Pregnancy weight gain

Pregnancy is a time of changes within the body. Every woman gain some weight during pregnancy due to the growth of the baby, placenta and fluid around the baby (amniotic fluid), but limiting the amount of extra weight you gain will improve your health and your baby’s, both now and in the future. Gaining the right amount of weight during pregnancy can help protect your health and the health of your baby. Eating a healthy, balanced diet can help you have a healthier pregnancy and manage your weight gain.

How much weight you will put on during your pregnancy depends on your weight before you become pregnant. Weight gain in pregnancy varies greatly. Most pregnant women gain between 22 lb and 26 lb (10kg to 12.5kg), putting on most of the weight after week 20. Much of the extra weight is due to your baby growing, but your body will also be storing fat, ready to make breast milk after your baby is born.

Putting on too much or too little weight can lead to health problems for you or your unborn baby.

Managing your weight in pregnancy is not about dieting or trying to lose weight. It’s about looking after yourself and your baby by eating healthily and staying active.

If you gain too little weight during pregnancy, you’re more likely than other women to have a premature baby or a baby with low birthweight. A premature baby is born too early, before 37 weeks of pregnancy. Low birthweight means your baby is born weighing less than 5 pounds, 8 ounces (2.5 kilograms).

If you gain too much weight during pregnancy, you’re more likely than other women to:

• Have a premature baby. Premature babies may have health problems at birth and later in life, including being overweight or obese. Being obese means you have an excess amount of body fat.
• Have a baby with fetal macrosomia. This is when your baby is born weighing more than 8 pounds, 13 ounces (4 kilograms). Having a baby this large can cause complications, like problems during labor and heavy bleeding after birth. This also increases your child’s risk of becoming obese in childhood and early adult life
• Have high blood pressure with complications in pregnancy (pre-eclampsia)
• Have diabetes during pregnancy (gestational diabetes)
• Need a cesarean birth (C-section). This is surgery in which your baby is born through a cut that your health care provider makes in your belly or uterus.
• Have trouble losing weight after your baby’s birth. This can increase your risk for health conditions like diabetes, high blood pressure, heart disease and some cancers later in life.

However, not gaining enough weight during pregnancy can increase your chances of having a premature (preterm) birth, or a small for age baby.

Weight gain during pregnancy during pregnancy key points:

• Every pregnant woman gains weight differently so there are no official guidelines for how much weight you should gain. The most important thing is to keep your weight gain to a safe and healthy level for you and your baby.
• It’s best to start pregnancy at a healthy weight. Talk to your doctor to find out a healthy weight for you before you get pregnant.
• Gaining too much or too little weight during pregnancy can be harmful to you and your baby.
• Don’t ever try to lose weight during pregnancy as this is not healthy for you or your baby. Some women may even lose weight during the first few months, especially if they have morning sickness, and that is absolutely normal.
• You only need about 200 to 300 extra calories a day during pregnancy to support your baby’s growth and development.
• Only some of the weight you gain in pregnancy will be body fat. The other things causing weight gain will include:
  • your baby
  • the placenta
  • the amniotic fluid (the water surrounding your baby)
  • your growing breasts
  • the increased blood you need
  • natural fluid retention.
• Staying active is important while you’re pregnant, as it’ll prepare your body for labor and birth. Keep up your normal daily activity or exercise, unless you have been advised by your midwife or doctor not to exercise.

Figure 1. Body mass index (BMI) chart

Why is it important to manage my weight now I’m pregnant?

If you manage your weight by eating well and staying active, it can help you have a healthier pregnancy and a safer birth. It will also mean you reduce the risks of some health problems for you and your baby.

Gaining too much weight during pregnancy

Putting on too much weight can affect your health and increase your blood pressure. But pregnancy isn’t the time to go on a diet, as it may harm the health of the unborn child. It’s important that you eat healthily.

Gaining too much weight can increase your risk of complications.

