Q & A: Trouble gaining weight in pregnancy

As I mentioned in one of my previous comments, I am currently 15 weeks pregnant with #3. My question is about weight gain. Since going mostly whole and healthful, etc. and starting to work out (last summer) I am finding it difficult to gain any weight this pregnancy (which is exactly opposite of the last 2!). I had no trouble maintaining my weight prior, so I’ve not been losing weight but I’m 15 weeks and have only gained 1.5 pounds – which is below where the dr. thinks I should be. If you wouldn’t mind, I would like your input on how to increase my weight the healthy way. And did you have this problem during either of your pregnancies, if so, what worked for you?Laura

Congratulations on your newest pregnancy, Laura, and thanks for the excellent question!

Although I used to struggle with my weight in previous years (particularly my teens and early university years), since I drastically altered my eating habits about 6 years ago, it has not been a struggle at all (in fact, it has switched over to the other extreme at times, as I struggle to keep the weight on). It seems that when I eat well and remain moderately active (by that, I just mean a busy, active lifestyle- I am not a really regular exerciser, though I am attempting to become more regular at it), then I am able to maintain a weight that I am very happy with.

So, it may come to you as no surprise that I gain little weight during my pregnancies. With my daughter, I gained 21 lbs, and with my son only about 17 lbs (or was it 19? I can't remember). Either way, it was low in comparison to many moms I know and hear about.My daughter was born 3 days past her due date, and weighed in at an extremely healthy 7 lbs 11 oz. My son was 8 days early, and weight 6 lbs 6 oz. Very mildly on the low end, but not a concern in the slightest.

During his pregnancy, I struggled to gain weight during my 3rd trimester, due to the stress of my husband's cancer ordeal, and so I know that he was a little bit smaller than he would have been otherwise. I imagine if it were not for that, and perhaps if he had gone to the full 40 weeks, he would have been more similar to my daughter in weight (maybe slighter lighter). Nonetheless, he was perfectly healthy!

I thought it was interesting that when he was born, so many people commented on how small he was that my friend, who was a nurse in the UK about 20 years ago, told me that babies here are so big and over there, a "normal" or expected size might be more like 5-8 lbs, rather than 7-10 lbs (or even up to 11, 12 or 13 lbs!), as is more the norm in North America.

I know that many doctors are now quite happy with up to 40-50 lbs weight gains, or even unlimited gain, even though the average used to be considered more like 25-35. Quite frankly, I can't understand why the need for so much gain, and it is my understanding that excess weight gain leads to greater complications in pregnancy and labor. When you consider the breakdown of what the weight gain should account for (baby, fluid, placenta, increased blood volume, sac, etc.) it means that the great, great majority of that weight is maternal fat stores. It's just not necessary, in my opinion.

Now, I will readily, 100% agree with the fact that some people just gain more weight naturally, and others do not. I have a friend who does not eat excessive sweets, tries to eat mostly whole grains, drinks a lot of water, exercises well, and still gains significantly more than I do (granted, she also retains much more water than I do and has higher blood pressure, which accounts for it somewhat). I have another friend who has continual nausea and vomiting throughout her pregnancies, and gains extra weight because she must continually eat to stave off the nausea. Completely understandable.

My own experience tells me, though, that it is perfectly acceptable to gain much less weight than we are accustomed to hearing about! If you ask a midwife what their main concerns are about weight gain (as I did frequently during my period of little/no weight gain with my son), all that they want to see if that you are eating according to your hunger (that is, you eat when you are hungry, until you are full), that your uterus growth is in line with the expected measurements, and that the weight gain is steady and does not have large fluctuations.

All of that said, please hear me when I say that I consider it very important to gain enough weight during pregnancy . Gaining enough weight ensures that your body is sufficiently well nourished in order to provide everything that your baby needs to grow adequately, as well as what your body needs to handle the demands of pregnancy. It is very important to consume enough calories and nutrients to make sure that your baby can grow strong and healthy, and to know that restricting what you eat in order to lose weight or gain less weight is never appropriate (though modifying the types of food that you are eating is very appropriate)!

