The first trimester: How much should you be eating?

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One of my clients recently found out she has a bun in the oven. Since it’s been quite awhile since I have looked at nutritional and exercise information for pregnant women, I’m going to have a bunch of posts coming up regarding pregnancy. I figure it’ll be a nice review for me, along with seeing what new information there is, and hopefully others can benefit too.

Some upcoming posts will be topics like: How much should you be eating?, How much weight should you expect to gain? Should you be exercising? What exercise is ok and what exercise isn’t?

I’m going to try and present this in simple terms everyone can understand. There is plenty information out there on this topic but most of it uses jargon your average mom-to-be is going to have a headache trying to understand. And they have enough giving them headaches already. 

Lastly, I’m going to present things trimester by trimester. I prefer to look at this as a step-by-step process and would much rather present it in 3 month intervals as opposed to, “Here’s guidelines for all 9 months.”

All of these numbers are rough averages intended to give you an idea of what to expect and what is considered healthy. Obviously check-in with your doctor on a regular basis. Depending on your starting bodyweight you might be recommended to eat a little more to help promote a greater weight gain during the pregnancy. Or, you might be recommended to eat a little less to limit your weight gain. A very active, very skinny woman might be an example of the former; an obese woman who just became pregnant is an example of someone in the latter.

 

Congratulations, you’re pregnant! Whether this was planned, a delightful surprise, or a “delightful” surprise, there is a lot about to change with your body. The most obvious is you are going to gain weight. You aren’t only eating for your own body, you are now also eating to help the development of a new person. But how much should you be eating? What’s enough? What’s too little? …What’s too much?

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You are not eating for two 

While I haven’t been around a whole lot of pregnant women (not typically the kind of meet up group I look for), I have been around enough to hear either them or their family and friends say, “You are eating for two now! Go head and eat that entire tub of ice cream.” This inevitably leads to pregnant women unnecessarily gorging themselves and gaining way more weight during their pregnancy than they need to.

Keep in mind when your baby pops out on average it will weigh about 7 pounds. Now compare 7 lbs to how much you weigh.

Typically your bodyweight in pounds multiplied by 15 is how many calories you eat each day in order to maintain your weight.

So let’s say your 150 lbs. 150 x 15 = 2250 calories. That means you eat, roughly, 2250 calories each day. If you’re really active you likely eat more, if you’re sedentary you likely eat less.

Just to make the math simpler let’s say your baby is bigger than average and will weigh 10lbs when he/she is born. 10lbs x 15 = 150 calories. But your baby is constantly growing so he/she is going to be needing some more calories than that in order to help promote that growth. Most of what you’ll read supports mother’s eating an extra 300 calories a day (more on this later) to help promote the baby’s growth. Or roughly 100% more calories than would be needed to maintain the baby’s birth weight.

A couple spoonfuls of peanut butter, two granola bars, a tall glass of whole milk, two slices of toast with some butter…all 300 calories. It doesn’t take much food to make a baby.

-> Not to mention how tired pregnant women get, and thus, how much they can end up laying around. In other words, you might not need to eat any extra calories, because you end up with a 300 calorie surplus through not moving as much.

The point with these numbers is to illustrate how there are no numbers even remotely close to needing to eat for another person i.e. eating an extra TWO THOUSAND calories per day during your pregnancy. You only need to eat enough to help promote the growth of your baby to a healthy birth weight. Again, a weight typically around 7 pounds.

Now back to that 300 number. Something crucial about this number, something WebMD doesn’t delineate, is that 300 calories per day is the average number of extra calories a pregnant woman should eat per day, over the course of her whole pregnancy.

This is a subtle, but critical distinction. As we all know, the 9 months of a pregnancy are not all the same. A pregnant woman doesn’t need to eat the same way throughout the whole process either. Your baby is going to be, say 7lbs, at the end of the pregnancy. As the baby grows and needs more food, you, the mother, grow and eat more food.

