Facilitators of Change Nutrition/Behavior Counseling


Height Height should be measured as soon as possible during pregnancy to eliminate confounding associated with postural changes (beginning at approximately 20 weeks). Pre-pregnancy Weight



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Height


Height should be measured as soon as possible during pregnancy to eliminate confounding associated with postural changes (beginning at approximately 20 weeks).


Pre-pregnancy Weight


The WIC program relies on self-reporting of pre-pregnancy weight, although it may not be reliable as weight is often underreported, and height is often overestimated. If pre-pregnancy weight cannot be reasonably determined, the recommendation is to identify gestational age and focus on rate of weight gain.

Target Range for Weight Gain

The recommended amount of weight gain during pregnancy varies according to the woman’s pre-pregnancy weight. Once this has been established as underweight, normal, overweight, or very overweight, appropriate weight gain ranges can be targeted and current weight gain status can be assessed.

These weight gain recommendations are general, meaning that there are wide variations in weight gain among women having optimal birth outcomes. These recommendations are assumptions based on average women having average gains and delivering average size infants weighing from 6.6 to 8.8 pounds. These recommendations may not apply to women at the extremes of pre-pregnancy weight.
The encouraged weight gain ranges for pregnancy are as follows:


Status


BMI

Recommended

Weight Gain

Underweight

<19.8

28-40 pounds


Normal

19.8-26.0

25-35 pounds


Twins




35-45 pounds


Overweight

26.0-29.0

15-25 pounds


Obese

29.1

15 pounds

Extremely obese women should be encouraged to gain within the lower range limit, and should never follow a weight reduction diet during pregnancy. These women should be encouraged to eat moderate amounts of nutritious food in order to consume sufficient quantities of essential nutrients.



Monitoring Weight Gain during Pregnancy
A desired pattern of weight gain is a progressive increase in weight that approximates the recommended rate, following a steady curve.
Monitoring weight gain over time requires accurate procedures and correctly operated equipment. Any abrupt or inconsistent changes should first be examined to see if they reflect errors in equipment or methods.

Special concerns to monitor include:



  • Obese woman who gains less than 1# per month after the first trimester

  • Normal weight woman who gains less than 2# per month after the first trimester

  • After 20 weeks gestation, a gain of more than 6.5# pounds per month

PRENATAL DISCUSSION SESSION: P-1

BACKGROUND INFORMATION




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