These include:

• gestational diabetes: too much glucose (sugar) in your blood during pregnancy can cause gestational diabetes, which increases your risk of having a large baby
• pre-eclampsia: a rise in blood pressure can be the first sign of pre-eclampsia; although most cases are mild and cause no trouble, it can be serious

Gaining too little weight during pregnancy

Gaining too little weight can cause problems such as premature birth and a baby with a low birth weight (less than 2.5kg or 5.5lb at birth).

It can also mean your body isn’t storing enough fat.

Lack of weight gain can be related to your diet and weight before you become pregnant.

But some naturally slim women stay slim while they’re pregnant and have healthy babies.

What is Body Mass Index?

The body mass index (BMI) or Quetelet index is a value derived from the mass (weight) and height of an individual. The body mass index (BMI) is defined as the body mass divided by the square of the body height, and is universally expressed in units of kg/m², resulting from mass in kilograms and height in meters.

The body mass index (BMI) is an attempt to quantify the amount of tissue mass (muscle, fat, and bone) in an individual, and then categorize that person as underweight, normal weight, overweight, or obese based on that value. Commonly accepted body mass index ranges are:

• A) Underweight: under 18.5 kg/m²
• B) Normal weight: 18.5 to 25 kg/m²
• C) Overweight: 25 to 30 kg/m²
• D) Obese: over 30 to 39.9 kg/m²
• E) Severely Obese: over 40 kg/m²

BMI is considered an important measure for understanding population trends. For individuals, it is one of many factors that should be considered in evaluating healthy weight, along with waist size, body fat composition, waist circumference, blood pressure, cholesterol level and blood sugar.

The World Health Organization defines overweight as a body mass index equal to or more than 25 – 29.9 kg/m² and obesity as a BMI equal to or more than 30.

Adults with a body mass index of 35 or higher and an obesity-related condition (e.g., diabetes) and adults with a BMI of 40 kg/m² or higher are considered severely obese.

Moreover, your Body Mass Index (BMI) does not take into account your age, gender or muscle mass. Nor does it distinguish between lean body mass and fat mass. As a result, some people, such as heavily muscled athletes, may have a high BMI even though they don’t have a high percentage of body fat. In others, such as elderly people, body mass index may appear normal even though muscle has been lost with aging.

To calculate your body mass index, you divide your body weight in kilograms by your height in meter squared (commonly expressed as kg/m²), see the body mass index formula below.

Alternatively, you can use the Figure 1 chart above to help you. Find your height, then go across the chart till you are in the column headed by your weight (kg). The number in the cell is your BMI (rounded to the nearest whole number). The color of the cell indicates which recommendations are right for you.

To find out about your body mass index (BMI), you can also use a FREE online BMI calculators from the Centers for Disease Control and Prevention (CDC) :

• Adults (https://www.cdc.gov/healthyweight/assessing/bmi/adult_BMI/english_bmi_calculator/bmi_calculator.html)

What is normal weight gain during pregnancy?

There are no official guidelines for how much weight women should gain in pregnancy because everyone is different. How much weight you should you gain during pregnancy depends on your health and your body mass index (BMI) before you get pregnant. BMI is a measure of body fat based on your height and weight. The most important thing is to keep your weight gain to a safe and healthy level for you and your baby.

Your health care provider uses your body mass index (BMI) before pregnancy to figure out how much weight you should gain during pregnancy. If you’re pregnant with one baby or twins, use the Tables 1 to 3 below to find your recommended weight gain based on your BMI before pregnancy. If you’re pregnant with triplets or more, talk to your provider about the amount of weight you should gain during pregnancy.

If you’re overweight or obese and are gaining less than the recommended amounts, talk to your doctor. If your baby is still growing well, your weight gain may be fine.

Gaining weight slowly and steadily is best. Don’t worry too much if you don’t gain any weight in the first trimester (first 12 weeks or pregnancy) or if you gain a little more or a little less than you think you should in any week. You may have some growth spurts—this is when you gain several pounds in a short time and then level off. Don’t ever try to lose weight during pregnancy.

If you’re worried about your weight gain, talk to your health care provider.

