Tip: Make One Change at a Time

Be active whenever you can.Being active even 10 minutes three times a day can:

• Give you more energy

• Lower stress and help you relax

• Work off your pregnancy weight

• Tone your muscles

• Help you feel great

Take it easy, at first. Your body needs to heal. Ask your doctor what you can do and when you can do it.

Walking is a great way to get and stay fit. Put your baby in a stroller or a front pack and walk. Walk at the mall, school, or community center. Ask your friends or family to join you.

Start with a 5 or 10 minute walk. After one week, walk a little longer or farther. Set a goal that works for you.

Here are other easy ways to move your body:

• March in place when you watch TV or talk on the phone.

• Play music and dance.

• Take the stairs instead of the escalator or elevator.

• Park the car farther away when you can.

Change health habits one at a time. Get used to one change before you make the next one.

• What food can you cut back on? Example: Cut back to one soda a day.

• What food can you change? Example: Use fat-free salad dressing.

• What can you do to be more active? Example: Take the stairs, not the elevator.

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Small Changes and Healthy Choices Add Up to a Healthier You!

A common question new moms ask is: "How can I feel good and lose the baby-weight after delivery?" If you're a mom who has this question, there's good news! Studies show small changes can make a big difference in helping you feel good, have more energy, and lose weight too. Here's tips moms have shared that worked for them:

• Don’t eat food directly from the package - portion out foods, like crackers, nuts, trail mix, pretzels, cheese cubes, etc… into individual containers or zip-top bags. Better yet, put vegetables in a container for quick healthy snacks without all the calories.

• Leave some food in the kitchen at mealtimes - serve lower calorie vegetables and salads family-style at the table and serve the main dish in the kitchen.

• Stop eating when you feel full – remind yourself that it’s OK to stop eating before your plate is empty or before everyone is done eating.

• Watch your portions – use smaller plates and put less on your plate. Studies show we eat more when there’s more to eat.

• Cut back on some foods – cut calories by cutting out foods high in fats and added sugar. Decide to choose sweet drinks, cookies, cakes, candies, and ice-cream as occasional treats. Limit meats like ribs, bacon, and hot-dogs.

• Cook at home – try healthier recipes that use less fat, sugar, and salt.

• Drink water – keep water with you throughout the day. Sipping water can help fill you up so you don’t eat as much.

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Eating healthy is only one part of feeling great and having more energy — being active helps too. Staying active helps new moms relieve stress — and having a new baby can be stressful! Ask your doctor when it’s OK to exercise and then start out slow. Refer to “Be Active” page 11. For a personal daily food plan, visit ChooseMyPlate.gov.

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Pregnancy Weight Gain

In May 2009, The Institute of Medicine (IOM) made changes to the guidelines concerning pregnancy weight gain. The last recommendations had been released in 1990 and many things have changed since then about the childbearing woman. Taking into consideration the demographics of the current childbearing woman, the IOM made their new guidelines using the World Helath Organizaiton’s (WHO) body mass index (BMI) as the starting point. These new guidelines give women a clear range of what a healthy weight gain looks like to help them avoid pregnancy complications such as gestational diabetes, pre-eclampsia and cesarean delivery.

Talking to your health care provider about your weight gain is important. Try not to worry if you’re slightly above or below these weights. Find a nutritionist in your area who can help you manage your weight with proper healthy eating.

Pregnancy Weight Gain: Facts • For women who were a normal weight before pregnancy with a BMI of 18.5-24.9 the recommended

weight gain guideline is 25-35 pounds. • Women who are underweight pre-pregnancy with a BMI of less than 18.5 should gain between 28-40

pounds unless your health care provider says differently. • Women who begin pregnancy overweight, with a BMI of 25-29, should gain between 15-25 pounds

unless your health care provider says differently. • Women who are obese with a pre-pregnancy BMI of 30 or more should strive for a weight gain of 11-

20 pounds unless directed differently by your health care provider. • Eating healthy meals will allow you to gain adequate weight during your pregnancy. Putting on weight

that is unnecessary is easy to do when eating junk food and foods that are higher in fat. • Eating a well-rounded diet is important. According to the American Congress of Obstetricians and

Gynecologists, a pregnant woman of normal weight, who gets less than 30 minutes of exercise a week should strive for a caloric intake of 1.,800 during the first trimester, 2,200 during the second trimester and 2,400 during the third trimester. These calories should be attained by eating a diet of grains, dairy, protein, fruits/vegetables and healthy fats and oils. Limiting processed foods, sugars and extra fats can help you attain your goals.

Pregnancy Weight Gain: Average Distribution • 7 ½ pounds is about how much the baby will weigh by the end of pregnancy • 1 ½ pounds is how much the placenta weighs. • 4 pounds is attributed to increased fluid volume. • 2 pounds is the wieght of the uterus.