What you find is the majority of a pregnant woman’s caloric needs come towards the latter half of the pregnancy. During the first trimester not a whole lot needs to change calorically speaking. There are supplements that are definitely advisable to start taking, if not already. But in terms of needing to eat extra food each day, the first three months really don’t necessitate it.

Said in another way: As your bump gets bigger you need more calories. The first three months present barely any bump at all.

 While you might not care if you gain an extra 5, 10, 15, etc. pounds while you’re pregnant,

1) You definitely should care

2) You are going to care when you aren’t pregnant anymore and have that extra 5, 10, 15, etc. to lose.

Because:

1) How much weight you have to lose and how much weight you have retained during the postpartum phase are correlated with your chances of postpartum depression. 

2) There is research suggesting the greater your BMI during your pregnancy the greater your chances of having issues during your pregnancy. From the NIH:

“Babies of overweight or obese mothers have an increased risk of neural tube defects (defects of the brain and spinal cord), stillbirth, prematurity, and being large for gestational age.”

From http://win.niddk.nih.gov/publications/health_risks.htm#pregs

3) Too much weight increase during pregnancy can increase the chances of your baby becoming obese during its lifetime.

4) You are increasing the likelihood of labor / delivery issues as well as making the process take longer.

5) You’re setting yourself up for all sorts of joint pain:

While I didn’t look too intensely for this, and I didn’t find research specifically looking for this, I would bet a lot of money the more weight you gain during your pregnancy, the greater your episodes of lower back pain.

There is a lot to suggest heavier women have greater episodes of lower back pain during their pregnancy. Having severe episodes of lower back pain during your pregnancy can also set you up for lower back issues even when you’re not pregnant. And it’s well understood heavier, non-pregnant people, have more issues with lower back pain.

Therefore, if you’re gaining an unnecessary amount of weight, especially during the first trimester, you’re just asking to experience lower back pain earlier in your pregnancy, have more severe episodes of it, and set yourself up for more issues postpartum.

I have seen a few mothers in the postpartum phase with shoulder issues too. In a future post I’ll show how being heavier is not helping in this regard either.

So, when your hormones are raging and you’re deciding whether or not to have that midnight ice cream, think about how much more difficult you are potentially making life for you and your baby!

This is my longwinded way of saying it is important to get started in the right direction. Don’t get me wrong, weight gain during your pregnancy is very healthy. But during the first trimester you should only expect to gain about 3lbs. That’s about 1 lb a month! Take advantage of the fact that’s all you need.

If you’re new to watching how you eat here’s how I would do it: Write down everything you eat for three days or more. The more days the better. Write it down as you eat it, not at the end of the day, and write down EVERYTHING.

Pick two weekdays and at least one weekend day as most people eat differently on weekends. Be honest about this. This number should come pretty close to your bodyweight x 15.

(A site such as MyFitnessPal.com is great for tallying up your total and tracking.)

As long as your weight is only going up a little each week / each month, keep eating this amount throughout your first trimester. Worry about adding calories once the second trimester comes around. This will help make sure you are 1) Eating enough and 2) Not eating too much during your first trimester.

Lastly, weigh yourself a couple of times per week and pay close attention to how much weight you are gaining each week and each month. A half-pound every two weeks or a pound a month is about right for the first trimester. Remember, these are averages. A little less or a little more is nothing to worry about. Gaining 20 lbs the first three months…something to worry about.

Then you can adjust how much you’re eating based on what your weight is doing and your doctor’s perspective.

Finally, remember all of these numbers are rough averages intended to give you an idea of what to expect and what is considered healthy. Obviously check-in with your doctor on a regular basis. Depending on your starting bodyweight you might be recommended to eat a little more to help promote a greater weight gain during the pregnancy. Or, you might be recommended to eat a little less to limit your weight gain. A very active, very skinny woman might be an example of the former; an obese woman who just became pregnant is an example of someone in the latter category.

For an EXTENSIVE look at pregnancy nutrition check out the Handbook of Nutrition and Pregnancy (Nutrition and Health).