• Explain the weight gain recommendations for pregnancy shown in the box on page 44:

    • Adequate gain reduces the risk of low birth weight.

    • Aim for a steady rate of weight gain: weight gain in early pregnancy goes mainly toward the mother's tissues (such as placenta, amniotic fluid, uterus, expanded blood volume, energy reserves) to support the baby's growth; weight gain in later pregnancy goes mainly toward the growth of the baby During the second and third trimesters, the recommended rate of gain is slightly more than 1 lb (0.5 kg) per week for women with low prepregnancy BMI, approximately 1 lb (0.5 kg) per week for women with moderate BMI, and 2/3 lb (0.3 kg) per week for women with high BMI.

  • Identify factors that may call for a higher weight gain during pregnancy (low prepregnancy weight for-height status, young age [82 years post menarche], African-American background, multiple gestation) or for weight gain at the lower end of the range (short maternal height).

  • Use the appropriate weight gain chart to show the range and rate of weight gain recommended.

  • Jointly agree upon a total weight gain goal, focusing on a range rather than a single number.

  • Show the woman how to plot her prepregnancy weight (if it is available) and her current weight on the weight gain chart. Offer her a chart and help her start to use it. Suggest: Please bring it with you next time.

  • Use the current measured weight as a baseline, and jointly set a realistic weight goal for the next visit.

  • Explain that: Weight can go up and down. Continue to eat well even if you think you're gaining weight too fast.

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