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Dietary Guidelines and Weight Gain in Pregnancy

Amount of weight you should gain during pregnancy

Pre-Pregnancy BMI

Recommended Total Weight Gain

Underweight (BMI less than 18.5)

28–40 lb

Normal weight (BMI 18.5-24.9)

25–35 lb

Overweight (BMI 25-29.9)

15–25 lb

Obese (BMI more than 30)

11–20 lb

Weight Gain

How much weight you should expect to gain in your pregnancy depends on your weight before pregnancy. A healthy amount to gain for most women is between 25 and 35 pounds. If you’re underweight to begin with, you can gain a bit more—30 to 40 pounds. If you’re overweight at the start, your goal should be to gain a little less—15 to 25 pounds. This weight gain should be accomplished by eating a healthy, well-balanced diet. Special situations, such as twins, may change the amount of weight we would recommend for you to gain. If you have questions regarding the correct amount for you to plan on gaining, we can address it in your visits.

When you put on weight may be as important as the total amount. You should expect to gain the least weight during the first trimester—roughly 2 to 5 pounds total–although some people may even lose a few pounds initially, especially if they have significant nausea or were overweight to start with. In the third trimester, when the baby is growing the most, you should expect to gain the greatest number of pounds—roughly a pound a week.

Well-Balanced Diet

Pregnancy is a time to eat smart. You only need on average an extra 300–500 calories a day to support the growth and development of your baby. By eating a healthy diet and taking a prenatal vitamin on a regular basis, you should be providing your pregnancy with all the necessary vitamins and minerals, including folic acid.

Foods: Special Considerations

Fish

Although there are potential health benefits to eating fish/seafood, some types are unhealthy to eat during pregnancy. A pregnant woman can safely eat up to 12 ounces (two average meals) a week of a variety of fish and shellfish. Avoid raw fish, especially shellfish such as oysters and clams, to avoid potentially dangerous infections.

Unpasteurized Foods

Unpasteurized foods can potentially contain harmful bacteria, one of which is called listeria. Avoid soft cheeses such as Brie, Feta, Camembert, and Roquefort, unless they are labeled as made with pasteurized milk. Also some fresh fruit juices, like homemade apple cider, may be unpasteurized and potentially risky. For other infectious reasons, you should avoid foods with raw or undercooked eggs in them.

Meats

Cook all meats, poultry, and seafood thoroughly to kill bacteria. Avoid raw or undercooked meats. Avoid patés or refrigerated meat spreads, due to the risk of infection. Some doctors recommend avoiding deli meats for similar reasons. If you choose to eat deli meats while pregnant, please make sure to heat them until steaming hot, which is the best way to significantly decrease the risk of infection. Processed meats, such as deli meats, hot dogs, pepperoni, sausage, and bacon, are also very high in nitrates and should be limited during pregnancy.

Caffeine

It is suggested to limit intake of caffeine to less than 200 mg a day. Remember to consider the caffeine you may consume in sodas and some teas.

Food/Beverage

Caffeine mg/oz

Barq’s Root Beer

23/12 oz

Chocolate milk

5/8 oz

Coca-Cola Classic

35/12 oz

Coffee—brewed

108/8 oz

Coffee—drip

145/8 oz

Dark chocolate

30/1.45 oz

Diet Coke

45/12 oz

Diet Mountain Dew

55/12 oz

Diet Pepsi

36/12 oz

Dunkin’ Donuts Coffee

143/16 oz

Einstein Bros Coffee

206/16 oz

Hot cocoa

5/8 oz

Lipton Iced Teas

50/20 oz

McDonald’s coffee

145/16 oz

Milk chocolate

11/1.55 oz

Nestea Iced Tea

34/16 oz

Starbucks Caffe Latte

150/16 oz

Starbucks Mocha

175/16 oz

Starbucks coffee—drip

260/12 oz

Starbucks Caffe Americano

225/16 oz

Best Choices

Eat 2 to 3 servings a week

OR

Good Choices

Eat 1 serving a week

Anchovy

Atlantic croaker

Atlantic mackerel

Black sea bass

Butterfish

Catfish

Cod

Crab

Crawfish

Flounder

Haddock

Hake

Herring

Lobster

Mullet

Pacific chub mackerel

Perch (freshwater and ocean)

Pickerel

Plaice

Pollock

Salmon

Sardine

Scallop

Shad

Shrimp

Skate

Smelt

Sole

Squid

Tilapia

Trout (freshwater)

Tuna (canned light, includes skipjack)

Whitefish

Whiting

Bluefish

Buffalo fish

Carp

Chilean seabass/Patagonian toothfish

Grouper

Halibut

Mahi mahi/dolphinfish

Monkfish

Rockfish

Sablefish

Sheepshead

Snapper

Spanish mackerel

Striped bass (ocean)

Tilefish (Atlantic Ocean)

Tuna (albacore. white tuna, canned and fresh/frozen)

Tuna (yellowfin)

Weakfish/sea trout

White croaker/Pacific croaker

Choices to avoid

Highest mercury levels

King mackerel

Orange roughy

Swordfish

Tuna (bigeye)

Marlin

Shark

Tilefish (Gulf of Mexico)

Alcohol

Because its effects are not completely known, NO amount of alcohol is considered safe during pregnancy. Babies exposed to alcohol during pregnancy are at risk of learning disabilities, physical deformities, low birth weight, and premature birth.

Marijuana

Marijuana use is discouraged in pregnancy due to an increased risk of stillbirth noted in some studies. It also has been associated with low-birth-weight babies. There have been limited studies associated with other side effects of marijuana use in pregnancy such as increased risk of learning disabilities, ADHD, and preterm delivery. Therefore, we recommend discontinuing marijuana use during pregnancy.

