Piling on the kilos

I GAINED 17KG when I was pregnant. It seems like a humongous figure (and I did cut one back then!), but can you believe that I actually had trouble gaining weight during my first trimester?

Owing to my condition—hyperemesis gravidarum—I hardly retained any of my meals and lost weight during the first two months. Luckily, the extreme form of morning sickness ended, and my health and appetite were restored.

I looked to gain all the lost weight and more, and quickly researched on how to. I found out that my body mass index (BMI) allowed me to gain 16kg. The announcement was met with disbelief, especially by women of the previous generation. Six or maximum eight kilos was the norm. This was double!

I checked and rechecked. The Institute of Medicine (now National Academy of Medicine), an independent body that advises the US government on health, had just released guidelines for weight gain during pregnancy. This was being (still is) followed by experts and organisations across the world. The guidelines were based on BMI categories set by the World Health Organization.

(Please note recommendations cover women of varying age, height, parity, smoking history, race and ethnicity)

It is possible to gain this weight these days because of

a) increased access to both nutritious and junk food

b) better rest and fewer labour-intensive jobs such as harvesting, cooking over

firewood or drawing water from the well

c) Starting pregnancies at a better weight than women of previous generation

d) Consumption of pre-natal medicines that helps babies reach optimum growth

But why have recommendations for weight gain undergone such a sea change?

Research has shown that

✦ underweight women must gain well to reduce incidence of preterm or low-term baby and to care and breastfeed the baby

✦ obese or overweight women must gain under supervision to avoid increasing their risk to gestational diabetes, high blood pressure, delivering a large baby (who can become obese or overweight later) or undergoing a C-section

✦ production and arrival of milk is delayed in women who are obese at the start of pregnancy or who gain beyond recommended standards

Research has also shown how much a woman should (and will) gain and how soon she will lose it depends on her health and weight before pregnancy.

Find out your BMI and health status at the start of your pregnancy and chart out with your doctor how much weight you need to gain.

Next issue: When is your baby due?