I think that if you are struggling to gain weight in general, or are having several weeks in a row with little or no gain, then it would be appropriate to try to step things up a bit. When I noticed this during my pregnancy with my son, here are the steps that I took and would suggest to anybody who is struggling:

  1. Eat more fatty foods (good fats only!)
  2. Eat more protein
  3. Eat more calories in general
  4. Eat more often

By putting in this extra effort, I was able to start gaining some weight again, even in the midst of a very stressful season.

Some good fats that can help are avacados, nuts and nut butters (almonds, walnuts, cashews, etc.), full fat dairy (from a good, natural source, preferably), coconut oil, olive oil, butter, eggs and fatty fish (like salmon).Try snacks such as yogurt or coconut milk smoothies, cheese, toast with almond butter, salmon sandwiches/melts or try adding canned salmon to salads, hard boiled eggs, healthy "milkshakes" (mine usually include raw milk, fruit, honey, ice, vanilla, etc.), yogurt with nuts or granola, trail mix when you're out, etc.

Eating before bed may also help, as you are less able to work off the calories before sleeping (usually on a diet, you are told not to eat before bed, so just do that in reverse!).

Make sure that you are truly eating whenever you are hungry. Laura, you mentioned that this is your third, and I know that your two other children are young. After the first, you are just naturally busier and more preoccupied with little ones to care for, and if you're anything like me, it's easy to get distracted and not pay as much attention to your body's signals that are telling you to eat. It might be a good idea to try to make a point (even schedule it) of eating a mid-morning as well as a mid-afternoon snack, and something before bed as well.

I hope these suggestions serve you as you work towards having the healthiest pregnancy possible!

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  1. You are right about each person being so different! I can’t even fathom having trouble gaining weigth in a pregnancy! For my 1st 2, I was stil on the S.A.D. and gained 45 and 35 lbs. I lost weigth b4 the 3rd and was eating better but not N.Traditions better (ie good fats, etc.). I gained 60 pounds!! I could not stop the gain and was worried about diabetes (runs in my family) but didn’t have any health problems with the pregnancy at all! I know that the weight slowed me down though. The baby was an 11 pounder – what a shock to us all!
    By the 4th I had learned to eat by N.T. – whole foods, fermented foods, grains, raw dairy, good fats. I stored up nutrition well prior to the pregnancy and was at my healthy college weight. AND THEN I GAINED 60 again!!! I was eating protein, liver, good fruits and veggies, raw dairy and eggs, nuts etc. Again, not a single complication. Only I never had a bit of morning sickness (something that I struggled with greatly with the other 3). This baby was born at home (AWESOME!) naturally in 3 hours. He was ALSO 11 pounds!!
    I often wonder whaqt part of this is genetic and what isn’t. My diet/lifestyle was so much better for the 4th and I was chasing 3 others but I stil gained the huge weight. I still don’t get it but hope that I can keep it down if we have a fifth.
    You have the right suggestions for gaining however! Thanks for your great post!

  2. I have had 5 healthy babies. Including a set of twins who I carried full term and had naturally at home. I really struggled at times to get all of my calories (even eating the correct amount of protein, fruits and veggies). I was very dedicated to eating healthfully and didn’t buy into the whole eating sweets for calories idea (I didn’t have anything sweet except for fruit). During those times, I would get up in the middle of the night, when my husband got home from work and either drink a glass of milk or eat some nuts. This really gave me a good boost. Then throughout the day, I looked for ways to add calories to my other food. I did that by topping big salads with nuts and cheese. The twins were 8#4oz 22in long and 7# 20 in long.

  3. What a great topic! During my fourth pregnancy I actually lost 10 lbs before I started gaining. I didn’t have much nausia, I just didn’t have much of an apetite and felt full sooner than usual. Although he’d have liked to have seen a more steady weight gain, my OB said that the fact is that there is very little data on what is normal for third and fourth pregnancies. They are not common anymore. I think your answer was bang on Stephanie! With my last pregnancy, I did begin to gain more in my last trimester (I got really hungry) and my daughter was a healthy 7 lbs 13 oz at 38 weeks! I had plenty of fat stores for my milk.

