When you need to gain more weight during pregnancy

Most women will gain 2 to 4 pounds (1 to 2 kilograms) during the first trimester, and 1 pound (0.5 kilogram) a week for the rest of the pregnancy. Through the entire pregnancy:

• Overweight women need to gain less (10 to 25 pounds or 4 to 11 kilograms or less, depending on their prepregnancy weight).
• Underweight women will need to gain more (28 to 40 pounds or 13 to 18 kilograms).
• You should gain more weight if you are having more than one baby. Women having twins will need to gain 37 to 54 pounds (16.5 to 24.5 kilograms).

Some women have a hard time gaining weight during pregnancy. Sometimes, it is because they start a pregnancy underweight, or they have other health issues that keep them from gaining weight. Sometimes, they are not able to keep food down due to nausea and vomiting.

Either way, a balanced, nutrient-rich diet (including using no tobacco or alcohol), along with moderate exercise, is the basis for a healthy pregnancy. Ask your health care provider how many calories you should eat each day, and how you can gain the right amount of weight.

If your provider says you should gain more weight, here are some tips to help:

• Do not skip meals. Instead of eating 3 big meals, eat 5 to 6 small meals every day.
• Keep quick, easy snacks on hand. Nuts, raisins, cheese and crackers, dried fruit, and ice cream or yogurt are good choices.
• Spread peanut butter on toast, crackers, apples, bananas, or celery. One tablespoon (16 grams) of creamy peanut butter will provide about 100 calories and 3.5 grams of protein.
• Add nonfat powdered milk to foods such as mashed potatoes, scrambled eggs, and hot cereal.
• Add butter or margarine, cream cheese, gravy, sour cream, and cheese to your meals.
• Try to eat more foods that are high in good fats, such as nuts, fatty fish, avocados, and olive oil.
• Drink juices made from real fruit that are high in vitamin C or beta carotene. Grapefruit juice, orange juice, papaya nectar, apricot nectar, and carrot juice are good choices.
• Avoid junk food.
• Ask your provider about taking prenatal vitamins and other supplements.
• See a dietitian or nutritionist for help with your diet, if your provider recommends it.

If you have struggled with your weight in the past, it may be hard to accept that it is OK to gain weight now. It is normal to feel anxious as the numbers on the scale edge up.

Pregnancy is not a time to diet or worry about weight gain. Keep in mind that weight gain is needed for a healthy pregnancy. The extra weight will come off after you have had your baby. Remember not to gain too much, as this can cause your baby to be too big. A healthy diet and regular exercise will help you have a healthy pregnancy and baby.

If worries about your body image affect your pregnancy or daily life, talk to your provider.