Table 1. Normal weight gain in pregnancy

Table 2. Recommendations for total weight gain during pregnancy, by pre-pregnancy or early pregnancy (less than 10 weeks) BMI

How much weight should I gain in pregnancy?

Everyone is different, but the amount of weight that you should gain during pregnancy depends on your pre-pregnancy body mass index (BMI). This is your weight (measured) in kilograms divided by your height (measured) in meters squared (see the formula above). You can ask your health provider to help you with this, especially if you do not have accurate scales at home.

For example: if you are 1.68 m tall and weigh 82 kg, your BMI is 29 kg/m², which is Overweight category.

In the first trimester (first 12 weeks), most women do not need to gain much weight (usually less than 4.4 pounds or 2 kg) – which is just as well for those who have morning sickness early in pregnancy. Some women even lose a small amount of weight. If this happens to you, you do not need to be concerned as long as you start to gain weight steadily in the second and third trimesters of your pregnancy.

The Table 2 above can be used as a guide to help you work out how much weight you should gain during your pregnancy. Regardless of your BMI at the start of pregnancy, you can still have a healthy weight gain during pregnancy.

Most women do not gain much weight during the first trimester of pregnancy (between a half and 2 kilograms). The rate of weight gain can vary during the rest of your pregnancy and may not be the same every week.

If you’re having twins

It is especially important to gain the right amount of weight when you’re expecting twins because your weight affects the babies’ weight. And because twins are often born before the due date, a higher birth weight is important for their health. It is important you work with your health care provider to determine what’s right for you.

Consider these general guidelines for pregnancy weight gain if you’re carrying twins:

Table 3. Recommendations for total weight gain during pregnancy, by pre-pregnancy or early pregnancy (less than 10 weeks) BMI

Where do I gain the weight during pregnancy?

If you’re at a healthy weight before pregnancy and gain 30 pounds (13.6 kilograms) during pregnancy, here’s where you carry the weight:

• Baby = 7.5 pounds (3.4 kilograms)
• Amniotic fluid = 2 pounds (907 grams). Amniotic fluid surrounds the baby in the womb.
• Blood = 4 pounds (1.81 kilograms)
• Body fluids = 4 pounds (1.81 kilograms)
• Breasts = 2 pounds (907 grams)
• Fat, protein and other nutrients = 7 pounds (3.17 kilograms)
• Placenta = 1.5 pounds (680 grams). The placenta grows in your uterus (also called womb) and supplies the baby with food and oxygen through the umbilical cord.
• Uterus = 2 pounds (907 grams). The uterus is the place inside you where your baby grows.

What is the average weight gain during pregnancy?

Most women put on between 22 lbs (10kg) and 28 lbs (12.5kg) during their pregnancy.

Your healthy weight gain during pregnancy may depend on the weight you were before you got pregnant. There are no official guidelines but the American College of Obstetricians and Gynecologists say that:

• women who are underweight (BMI under 18.5) are recommended to put on between 28-40 lbs (13-18kg)
• women in the normal weight range (BMI of 18.5-24.9) are recommended to put on between 25-35lbs (11-16kg)
• women who are overweight (BMI between 25 and 29.9) are recommended to put on between 15-25lbs (7-11kg)
• women who are affected by obesity (BMI of 30 or more), are recommended to put on between 11-20 lbs (5-9kg).

The recommended weight gain for women expecting twins is:

• women in the normal weight range (BMI of 18.5-24.9) are recommended to put on between 37-54 lbs (16.8-24.5kg)
• women who are overweight (BMI between 25 and 29.9) are recommended to put on between 31-50 lbs (14.1-22.7kg)
• women who are affected by obesity (BMI of 30 or more), are recommended to put on between 25-42 lbs (11.3-19.1kg).

Try not to get too concerned about these guidelines. The most important thing is to keep your weight gain to a safe and healthy level for you and your baby.

Your doctor or midwife will be able to advise and reassure you about what is right for you. If you are underweight or overweight, you should get extra care and support during your pregnancy.

How do I manage my weight gain during pregnancy?

