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A Weighty Issue

The best way to put on pounds

The safe and smart amount of pregnancy weight gain depends on the individual mom, how much she weighed beforehand, and her dietary and lifestyle habits. A decade ago, the Institute of Medicine raised the recommended pregnancy weight gain to 25 to 35 pounds, to ensure optimum nutrition for the fetus. (Previous generations had been advised to gain less, with about 22 pounds being average in the 1960s.)

That standard is intended for women entering pregnancy at a normal weight. Those who are underweight should gain 28 to 40 pounds; those who are overweight, 15 to 25 pounds; and those who are obese, 15 pounds, according to the American College of Obstetricians and Gynecologists (ACOG). Within those 10- to 15-pound ranges, the low end is what the baby needs to thrive, and the high end is the limit at which moms need to stop gaining or risk their own future health, says Hope Ricciotti, M.D., assistant professor of obstetrics and gynecology at Harvard Medical School and author of The Pregnancy Cookbook. Your health care provider will suggest an appropriate weight gain based on your BMI and possibly factor in other issues, such as activity level. To gain the average of 28 pounds, Dr. Ricciotti recommends adding just 100 calories a day during the first trimester, followed by a careful, gradual increase to about 200 extra calories a day as you start the second trimester, and then 300 to 500 extra as you start the third. Translated into pounds, that means gaining about 3 to 6 pounds in the first trimester, and 6 to 12 pounds in both the second and third trimesters. Another way to look at it is 10 pounds in the first half (20 weeks) of pregnancy, and 18 pounds in the second half.

Women who are very physically active or have tall, big-boned frames may be able to add as many as 500 additional calories and still stay within the recommended weight guidelines. On the other hand, heavier short women may be advised to stay at the lower end of the weight-gain range, says Dr. Pupkin. Young or African-American mothers-to-be may be told to gain at the higher end of the range because they have higher rates of preterm birth and low-birthweight babies.