Dietary Guidelines and Weight Gain in Pregnancy

Amount of weight you should gain during pregnancy

Pre-Pregnancy BMI

Recommended Total Weight Gain

Underweight (BMI less than 18.5)

28–40 lb

Normal weight (BMI 18.5-24.9)

25–35 lb

Overweight (BMI 25-29.9)

15–25 lb

Obese (BMI more than 30)

11–20 lb

Weight Gain

How much weight you should expect to gain in your pregnancy depends on your weight before pregnancy. A healthy amount to gain for most women is between 25 and 35 pounds. If you’re underweight to begin with, you can gain a bit more—30 to 40 pounds. If you’re overweight at the start, your goal should be to gain a little less—15 to 25 pounds. This weight gain should be accomplished by eating a healthy, well-balanced diet. Special situations, such as twins, may change the amount of weight we would recommend for you to gain. If you have questions regarding the correct amount for you to plan on gaining, we can address it in your visits.

When you put on weight may be as important as the total amount. You should expect to gain the least weight during the first trimester—roughly 2 to 5 pounds total–although some people may even lose a few pounds initially, especially if they have significant nausea or were overweight to start with. In the third trimester, when the baby is growing the most, you should expect to gain the greatest number of pounds—roughly a pound a week.

Well-Balanced Diet

Pregnancy is a time to eat smart. You only need on average an extra 300–500 calories a day to support the growth and development of your baby. By eating a healthy diet and taking a prenatal vitamin on a regular basis, you should be providing your pregnancy with all the necessary vitamins and minerals, including folic acid.

Foods: Special Considerations

Fish

Although there are potential health benefits to eating fish/seafood, some types are unhealthy to eat during pregnancy. A pregnant woman can safely eat up to 12 ounces (two average meals) a week of a variety of fish and shellfish. Avoid raw fish, especially shellfish such as oysters and clams, to avoid potentially dangerous infections.

Best Choices

Eat 2 to 3 servings a week

Anchovy

Atlantic croaker

Atlantic mackerel

Black sea bass

Butterfish

Catfish

Cod

Crab

Crawfish

Flounder

Haddock

Hake

Herring

Lobster

Mullet

Pacific chub mackerel

Perch (freshwater and ocean)

Pickerel

Plaice

Pollock

Salmon

Sardine

Scallop

Shad

Shrimp

Skate

Smelt

Sole

Squid

Tilapia

Trout (freshwater)

Tuna (canned light, includes skipjack)

Whitefish

Whiting

Good Choices

Eat 1 serving a week

Bluefish

Buffalo fish

Carp

Chilean seabass/Patagonian toothfish

Grouper

Halibut

Mahi mahi/dolphinfish

Monkfish

Rockfish

Sablefish

Sheepshead

Snapper

Spanish mackerel

Striped bass (ocean)

Tilefish (Atlantic Ocean)

Tuna (albacore. white tuna, canned and fresh/frozen)

Tuna (yellowfin)

Weakfish/sea trout

White croaker/Pacific croaker

Choices to avoid

Highest mercury levels

King mackerel

Orange roughy

Swordfish

Tuna (bigeye)

Marlin

Shark

Tilefish (Gulf of Mexico)

Unpasteurized Foods

Unpasteurized foods can potentially contain harmful bacteria, one of which is called listeria. Avoid soft cheeses such as Brie, Feta, Camembert, and Roquefort, unless they are labeled as made with pasteurized milk. Also some fresh fruit juices, like homemade apple cider, may be unpasteurized and potentially risky. For other infectious reasons, you should avoid foods with raw or undercooked eggs in them.

Meats

Cook all meats, poultry, and seafood thoroughly to kill bacteria. Avoid raw or undercooked meats. Avoid patés or refrigerated meat spreads, due to the risk of infection. Some doctors recommend avoiding deli meats for similar reasons. If you choose to eat deli meats while pregnant, please make sure to heat them until steaming hot, which is the best way to significantly decrease the risk of infection. Processed meats, such as deli meats, hot dogs, pepperoni, sausage, and bacon, are also very high in nitrates and should be limited during pregnancy.

Caffeine

It is suggested to limit intake of caffeine to less than 200 mg a day. Remember to consider the caffeine you may consume in sodas and some teas.

Food/Beverage

Caffeine mg/oz

Barq’s Root Beer

23/12 oz

Chocolate milk

5/8 oz

Coca-Cola Classic

35/12 oz

Coffee—brewed

108/8 oz

Coffee—drip

145/8 oz

Dark chocolate

30/1.45 oz

Diet Coke

45/12 oz

Diet Mountain Dew

55/12 oz

Diet Pepsi

36/12 oz

Dunkin’ Donuts Coffee

143/16 oz

Einstein Bros Coffee

206/16 oz

Hot cocoa

5/8 oz

Lipton Iced Teas

50/20 oz

McDonald’s coffee

145/16 oz

Milk chocolate

11/1.55 oz

Nestea Iced Tea

34/16 oz

Starbucks Caffe Latte

150/16 oz

Starbucks Mocha

175/16 oz

Starbucks coffee—drip

260/12 oz

Starbucks Caffe Americano

225/16 oz

Alcohol

Because its effects are not completely known, NO amount of alcohol is considered safe during pregnancy. Babies exposed to alcohol during pregnancy are at risk of learning disabilities, physical deformities, low birth weight, and premature birth.

Marijuana

Marijuana use is discouraged in pregnancy due to an increased risk of stillbirth noted in some studies. It also has been associated with low-birth-weight babies. There have been limited studies associated with other side effects of marijuana use in pregnancy such as increased risk of learning disabilities, ADHD, and preterm delivery. Therefore, we recommend discontinuing marijuana use during pregnancy.

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