Week 13: Eating For Two?

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This is your Pea in the Podcast for week 13 of your pregnancy. I'm Bonnie Petrie joined by Dr. Laurie Swaim, an obstetrician with Houston Women's Care Associates in Houston, Texas.

At week 13 you may have gained four or five pounds by now. That's normal, but you may be surprised to find out pregnancy is not a free for all food fest, when eating for two means eating two of everything, "There is an expected amount of weight gained based on someone's body mass index. Years ago it used to be 'oh, a fat baby is a healthy baby', and gain a bunch of weight. And then things change and 'oh, you know, we can amphetamines when you're pregnant not to gain weight' and so then finally it was studied and we now know what weight gain is associated with the best outcome. So for a woman who is average weight we anticipate a weight gain of somewhere between 25 and 35 pounds for the entire pregnancy. For some women who are underweight then somewhere between 35 and 45. For someone who's overweight somewhere between 15 and 25. Now that doesn't mean there aren't wide ranges, I mean we have some people who are normal size, they only gain 15 or 20 pounds, but the baby has appropriately grown and they seem to be nutritionally okay. Then there are some people who are really overweight and they don't gain that much weight, they may only gain 10 or 12 pounds. We don't want them to lose weight, I mean I really don't want my patients to weight. It's not that big of a deal if one week to the next they went from 205 to 204, that doesn't bother me so much, but over time it's really not healthy to lose weight when you're pregnant."

And now is also not the time to luxuriate on the couch while being fanned with palm leaves either no matter what your pre-pregnancy fantasies might have included. "Exercise in pregnancy is a really good thing as long as you have a low risk pregnancy and you've discussed it with your doctor. But there's this myth that pregnant women should sit around on their butts all day, I think that's actually going out of favor anyway, not too many of our patients are really surprised when I tell them that exercise is a good thing. I don't mean going out and running a marathon, although running is actually okay if you've been doing it already and you're otherwise healthy. But even walking, because here's the thing, women who pack on a bunch of weight not only have to lose it on their own but it will ultimately affect the size of the fetus and if you put on 60 or 70 pounds you're going to have a baby that's a little chunky and may not fit through the door or, if it does, there may be associate birth trauma to the baby or the mother. And those are things we like to avoid. Although there are lots of women who are dying to have cesareans, for reasons that are completely unclear to me, it's not a healthy thing to do and it does adversely affect your future pregnancies. So anyways ,there I got on my soapbox about weight gain." Okay so from here on out you're going to resolve to move some every day whether it's your regular pre-established exercise routine or maybe a prenatal yoga class or even just getting out and walking around the block everyday, every little bit helps. And remember labor is work, that's why they call it labor, so you should prepare for it like you would prepare for a marathon. Also studies are now indicating that exercise may be good for your baby's brain development.

More about eating, up until now you shouldn't really have been eating anymore than you normally do but starting about this time you can add some calories. You should be consuming about 1900 to 2500 calories in a day of nutrient dense food. Believe it or not that's a caloric increase only equivalent to one baked potato or a bagel with cream cheese or a bran muffin. The American Dietetic Association recommends upping your intake to seven servings of fruits and vegetables everyday in order to account for your pregnant body's increased demand for vitamins and minerals so if you've gained five pounds so far that's okay but your biggest weight gain is still ahead of you. "The rate of weight gain is actually greatest between 20 and 30 weeks so people will come in at their 20 week and 24 week visit like 'ahhh I gained so much weight', so we try and talk to them about not getting so upset about that, that after 30 weeks, although they'll continue to gain weight, they may not gain it with the same voracity that they have between 20 and 30 weeks."

Now if you're supposed to gain between 25 and 35 pounds in the average pregnancy and your average baby weighs seven and a half pounds, where's all that weight coming from? Well seven pounds is extra stored protein, fat and other nutrients; four pounds extra blood; other extra bodily fluid adds another four pounds; you get two pounds accounting for bigger breasts (yay); two pounds for your enlarged uterus; and the amniotic fluid surrounding your baby will weigh about two pounds as well; and the placenta weighs a pound and a half. So I know you hear those hot fudge sundaes calling you, we all do when we're pregnant, we all forget our doctor's warnings and eat for two, but if you splurge every once in a while, I won't tell.

So what's up with your baby this week? Well it's two and a half ounces and about three and a half inches long. The intestines are now moving from the umbilical cord into the abdomen as the liver begins to secrete bile and the pancreas begins to secrete insulin. Your baby can smile now, under those gums there are twenty little teeth waiting to keep you up nights next year. Your baby's practicing swallowing by taking in the surrounding amniotic fluid and passing it back in his urine. The vocal cords are quickly developing and the baby looks more and more human as their eyes move closer together and their ears begin to move to what will be their normal positions. The baby has the beginnings of fingerprints and footprints and it's becoming quite the perfect little human.

How about you? Well you are moving into the honeymoon phase, you may have some lingering fatigue or lingering sickness, in fact some moms do stay sick for their entire pregnancy but most moms find that if they were sick it's subsiding as they enter the second trimester so enjoy. You're 13 weeks pregnant and you have 27 weeks to go until week 40.

That's your Pea in the Podcast for week 13 of your pregnancy. Dr. Swaim and I look forward to talking to you again next week. Enjoy this week. I'm Bonnie Petrie, thanks for listening.