While it is ideal to be a healthy weight before becoming pregnant (ie, a BMI between 18.5 and 24.9 kg/m²), scientists know that this doesn’t always happen. If you are outside the healthy weight range, you can still help your baby by gaining weight within the recommended range for your BMI category.

For most women, if you have always been active, continuing to exercise at the same level during pregnancy is safe and healthy.

If you are not used to being active, try doing some gentle exercise for about 15 minutes a day, three times a week before building up slowly to 30 minutes a day. Remember, you’re not trying to get as fit as possible, you just need to stay physically active. You can do most types of exercises in pregnancy so there are lots of things you can try.

If doing physical activities is difficult, just try not to stay sitting down for long periods of time. Try to walk as much as you can and make small changes to increase your daily physical activity. For example, take the stairs instead of the lift at work, or get off the bus a stop earlier.

Talk to your midwife or doctor about how you can monitor your weight, and for advice about eating and being active during your pregnancy. They are there to help and won’t judge you.

How can I track my weight gain during pregnancy?

Your doctor checks your weight at each prenatal care visit. Use the weight-gain tracking chart to track your weight yourself.

Figure 2. Weight-gain tracking chart

Is it safe to lose weight when pregnant?

Dieting to lose weight during pregnancy is not recommended.

Who should manage their weight during pregnancy?

Everyone. But it’s especially important to manage your weight during pregnancy if your body mass index (BMI) was 30 or higher, or lower than 18.5 before you became pregnant. Use our BMI calculator to find out what your current body mass index is.

Healthy weight gain tips for healthy women

Here are some tips to help you manage healthy weight gain during pregnancy:

• Pregnancy is not about ‘eating for two’. In the first 12 weeks of pregnancy, you can eat the same amount as you usually would. It is important you eat healthy food.
• After the 12th week, and if you are a healthy weight, the extra food you need each day is about the same as a wholegrain cheese and tomato sandwich, or a wholegrain peanut butter sandwich and a banana. If you are overweight or obese, the extra food you need is about the same as 1 slice of wholegrain bread or 2 apples.
• Drink water rather than sweetened drinks or fizzy drinks.
• Drink low-fat or extra-calcium milk instead of full-fat milk.
• Choose wholegrain bread instead of white bread.
• Eat a healthy breakfast every day, such as wheat biscuits or porridge with low-fat milk, or 2 slices of wholegrain toast.
• Have at least 4 servings of vegetables and 2 servings of fruit every day. Buy vegetables and fruits that are in season, or buy frozen vegetables to help reduce cost, wastage and preparation time. Tinned fruit in juice are also a good option.
  • Examples of a vegetable or fruit serving:
    • half a cup of peas, broccoli or carrots
    • 1 medium-sized potato, banana, orange or apple
    • 1 large kiwifruit.
  • If vegetable/fruit juice or dried fruit is consumed, it contributes a maximum of only 1 serving of the total recommended number of daily servings for fruit/vegetables.
• Prepare and eat meals at home. Have takeaways no more than once a week.
• Choose healthy snacks such as unsweetened or low-sugar, low-fat yogurt, fruit, cheese and crackers, home-made popcorn, a glass of trim milk, a few unsalted nuts (e.g., 6 or 7 almonds) or a small wholegrain sandwich.
• Aim to do at least 30 minutes of moderate intensity activity 5 or more days a week, e.g., brisk walking or swimming (or as advised by your doctor, midwife or physiotherapist). The ‘talk test’ is a simple way to estimate intensity: as a guide, you should be able to carry out a conversation but not sing while doing moderate intensity activity.

Foods to avoid in pregnancy

Most foods and drinks are safe to have during pregnancy. But there are some things you should be careful with or avoid.

When you’re pregnant, it’s also important to avoid food-borne illnesses, such as listeriosis and toxoplasmosis, which can be life threatening to an unborn baby and may cause birth defects or miscarriage.

