Suzy* is a bubbly 26-year-old first-time mum. She is excited about motherhood, and having had an uneventful pregnancy and delivery, she has nothing to complain about. When she comes for her post-natal clinic at two weeks, she is doing well, and has settled into breastfeeding rather easily.
Her final post-natal clinic is rather dramatic, though. She is accompanied by her older sister, who is not amused that the new mum has gained seven kilogrammes since the delivery of her baby, not counting the nine kilos gained during pregnancy. From a svelte 56kgs to an uncomfortable 72 kilogrammes! She has no fitting clothes and has invaded her sister’s wardrobe
Motherhood is one of the most cherished states for a woman. It brings contentment, excitement, a sense of accomplishment and even social elevation in some communities. In Africa and India, most communities will look down on a woman who has not achieved this feat.
During pregnancy a woman should, on average, gain eight to 12 kilogrammes by the time the baby is being born at term. This weight is derived from the baby itself, the amniotic fluid, the placenta, the increased breast tissue, the expanded maternal blood volume and a bit of fat stored in preparation for breastfeeding, commonly noticed under the shoulder blades.
The smaller the woman, the more likely she is to gain less weight. The obese woman has challenges balancing the necessary weight gain against an excess that is unhealthy.
Women with pregnancy complications such as pre-eclampsia will gain several more kilogrammes due to excessive retained fluid. This weight gain is usually sudden and the patient appears puffy.
The expectant woman’s calorie requirements in pregnancy varies with gestation. In the first trimester, one has no need for extra calories, hence dietary intake should provide about 1,800 kilocalories a day. This requirement goes up to 2,200kcal in the second trimester and 2,400kcal in the third.
The myth about a pregnant woman eating for two is not only false, but outright harmful. Extra calories during pregnancy lead to piling on unnecessary weight that may lead to unwarranted obesity. This myth continues into the post-natal phase under the pretext of breastfeeding. Studies have shown that women who put on weight beyond the recommended pregnancy kilos have a higher chance of retaining the excess weight right up to a year after delivery.
Once the baby comes, the new mum has a new mountain to climb. Well-meaning family members will visit with heaps of food and they expect the new mum to eat non-stop for the duration of breastfeeding.
Mugs of hot chocolate, porridge, soup and fermented milk are served without ceasing. Food servings are increased and the number of meals increases from three to five. Woe unto her if she has challenges with a good flow of breastmilk, or if the baby is colicky and cries all night. She will be forced to eat more to produce ‘enough’ milk for her baby.
Within weeks, instead of shedding the baby weight, the new mum continues to gain weight at an alarming rate. Since she is still on maternity leave and does not need to dress up; she wears comfortable loose clothing and has no idea that her wardrobe no longer fits.
Suzy is in this trap. She has a doting mother-in-law who is visiting her first grandchild. The older lady spends all day in the kitchen cooking one delight after another and Suzy cannot resist pigging out.
In the breastfeeding phase, all Suzy needs is an extra 500kcal in addition to her daily requirements to cater for the baby. This way, women are able to lose the stored pregnancy fat and resume normal weight. What is required in large volumes is water. Quite an amount of water is lost in the breastmilk and it is important to replace this.
EAT JUST ENOUGH
It is not in order to keep unnecessary weight under the guise of having more babies. Most lazy mothers will ignore the weight and cite their desire to have another baby and complete the family size as the excuse.
They will plan to lose the weight after they are done with having a second baby. The danger is that, with each successive pregnancy, they are already starting from a point of disadvantage, by being overweight or outright obese. The weight loss project ultimately becomes even more difficult.
Post-pregnancy weight loss must start from the delivery room. The mother should learn to eat only what her body requires. She must decisively choose what she needs to eat and not let that be dictated to her. Simple exercises such as brisk walking and swimming to boost metabolism are encouraged. Above all, breastfeeding in itself helps with the weight loss as the body is pushed to use the pregnancy fat that was stored specifically for this.
This is also a good period to initiate weight loss in those diagnosed with obesity during pregnancy. The danger of rapid weight loss in pregnancy is gone and the joints are under less pressure hence can tolerate exercise.
Look out for the contraceptive used too. Some women may gain weight especially if they use progesterone-based hormonal contraceptives. For this group of women, safe options are available and should be used as needed.
Also note that each woman is inherently different, some may have a high metabolism and lose weight in weeks. Others need a little longer to catch up. Whatever the case, shed off the post-natal weight safely.