• 2 pounds is the weight of breast tissue. • 4 pounds is because of increased blood volume. • 7 pounds is attributed to maternal stores of fat, protein and other nutrients • 2 pounds for the amniotic fluid. • Total: 30 pounds.

On a trimester basis in a woman with a normal pre-pregnancy weight: • First trimester: 1-4.5 pounds • Second trimester: 1-2 pounds per week • Third trimester: 1-+2 pounds per week

Remember this is just an average; you and your health care provider need to decide what is best for you.

Compiled using information from the following source:

American Congress of Obstetricians and Gynecologists, http://www.acog.com

Institute of Medicine, Report Brief May 2009, Weight Gain during Pregnancy: Reexaminig the Guideline, http://www.iom.edu

Healthy Weight Gain

During Pregnancy

Here are some tips that have helped other women gain a healthy amount of weight during pregnancy:

Nutrition Tips • Drink plenty of fluids, like water and low or non-

fat milk. Try to avoid drinks which add extra calories but limited nutrients, i.e., sweet tea, juice, soda, lemonade and flavored coffee.

• Eat small meals and snacks regularly. Try not to go longer than 3-4 hours during the day without eating something. This will help keep your blood sugar steady and prevent overeating and heartburn.

• Choose healthy snacks. Good choices for snacks are fresh fruits, vegetables, nuts, non-fat yogurt and other low fat dairy foods.

• Choose healthier options when eating out. Limit how often you eat out. If that is not possible, stay away from fried or breaded items, keep sauces and dressings on the side and drink water.

• Try to include some protein in most meals and snacks. Some choices high in protein are beans, tofu, peanut butter, nuts, cheese, hummus, eggs, tuna, chicken, beef, ham or turkey

• Eat plenty of fiber. Choose whole grain breads, cereals, beans, fruits and vegetables, These can help you feel full and reduce other pregnancy issues like constipation

• Plan meals and snacks ahead of time. This saves time and money and helps you make healthy food choices easily and more often

For more detailed information about what you should and should not eat during pregnancy, go to the resources listed at the end of this sheet.

Energize Your Life Being active helps boost your mood, energy level, relieve stress and supports healthy weight gain during pregnancy. Walk, swim or incorporate other aerobic activity into your life, at least three times a week for 30-45 minutes.

Here are some tips that have helped other women to enjoy and fit activity into their busy lives:

• Do activities you enjoy • Be active with a buddy • Break the physical activity up into 15-minute

periods • Walk your kids to school or daycare • Dance with your kids, partner or by yourslef • To add more steps to your day, try to take the

stairs or get off the bus a stop or two early • Walk around the playground as children play • If money is tight, ask for a scholarship at a gym

or pool

Gaining a healthy amount of weight can help prevent problems for you and your baby, like diabetes, high blood pressure, poor infant growth, early delivery and

difficulty returning to pre-pregnancy weight.

• Set times for activities and use your phone to remind you

• Form a walking group with other women • Use social network sites for support

Breastfeeding

Breastfeeing is healthy for your baby and can also help you lose weight after delivery.

If you have questions about breasfeeling resources in your area, contact Parent123: www.parenthelp123.org (1-800-322-2588, Monday-Friday). For weekend or evening support, contact your local La Leche League: www.llli.org/web/washington.html

Pregnancy Weight Gain Guidelines Institue of Medicine’s Recommendations

Pre-pregnancy BMI

Total Weight Gain

2nd and 3rd Tri lbs./week

2nd and 3rd Tri lbs./month Twins

<18.5 28 – 40 lbs. 1 – 1.3lbs./week 4 – 6 lbs./month No guidelines 18.5 – 24.9 25 – 35 lbs. 0.8 – 1 lb./week 4 lbs./month 37 – 54 lbs 25.0 – 29.9 15 – 25 lbs. .05 – .07 lb./week 2 lbs./month 31 – 50 lbs.

>30.0 11 – 20 lbs. .04 – .05 lb./week 1.5 – 2 lbs./month 25 – 42 lbs. *to find your pre-pregnancy bady mass index (BMI) go to www.nhlbisupport.com/bmi/bmicalc.htm

How can you support a healthy weight gain? These are some things I already to to make sure I gain a healthy amount of weight during my pregnancy:

These are some things I could change about the foods I eat or how much activity I get:

These are some things that might make it hard for me to make changes:

These are some ideas I have that would help me be successful in making healthy changes:

Based on your pre-pregnancy weight of ______________(BMI__________),

A good weight gain for this pregnancy is __________pounds:

_____________pounds a week or ________________ pounds a month.

www.ecy.wa.gov/Waste-Toxics

https://americanpregnancy.org/

Exercise and Pregnancy

Before you begin exercising, remember that it is important to talk to your health care provider. If you are

already exercising, you will probably be able to continue with your routine and adapt it as your pregnancy

progresses. Exercise and pregnancy usually work well together.