Foods to steer clear of include:

• Soft, unpasteurized cheeses (often advertised as “fresh”) such as feta, goat, Brie, Camembert, and blue cheese. Soft cheeses including imported soft cheeses may contain listeria. You would need to avoid soft cheeses such as Brie, Camembert, Roquefort, Feta, Gorgonzola, and Mexican style cheeses that include Queso Blanco and Queso Fresco unless they clearly state that they are made from pasteurized milk. All soft non-imported cheeses made with pasteurized milk are safe to eat.
• Unpasteurized milk, juices, and apple cider. Unpasteurized milk may contain listeria. Make sure that any milk you drink is pasteurized.
• Raw eggs or foods containing raw eggs, including mousse and tiramisu. Raw eggs or any foods that contain raw eggs should be avoided because of the potential exposure to salmonella. Some homemade Caesar dressings, mayonnaise, homemade ice cream or custards, and Hollandaise sauces may be made with raw eggs. If the recipe is cooked at some point, this will reduce the exposure to salmonella. Commercially manufactured ice cream, dressings, and eggnog is made with pasteurized eggs and do not increase the risk of salmonella. Restaurants should be using pasteurized eggs in any recipe that is made with raw eggs, such as Hollandaise sauce or dressings.
• Raw or undercooked meats, fish, or shellfish. Uncooked seafood and rare or undercooked beef or poultry should be avoided during pregnancy because of the risk of contamination with coliform bacteria, toxoplasmosis, and salmonella.
• Pate. Refrigerated pate or meat spreads should be avoided because they may contain the bacteria listeria. Canned pate or shelf-safe meat spreads can be eaten.
• Raw shellfish. The majority of seafood-borne illness is caused by undercooked shellfish, which include oysters, clams, and mussels. Cooking helps prevent some types of infection, but it does not prevent the algae-related infections that are associated with red tides. Raw shellfish pose a concern for everybody, and they should be avoided altogether during pregnancy.
• Processed meats such as hot dogs and deli meats (these should be thoroughly cooked). Deli meats have been known to be contaminated with listeria, which can cause miscarriage. Listeria has the ability to cross the placenta and may infect the baby, which could lead to infection or blood poisoning and may be life-threatening. If you are pregnant and you are considering eating deli meats, make certain that you reheat the meat until it is steaming.
• Fish that are high in mercury, including shark, swordfish, king mackerel, marlin, orange roughy, tuna steak (bigeye or ahi), and tilefish. Mercury consumed during pregnancy has been linked to developmental delays and brain damage. A sample of these types of fish includes shark, swordfish, king mackerel, and tilefish. Canned, chunk light tuna generally has a lower amount of mercury than other tuna, but still should only be eaten in moderation.
• Smoked seafood. Refrigerated, smoked seafood often labeled as lox, nova style, kippered, or jerky should be avoided because it could be contaminated with listeria. (These are safe to eat when they are in an ingredient in a meal that has been cooked, like a casserole.) This type of fish is often found in the deli section of your grocery store. Canned or shelf-safe smoked seafood is usually fine to eat.
• Fish exposed to Industrial Pollutants. Avoid fish from contaminated lakes and rivers that may be exposed to high levels of polychlorinated biphenyls. This is primarily for those who fish in local lakes and streams. These fish include bluefish, striped bass, salmon, pike, trout, and walleye. Contact the local health department or the Environmental Protection Agency to determine which fish are safe to eat in your area. Remember, this is regarding fish caught in local waters and not fish from your local grocery store.
• Unwashed vegetables. Vegetables are safe, and a necessary part of a balanced diet. However, it is essential to make sure they are washed to avoid potential exposure to toxoplasmosis. Toxoplasmosis may contaminate the soil where the vegetables were grown.

If you’ve eaten these foods at some point during your pregnancy, try not to worry too much about it now; just avoid them for the remainder of the pregnancy. If you’re really concerned, talk to your doctor.

