills, California.
If you're at the "thinking about it" stage of pregnancy, or trying to conceive, consider making a preconception appointment. Your healthcare provider can help you figure out your current body mass index (BMI) and suggest ways to lose weight if necessary.
2. Eat moderately and often
You don't need that many extra calories per day to nourish your growing baby. Current guidelines call for 340 extra calories per day in your second trimester and 450 extra calories per day in your third trimester if you're starting pregnancy at a healthy weight. (If you're underweight or overweight, these numbers will differ based on your weight gain goal.)
That's not a lot of extra to play around with, so choose foods that pack a big nutritional punch and help you feel satisfied.
"Focus on small, frequent meals that are high in lean proteins, fruits, and vegetables," says Hyman. Learn more about meal planning during pregnancy.
Then choose healthy snacks between meals.
"Eating a healthy snack every three hours should help you avoid overdoing it at mealtimes," advises dietitian Frances Largeman-Roth, author of Feed the Belly: The Pregnant Mom's Healthy Eating Guide. Not only will you be providing good nutrition for your baby, but your blood sugar will stay level throughout the day so you're less likely to feel starving at dinnertime.
Choose meals and snacks that include protein, fiber, and some healthy fat, says Largeman-Roth. Examples include an apple with two tablespoons of peanut butter, an English muffin with a scrambled egg and spinach, protein-enriched pasta and tomato sauce, or Greek yogurt with a palmful of nuts or granola sprinkled on top.
Fruit with lots of fiber and high water content – like grapefruit, oranges, apples, berries, pears, and plums – can also help you feel full and keep constipation at bay.
3. Drink up (water, that is)
It's important to avoid dehydration during pregnancy – and drinking enough water has the added benefit of helping you feel satisfied between meals and snacks.
The Institute of Medicine advises pregnant women to drink 10 8-ounce glasses of water or other beverages each day. Some nutritionists suggest adding more for each hour of light activity. Largeman-Roth recommends three liters of water daily, or 101 fluid ounces.
Other experts suggest monitoring urine color: If it's dark yellow or cloudy, your body needs more fluids. Sip throughout the day to keep your urine color pale yellow or clear – a sign of proper hydration.
Drinking water also eases constipation, one of the less happy side effects of growing a person inside of you. When you're pregnant, your digestive system slows down, which ensures that you wring every possible bit of nutrition from your food. Getting enough fluids will help keep things moving along and prevent uncomfortable bloating.
Largeman-Roth, who recently gave birth to her third child, ups her water intake by keeping a pretty glass or water bottle with her at all times and chilling pitchers of water with sliced lemon, lime, or cucumber to make it more appealing. "You drink more when your water tastes good," she says.
4. Make your cravings constructive
No one expects you to avoid french fries and ice cream completely when you're pregnant. After all, cravings come with the territory.
The key is to satisfy your urges while getting the protein and healthy fats that you and your baby need (and that will help you feel full).
"A little trick I use is to combine something healthy with one of my less-healthy cravings," says Largeman-Roth. "For example, I mix a high-fiber cereal with some really yummy granola on top. You get the fiber you need to help prevent constipation, plus the sweet crunch you're craving."
When Largeman-Roth was pregnant and craved the salty satisfaction of chips and salsa, she toasted a tortilla, then topped it with a fried egg and a pile of shredded cheese, salsa, and diced avocado.
"It has more calories than just the chips," says Largeman-Roth, "but it packs in a lot more nutrients." The added protein from the cheese and egg will help you feel full longer.
5. Make starches work harder
Carbohydrates can be a pregnant woman's best friend, especially if you're battling the nausea and vomiting of morning sickness. But simple starchy food such as white bread, rice, and pasta raise your blood sugar without giving you the nutrition that comes with whole grains.
Better to reach for complex carbohydrates – such as brown rice, quinoa, and whole grain breads and pastas – which not only provide you and your baby with more nutrients, but will help you feel full for longer and make you less likely to give in to unhealthy cravings later in the day.
6. Start a simple walking regime
"The most valuable thing any pregnant woman can do is walk," says Jeanne Conry, past president of the American College of Obstetricians and Gynecologists. For expecting moms who are new to exercise, Conry recommends a program she calls "10 Minutes for Me." She has her patients walk 10 minutes a day and keep track of when they do it. Every 30 days, she has them add another 10 minutes, so that by the end of the first trimester they're walking 30 minutes daily, which they can continue to do for the rest of pregnancy.
Boston ob-gyn Laura Riley, who is medical director of labor and delivery at Massachusetts General Hospital, suggests that her patients purchase pedometers and shoot for 10,000 steps a day. It may sound daunting, but remember that steps done while running errands and walking around the office still count.
"It's not just important for managing weight gain," says Riley. "You'll have a lot fewer aches and pains as you get to the end of pregnancy if you stay active."
7. If you're already moving, don't stop
Unless your workout routine includes competitive kickboxing or other risky activities for expecting moms, there's no reason you can't keep it up during pregnancy.
With the exception of contact sports, Riley tells her patients to "do whatever they normally do – running, walking, aerobics, whatever. There are very few things you cannot do during pregnancy."
You may have to modify your movements as your girth grows and your center of gravity changes, but otherwise, says Riley, there's no reason you can't stick to your usual activity.
Learn the best kinds of exercise during pregnancy and find out when it's not safe to work out.
8. Have the occasional indulgence
Largeman-Roth satisfied her pregnancy sweet tooth with a half-cup serving of full-fat ice cream (about the size of a tennis ball) served in a small bowl to make it look bigger.
Hyman, the California ob-gyn, agrees that her patients shouldn't deprive themselves of a favorite treat. Instead of making that indulgence a daily habit, though, she advises enjoying it once a week.
9. Make weight a regular discussion
Having a conversation about weight gain with your doctor or midwife at every prenatal visit will help you stay on track and make changes if you need to.
Conry calculates her patients' body mass index (BMI) at the first visit, then gives guidance on pregnancy weight gain.
"I tell them what their goals are and what will happen during the different trimesters," Conry says.
Calvin J. Hobel, a maternal-fetal medicine expert at Cedars Sinai Medical Center in Los Angeles, studies the health of women during and after pregnancy. He recommends that doctors show women how they are gaining on a curve to help them stay on track.
"Seeing where you are at the beginning and then watching your trajectory is very important," says Hobel.
To see where you land on the weight-gain curve, and learn how much you should gain based on your height and pre-pregnancy weight, try BabyCenter's pregnancy weight gain estimator.
10. Breastfeed if you can
While this tip won't help during pregnancy, it's worth knowing that breastfeeding can help you meet your goals for healthy weight loss afterward.
"Breastfeeding is the best fix for losing the extra weight you've gained during pregnancy," says Hobel.
When breastfeeding goes well, it burns 500 calories daily. Also, birth and the body changes that happen in the first six weeks postpartum should help you drop your first 20 pounds (just from the baby, placenta, and water weight leaving your body). It's a great jump start to losing your pregnancy weight.
Kate Rope is a freelance writer and editor and coauthor of The Complete Guide to Medications During Pregnancy and Breastfeeding.