Recommended Exercises During Pregnancy

Kegel Exercises

Pregnant women who perform Kegel exercises often find they have an easier birth. Strengthening these

muscles during pregnancy can help you develop the ability to control your muscles during labor and

delivery. Toning all of these muscles will also minimize two common problems during pregnancy: bladder

leaks and hemorrhoids.

Kegel exercises are also recommended after pregnancy to promote perineal healing, regain bladder control,

and strengthen pelvic floor muscles. Kegel exercises can be done anywhere, and no one knows you’re doing

them.

Swimming

Many health care providers and fitness professionals say swimming is the safest exercise for pregnant

women. Swimming keeps your body toned without adding weight and stress to your joints. Swimming

raises your heart rate and allows you to enjoy a safe cardiovascular exercise that is not likely to cause

overheating.

Another benefit of swimming during pregnancy comes from the safety of not falling. During pregnancy, your

balance will be off making you more susceptible to tripping or falling. Swimming cancels that risk (at least

while you are in the pool). Although swimming is a water sport, not all water sports are safe during

pregnancy. You should avoid other water activities such as scuba diving or water skiing.

https://americanpregnancy.org/ Walking

Walking is very beneficial because it is safe for your body. It is easier on your knees than running and can be

easily worked into your schedule. Start slowly and be sure you stretch well before you begin. Set realistic

goals and wear good shoes to decrease the risk of falling or pressure on your feet.

Running & Jogging

Usually, if you are in a habit of running, you can continue running. However, if you did not run before

pregnancy, you may want to speak to your health care provider before you begin a running program. If you

run, make sure you’re well hydrated, you avoid over-heating, and you wear good shoes.

Bicycling

The best thing about biking is that the bike supports your weight, so there is less stress on your body. A

stationary bike is a great exercise because there is a low risk of falling. As you grow, your center of gravity is

shifting so you are at an increased risk of falling. As your abdomen grows, it can put a lot of stress on your

back. Start slowly and do not over-exert yourself.

Stair Climbing Machines

These machines pose a small risk of falling. The side rails provide balance support. Stair climbing is an

excellent way to raise your heart rate.

Yoga

Yoga has a long-standing reputation for relieving stress and pressure on your body. Most forms of yoga will

be safe for you and your baby, as long as they are not excessively rigorous. Some yoga instructors offer

special classes for pregnant women. Avoid lying flat on your back for extended periods of time and try not to

overstretch.

There are a number of DVDs available that educate and equip you for doing yoga from the comfort of your

own home.

If you already participate in aerobics, you will most likely be able to continue; however, you should speak

with your health care provider before beginning a new program. Keeping your balance can sometimes be

difficult, so you’ll want to be careful as you get further along in your pregnancy. Taking a class specifically

designed for pregnant women is a good idea. Most health clubs offer them. Do not exercise lying flat on your

back for extended periods of time.

https://americanpregnancy.org/ Dance

Dancing can be done in your home or at a gym that offers special classes for pregnant women. Avoid a lot of

spinning, leaping, and jumping.

Exercises to Avoid During Pregnancy

Skiing

Although cross-country skiing is a fairly safe sport for pregnant women, there is a risk of falling. Downhill

skiing has a greater risk of falling and is not recommended while pregnant.

Water Skiing

Water skiing could result in abdominal trauma, especially in the second and third trimesters.

Horseback Riding

Riding a horse can involve a lot of jolts and quick movements, which can hurt you and your baby. There is

also a risk of falling.

Tips to Use When Exercising

Don’t wear tight clothes, but do wear a sports bra that will give you good support. Wear shoes that have

good support and are not slippery so you won’t fall. Also make sure to breathe deeply, and drink plenty of

water. Avoid jerking motions and lying on your back for extended periods of time.

Stop exercising if you have any vaginal bleeding, dizziness, chest pain, faintness, shortness of breath,

contractions, nauseous feelings, leaking fluid from your vagina, or decreased fetal movement.

Compiled using information from the following sources:

1. Mayo Clinic Staff. (2012, May 16). Postpartum Care: What To Expect After a Vaginal Delivery.

https://www.mayoclinic.org/healthy-living/labor-and-delivery/in-depth/postpartum-care/art-20047233

2. Simkin, P., Whalley, J., & Keppler, A. (1991). Pregnancy, Childbirth, and The Newborn: The Complete Guide. Deephaven, MN:

Meadowbrook Press.

3. The American College of Obstetricians and Gynecologists (ACOG), (2011). Exercise during pregnancy.

https://americanpregnancy.org/

https://www.acog.org/~/media/For%20Patients/faq119.pdf?dmc=1&ts=20120219T2315308141