Cheese, milk and other dairy

• What you can eat
  • all hard cheeses such as Cheddar, Stilton and parmesan
  • soft pasteurised cheeses such as cottage cheese, mozzarella, feta, cream cheese, paneer, ricotta, halloumi, goats’ cheese without a white coating on the outside (rind) and processed cheese spreads
  • thoroughly cooked soft unpasteurized cheeses, until steaming hot
  • thoroughly cooked soft cheeses with a white coating on the outside, until steaming hot
  • thoroughly cooked soft blue cheeses, until steaming hot
  • pasteurized milk, yogurt, cream and ice cream
• What to avoid
  • mold-ripened soft cheeses with a white coating on the outside, such as brie, Camembert and chevre (unless cooked until steaming hot)
  • soft blue cheeses such as Danish blue, Gorgonzola and Roquefort (unless cooked until steaming hot)
  • any unpasteurized cow’s milk, goats’ milk or sheep’s milk
  • any foods made from unpasteurized milk, such as soft goats’ cheese
  • NOTE:
    • Unpasteurized dairy products may contain listeria. This bacteria can causes an infection called listeriosis.
    • There’s a small chance listeriosis can lead to miscarriage, stillbirth, or make your newborn baby very unwell.
    • Soft cheeses with a white coating on the outside have more moisture. This can make it easier for bacteria to grow.

Meat and poultry

• What you can eat
  • meats such as chicken, pork and beef, as long as they’re well-cooked with no trace of pink or blood; be especially careful with poultry, pork, sausages and burgers
    cold, pre-packed meats such as ham and corned beef
• What to be careful with
  • cold cured meats, such as salami, pepperoni, chorizo and prosciutto (unless cooked thoroughly)
• What to avoid
  • raw or undercooked meat
  • liver and liver products
  • all types of pâté, including vegetarian pâté
  • game meats such as goose, partridge or pheasant
• NOTE:
  • There’s a small risk of getting toxoplasmosis if you eat raw and undercooked meat, which can cause miscarriage.
  • Cured meats are not cooked, so they may parasites in them that cause toxoplasmosis.
  • Liver and liver products have lots of vitamin A in them. This can be harmful to an unborn baby.
  • Game meats may contain lead shot.

Eggs

• What you can eat
  • eggs as long as the whites and yolks are cooked thoroughly until solid
• What to avoid
  • raw or partially cooked eggs
  • duck, goose or quail eggs, unless cooked thoroughly until the whites and yolks are solid
• NOTE:
  • Salmonella is unlikely to harm your unborn baby, but you could get food poisoning.
  • If you eat eggs or not from hens, make sure the whites and yolks are cooked thoroughly.

Fish

• What you can eat
  • cooked fish and seafood
  • smoked fish such as smoked salmon and trout
  • raw or lightly cooked fish in sushi, if the fish has been frozen first
  • cooked shellfish, such as mussels, lobster, crab, prawns, scallops and clams
  • cold pre-cooked prawns
• What to limit
  • you should eat no more than 2 portions of oily fish a week, such as salmon, trout, mackerel or herring
  • you should eat no more than 2 tuna steaks (about 140g cooked or 170g raw) or 4 medium-size cans of tuna (about 140g when drained) per week

Tuna does not count as an oily fish

You can have 2 tuna steaks, or 4 medium-size cans of fish, as well as 2 portions of oily fish.

• What to avoid
  • swordfish
  • marlin
  • shark
  • raw shellfish
• NOTE:
  • You should limit tuna because it has more mercury in it than other fish. If you eat too much mercury, it can be harmful to your unborn baby.
  • You should limit oily fish because they can have pollutants such as dioxins and polychlorinated biphenyls in them. If you eat too much of these, they can be harmful to your unborn baby.
  • You should avoid raw shellfish because they can have harmful bacteria, viruses or toxins in them. These can make you unwell and give you food poisoning.

Figure 2. EPA and FDA advice on eating fish and shellfish (you can use this chart to help you choose which fish to eat, and how often to eat them, based on their mercury levels. The “Best Choice” have the lowest levels of mercury)

Footnote: This advice is geared toward helping women who are pregnant or may become pregnant – as well as breastfeeding mothers and parents of young children – make informed choices when it comes to fish that is healthy and safe to eat.

