What Is Safe?
I am 20 weeks pregnant and have only lost weight (about 5 pounds). Is this a problem? - Jessica, Houston TX
The expert answers
The average weight gain for a full term pregnancy is 25-30 pounds. This takes into account the increase in the mother's blood volume and fluids, the increase in the size of the uterus, the baby, the placenta, the membranes and fluid surrounding the baby. All things being equal for everyone, this pregnancy would end in an "average" sized infant of approximately seven and a half pounds, and the mother would probably need to lose five pounds or so to be back at her pre-pregnant weight after the first few months.
A few other things need to be addressed on the issue of weight gain. One thing is that the mother needs to consider where she has started with her weight. If she is 200 pounds, she may not gain the weight that someone who starts out at 100 pounds would gain to maintain an average healthy pregnancy. Nutrition is the factor to be stressed here. A healthy diet is required for all pregnant mothers, regardless of the starting weight.
No one should try to diet and not gain, or try to lose weight during a pregnancy. The baby needs good nutrition, and so does the mother, so that neither one is lacking after this wonderful process is completed.
A lot of people struggle with hyperemesis or pregnancy-induced nausea and vomiting (formerly known as "morning sickness") which seems to stem from the increase in hormones during early pregnancy. This can cause some mothers to lose weight during the first of their pregnancy. This is usually remedied quickly as the nausea and vomiting passes and the weight picks up.
Pregnancy causes fluids to pool in the lower part of the body and the extremities, hence the swelling that a lot of mothers experience. This can cause a rapid increase in weight but with rest and decreased salt intake, this usually reverses itself, unless it is associated with other problems such as pregnancy induced hypertension or high blood pressure.
Some mothers may experience unusual weight changes as a result of gestational diabetes, which is tested for at or about 28 weeks gestation and can be controlled by diet or insulin. Other factors that make a difference in weight gain or loss can be caused by the baby and can contribute to the mother having an abundance or lack of amniotic fluid which also can cause a change in weight.
To specifically answer your question, a five pound weight loss at 20 weeks gestation should be looked at to try to establish the reason. Did you have morning sickness? Were you overweight before you became pregnant? Are you eating a healthy diet? Are you dieting? Do you have a good appetite? Your doctor or midwife can help you see where you stand and make plans for a healthy pregnancy.