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NICE guidelines for managing your weight before/during/after pregnancy.

29/07/2010

The National Institute for Health and Clinical Excellence (NICE) have released weight management guidelines for women before/during/after pregnancy.  You can take a look by clicking here

I’m the first to admit I am no expert in this department, so if you are, let me know where I’m going wrong.  But the guidelines are 60 pages long, so here are some of the bits that caught my eye, and my personal comments in brackets… 

Health risks for obese women and their babies.

Weight management when pregnant.

If your BMI is 30 or above, you and your unborn child have higher risks of: 

  • Impaired glucose tolerance and gestational diabetes.
  • Miscarriage.
  • Pre-eclampsia.
  • Thromboedolism.
  • Maternal death.
  • Gestational hypertension.
  • Induced/longer labour.
  • Instrumental delivery.
  • Caesarian section.
  • Spending longer in the hospital during delivery.
  • Fetal death.
  • Stillbirth.
  • Congenital abnormality.
  • Shoulder dystocia.
  • Macrosomia.
  • Obesity in the child later in life.

General guidelines.

These are general guidelines for all women who are/have been/will be pregnant.  Note that they are identical to the guidelines for all populations.  They are: 

  • Diets should consist of less junk food and more “real” food.  (take a look at what a “healthy” diet should look like by clicking here, or by following these simple rules here…These healthy diets are the same for everyone, not just women.)
  • Don’t go mad on portion size.
  • Increase your Background Activity levels.
  • Use behaviour changes to bring about changes in your weight (instead of “quick fixes” that have little long term value.  To help change your behaviour, click here.)

Before Pregnancy:

If you are planning on getting pregnant, try to ensure you fulfill the following: 

  • Having a BMI of less than 30 will reduce risks to both the mother and baby (risks include those outlined above).
  • Having a BMI of between 18.5 – 25 is even better.
  • Even a weight loss of 5-10% of your weight will have significant health benefits.

During Pregnancy:

  • The mothers weight before pregnancy is a better health indicator than the weight gain during pregnancy (so try to be a healthy weight before you get pregnant).
  • Dieting during pregnancy is not recommended, but eating healthily is recommended.  (Remember, eating healthily is not “going on a diet”.)  Lose any excess weight after the delivery.
  • There are no evidence based UK guidelines on weight gain during pregnancy.  It varies widely between people.
  • Moderate intensity activity, eg swimming, quick walking and strength conditioning, will not harm the mother or baby.
  • Aim to maintain fitness, rather than reach peak fitness.
  • If you have never done exercise before, start with 15 minutes of continuous exercise 3 times a week.  Gradually move towards 30 minutes of continuous exercise every day.
  • If you regularly do exercise anyway, you should be able to continue with no bad effects.
  • There is no need to “eat for two” when you are pregnant.  Your energy needs do not change for the first 6 months, and only increase by about 200 calories a day (only equal to a 4 finger Kit Kat!) for the final 3 months.
  • It is important NOT to be sedentary.  Start/keep walking and take stair instead of lifts (when possible/practical), and avoid sitting for long periods of time.
  • Do not weigh yourself repeatedly.  Only if there is a clinical or nutritional concern (you have more important things to be thinking of).

After Pregnancy:

  • If the pregnancy and delivery was ok, then “mild” exercise such as walking, pelvic floor exercises and stretching can begin immediately.
  • After a complicated delivery, check with your care-giver during your first check-up, 6-8 weeks after delivery.
  • Avoid “high impact” activities too soon after delivery.
  • Increase your Background Activity levels again.
  • Eating healthily and taking regular exercise will not effect the quantity or quality of their breast milk.

If this has been of any interest to you, a while back I listed more specific recommendations for exercise during pregnancy.  You can take a look at them by clicking here… 

And if you really like what I’m writing, you can even subscribe to this blog by clicking on either the email or RSS thingy at the top right of this page. 

And if you think the sun shines out of my bum…and you live in or around Skipton, you can even hire me to train you.  Click here for details…

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