  4. hehe I was the 50 pound weight gainer! For both of my pregnancies. Glowed for the 1st, but not the second. I did stop my regular running (marathon miles) and walked. I ate very healthy (Bradley Method/Dr. Brewer) way of eating which is high protein. And yes I had an occasional creamy pasta and Dairy Queen run, come on not pregnant every day:) Both my babes were natural (no drugs) and the second one was breach! Both very healthy weights. 7 13 and 8 13. I lost my weight with in 15 months. I nursed my daughter till she was 2 1/2 , she could of kept going, but we wanted one more addition to our family and my son wanted no part of it at a year. Each body does what it needs to do to support and maintain our pregnancies. As long as you eat often, very healthy, full of nutrition and protein and fibrous foods you are on the best track. You may with no weight gain visit the DR. more and if available I’d talk with a naturopath also. Good luck. How exciting for you and your family. Love the BLOG:)
    Carey from Alberta!

  5. With both of my children I hardly gained any weight for about the first half of the pregnancy. Everyone kept asking me if I was sure I was pregnant. Then I started putting on the pounds. I gained about 50 with each of mine with I know is to much and I am going to try to do better next time. But I wouldn’t worry if you don’t gain much at first, everyone is different.

  6. HI there I read your post about going with out “poo” and found it very interesting, I don’t think I am ready to take the plunge yet but was wondering if you would please share what kind of other shampoo etc…you used before that. I want to switch over to the natural kind but haven’t because of cost, my kids use natural though. Thanks

  7. Stephanie,

    Thank you so much for answering my question so wonderfully. It’s nice to know I’m not the only one in the lower weight gain category.

    I am nearly 20 weeks now and went in for my regular checkup this morning and found that I’ve gained appx. 8.5-9 lb. and I’m very happy with this. I have realized that in the beginning I really wasn’t eating enough, I was getting headaches mid-morning nearly every day and finally figured out my body was telling me I needed some protein and fat at that time of day. Since I started remembering to eat (even though my tummy didn’t feel hungry) I haven’t had the headaches (except on days I forget the mid-morning snack)…. My dr. did NOT even mentioned the weight gain when I was there today, so it is a non-issue right now. I think as long as I gain a small amount steadily all will be well.

    Also, my first two pregnancies and births were at sea level and I now live at high altitude (6,500 ft) and have done some research and discovered that high altitude pregnancies tend to gain less weight and have a little bit smaller (but healthy) babies. My oldest was 9lb15oz and I gained 53lbs. and #2 was 8lb15oz and I gained 45lbs., so I’m ok with having one that’s a little smaller as long as he/she is healthy!!!

    Thank you again for answering my question. You are such a wealth of knowledge. I am learning a tremendous amount from reading your blog!


  8. I just wanted to add some encouragement. I am in the UK and here you don’t get weighed during pregnancy. I am on number 3 and don’t have a clue how much I gained in my first 2 pregnancys. In the UK they base healthy growth on the size of your utereus rather than on actual weight gain.
    I agree that you need to gain enough to support your baby but until I read this post I didn’t even know that there was an ideal amount to gain! 🙂
    I hope it takes away some of the worry to know that there is a nation of women who are rarely told (unless their is a wieght issue or medical reasons) what correct weight gain is.
    Amy and the Tummy Tot (due August)

  9. I think both my doctors, and the midwife I worked with were helpful in their view towards weight. They felt that while it was important to gain weight, that it wasn’t something that had to fit some type of schedule. I think I gained at least 40 pounds, on a healthy diet, with both of my pregnancies, and lost most all of it afterwards (I didn’t get quite as skinny, but I was a little to small before babies.) In my mother’s day, they would have told me I was gaining way to much and put me on a diet. My grandmother was put on a grapefruit diet with some of her pregnancies!!!! Not exactly nourishing! Overall, I think it’s important to concentrate on eating what’s good for you and your baby, and not worry so much about the weight. If you are eating plenty of good food, that’s what is important.

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