How do to use the chart

Fish are a high quality protein source, and lower mercury fish are a good choice for everyone. This advice is specifically for women who are pregnant, might become pregnant or are breastfeeding, and for young children, but everyone can follow this advice.

• Use the chart to help you choose which fish to eat each week. Eating a variety of fish is better for you and your child than eating the same type every time.
• You can eat 2 to 3 servings a week of fish in the “Best Choices” category, based on a serving size of four ounces, in the context of a total healthy diet.
• You can eat 1 serving a week of fish in the “Good Choices” category.
• You should NOT eat fish in the “Choices to Avoid” category or feed them to young children. However, if you do, eat fish with lower mercury levels in the following weeks.
• Eat a variety of fish.
• Serve 1 to 2 servings of fish a week to children, starting at age 2.
• If you eat fish caught by family or friends, check for fish advisories. If there is no advisory, eat only one serving and no other fish that week. Some fish caught by family and friends, such as larger carp, catfish, trout and perch, are more likely to have fish advisories due to mercury or other contaminants. State advisories will tell you how often you can safely eat those fish.

How can some fish be in more than one category?

There are different types (or species) of tuna, such as albacore, bigeye, and yellowfin. Some types of tuna that are bigger or live longer tend to have higher mercury levels, and that is why they are in different categories. So, canned light tuna is in the “Best Choices” category. Albacore (or white) tuna and yellowfin tuna are in the “Good Choices” category, and bigeye tuna is in the “Choices to Avoid.” In addition, fish of the same species that are caught in different geographic locations can vary in mercury content. For example, tilefish are in two categories because tilefish in the Gulf of Mexico have higher mercury levels than those in the Atlantic Ocean

Why are some fish not on the chart?

If you are looking for a species of fish that is not on the chart, such as mussels, that means the EPA and the FDA did not have enough reliable mercury data to include it. The agencies are planning to update the chart as they get more data.

What is a serving?

For adults, a typical serving is 4 ounces of fish, measured before cooking. Our advice is to eat 2 to 3 servings of a variety of cooked fish, or about 8 to 12 ounces, in a week.

How can I tell how much 4 ounces is?

Four ounces is about the size and thickness of an adult’s palm.

What happens if I eat less fish than the 2 to 3 servings a week you recommend?

You could miss out on the high quality protein, minerals and vitamins present in fish that are beneficial to overall health. Simply try to eat the recommended amount from a variety of fish in the following weeks. Our advice is provided as a general guideline for how much fish to eat weekly.

What happens if I eat more than 3 servings of fish in a week?

Try to vary the fish you eat. If you eat more than 3 servings in a week and some include fish with higher mercury levels, try to eat fish with lower mercury levels in the following weeks.

Should I make any changes to the advice based on my weight?

The advice provided here is intended as a general guideline. Women who weigh less than the average (165 pounds) may wish to eat smaller portions or to eat two servings of fish a week instead of three.

Nutrition for expectant moms

Eating well-balanced meals is important at all times, but it is even more so when you are pregnant. There are essential nutrients, vitamins, and minerals that your developing baby needs.

Scientists know that your diet can affect your baby’s health — even before you become pregnant. For example, research shows that folic acid helps prevent neural tube defects (including spina bifida) during the earliest stages of fetal development. So it’s important to get plenty of it before you become pregnant and during the early weeks of your pregnancy.

Doctors encourage women to take folic acid supplements before and throughout pregnancy (especially for the first 28 days). Be sure to ask your doctor about folic acid if you’re considering becoming pregnant.

Calcium is another important nutrient. Because your growing baby’s calcium demands are high, you should increase your calcium consumption to prevent a loss of calcium from your own bones. Your doctor will also likely prescribe prenatal vitamins for you, which contain some extra calcium.

Your best food sources of calcium are milk and other dairy products. However, if you have lactose intolerance or dislike milk and milk products, ask your doctor about a calcium supplement. (Signs of lactose intolerance include diarrhea, bloating, or gas after eating milk or milk products. Taking a lactase capsule or pill or using lactose-free milk products may help.) Other calcium-rich foods include sardines or salmon with bones, tofu, broccoli, spinach, and calcium-fortified juices and foods.

