Pregnancy: Should we eat for two?

Pregnancy messes up the body and appetite, needs change, and so do desires. Where’s the middle ground between food cravings, fear of gaining weight, and medical advice?

“I say all the time that you have to try to eat twice as well, but above all not twice as much,” explains gynecologist-obstetrician Philippe Deruelle from Lille University Hospital. Except that sometimes we crack. Audrey undoubtedly sets the example that the medical profession believes should not be followed. “I told myself if I just have to have one child, I’ll let go during my pregnancy, I wanted to allow myself everything,” she says without regret. As a result, she gained 30 pounds for her first baby at age 34. Her gynecologist knew how to stay kind, advising her to be a little careful not to suffer major depression after childbirth, but the young woman accepted to the end and without complications. Luckily, her second pregnancy was accompanied by immediate gestational diabetes, which forced her to check her blood sugar six times a day, inject insulin and follow a controlled diet. She ended up gaining nearly 40 pounds this time, of which she has only 15 pounds left that won’t melt and puts her at risk for type 2 diabetes in the future.

An average of 11 to 16 kilos in nine months

Between indulgence, letting go and rules of hygiene, pregnancy is a time when many commandments hit the mother-to-be: be fulfilled, “take well” but not gain too much weight, take care of the baby, follow the instructions for food hygiene, to be a prevent possible contamination (salmonella, toxoplasmosis) without forgetting to have fun… Women rarely lack information on weight gain. In addition to the advice from the doctor and midwife, there is also advice from friends and specialist books. The most accurate medical recommendations on this subject come from the American Institute of Medicine: A normally built woman can gain 25 to 30 pounds in nine months, 1 pound a month for the first 6 months, and 5 pounds for the last 3 months. If you are overweight, the average should be between 15 and 25 pounds, and between 10 and 20 pounds for an obese woman.

The Danger of Mumyrexia

Preserved ideas and fads circulate on social networks. The “mummyrexia,” a contraction of mom in English and anorexia, is undoubtedly the one that makes the most jump, with photos of women close to the term showing an almost flat stomach and very young mothers posting a selfie , while they have abs The smallest parturient makes a good elastic 42 when leaving the delivery room. Mummyrexia spreads an ideal of thinness that is dangerous for those who badly experience the transformation of their body because if you do not eat enough you risk having a smaller baby to get. This phenomenon, although marginal, worries caregivers. “We see extremely restrictive skinny women,” testifies Philippe Deruelle. Which presents us with a complicated problem because they are proud of themselves and we find it difficult to counteract their way of thinking. »

However, in terms of public health, the problem tends to remain with overweight and obesity, which increases the number of complications for the mother (gestational diabetes, hypertension, pre-eclampsia) and the risk of having a very large baby. which would make childbirth difficult. Paradoxically, dietary restriction and obesity multiplies the child’s risk of future obesity. Several studies tend to show that the mother’s diet influences the expression of the baby’s genes. Conditioning a fetus to a “diet” environment of restricted nutrition during pregnancy can predispose a child to obesity, which in an affluent society like ours can easily express itself.

No magic bullet

Some women go to a nutritionist. “They use their pregnancy to ask how to review their diets that they feel are unbalanced. But there is no ready-made answer, answers Fabienne Pommera, nutritionist. I don’t give prescriptions. Eating during pregnancy is like everything else: Eat a varied, balanced diet when you are hungry, spread out meals throughout the day if you suffer from indigestion. » Better an apple than chips if you are hungry. “Gaining weight is normal, women are programmed for it,” recalls Philippe Deruelle. It’s hormone dependent and will stop after birth if we were sensible. Don’t obsess over this question either. On the other hand, there is a very strong pressure from her environment, which sometimes states that a woman is not “pregnant enough”, which creates unnecessary stress for the actually perfect mother-to-be. In this case, a simple measurement of the height of the uterus by the gynecologist is enough to show that the baby is growing well, information that an ultrasound can confirm.

Pregnant women have long been considered fragile things. Today the medical profession recognizes that exercise is very beneficial provided it is adapted. So the lifestyle can be summed up in three numbers: 0 cigarettes, 5 fruits and vegetables and 30 minutes of activity per day. Finally, of course, we take delivery on the day of delivery. For a woman who has gained 25 pounds, the child accounts for about a third of the weight; placenta, amniotic fluid, blood volume and uterine muscle, another third; the rest is stored fat for breastfeeding.

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