Doctors don’t usually recommend starting a strict vegan diet when you become pregnant. However, if you already follow a vegan or vegetarian diet, you can continue to do so during your pregnancy — but do it carefully. Be sure your doctor knows about your diet. It’s challenging to get the nutrition you need if you don’t eat fish and chicken, or milk, cheese, or eggs. You’ll likely need supplemental protein and may also need to take vitamin B12 and D supplements.

To ensure that you and your baby receive adequate nutrition, consult a registered dietitian for help with planning meals.

Here are some of the most common nutrients you need and the foods that contain them:

7 tips for eating well in pregnancy

These 7 simple tips will help you have a healthy diet during pregnancy. Now is not the time to diet. Diets can harm your baby by depriving them of food groups. But managing your weight by eating well and keeping active is good for you and your baby.

1. Don’t eat for two. First things first, the whole ‘eating for two’ thing is a myth. During pregnancy you don’t need to consume any extra calories for your baby, until the final trimester. At that point you need an extra 200 calories only.
2. Choose low glycemic index foods (low GI foods). Choose foods that release their energy slowly, rather than give you an energy spike, which ends with a crash (think sugary things like biscuits, cakes). Instead try: multigrain or granary bread, basmati rice, potatoes – new, boiled, baked – and eat the skin, sweet potatoes and wholemeal pasta.
3. Breakfast like a king. Don’t skip breakfast. People who eat breakfast are better able to manage their weight. Choose sugar-free wholegrain cereals. Try and get some of your 5 a day in if possible by adding fruit. During pregnancy, it can also help ease morning sickness by boosting your blood sugar levels and is likely to stop you overeating later in the day.
4. Stay active. Another pregnancy myth is that exercise might harm your baby. It won’t. Staying active will benefit both you and your baby, and help get your body ready for labour.
5. Healthy food swaps. When you get a craving for sweet foods, it’s easy to reach for a comforting slice of cake. That’s fine as a special treat once in a while, but you and your baby will benefit from some more nutritious calories.
6. Drink water. Your body needs extra fluids to keep up with the demands of pregnancy. Water is the best choice, but if you need to mix it up try to avoid sugary drinks like cola and stick to one glass of fruit juice a day. High in natural sugar, fruit juice can make your blood sugar levels fall and rise rapidly. Choose fresh juice with pulp, and avoid shop-bought juices with added sugar, or ‘made from concentrate’. Calcium is great for you and your baby, but when drinking milk, choose semi-skimmed, not full-fat.
7. Eating smaller meals throughout the day can help in all sorts of ways. It can:
   • prevent nausea and sickness
   • help with indigestion and heartburn
   • make you feel more comfortable as the baby gets bigger
   • keep sudden pregnancy cravings under control.

Returning to pre-pregnancy weight

Gaining the right amount of weight during pregnancy through a mixture of good eating and activity choices will make returning to your pre-pregnancy weight easier.

If you were overweight or obese before becoming pregnant but established good eating and activity habits during pregnancy, continuing to do so after your baby is born will help support gradual weight loss. This will not adversely affect the ability to breastfeed or the quantity or quality of your breast milk.

The greatest amount of weight loss usually occurs in the first 3 months after birth and then continues at a slow and steady rate until 6 months after birth. Breastfeeding helps you return to your pre-pregnancy weight as some of the weight you gain during pregnancy is used as fuel to make breast milk.

Future pregnancies

If you are planning another pregnancy, it is a good idea to establish healthy eating and activity patterns and try to reach a healthy weight before becoming pregnant. For some, this will be a matter of returning to your pre-pregnancy weight or close to it.

Retaining excess weight over subsequent pregnancies increases your risk of developing diabetes and heart disease later in life.

Speak to your lead maternity carer for more advice.

Don’t forget to take an 800 mcg tablet of folic acid each day if you are trying to become pregnant.