NICE issues pregnancy weight management guidance, as the number of obese mothers soars
Obese mums-to-be should be encouraged to lose weight before they become pregnant, in order to reduce the risk of major complications during pregnancy, latest NICE guidance suggests.
The new advice on weight management before, during and after pregnancy comes as the number of obese mothers in England rises, with 15-20 per cent of women now overweight or obese during pregnancy.
Being obese in pregnancy exposes women to a greater risk of developing gestational diabetes, pre-eclampsia and leaves them more likely to suffer a miscarriage.
Evidence also appears to suggest that babies born to obese mothers are more likely to become obese themselves in later life because of changes that occur inside the womb.
This latest guidance, out today, recommends that healthcare professionals, including GPs and midwives, make clear to women with a Body Mass Index (BMI) of 30 or more the health risks of being overweight or obese during pregnancy.
Currently, health professionals do not generally give women information about the risks of obesity during pregnancy and the importance of weight management before or after pregnancy.
During pregnancy, women should be advised against following the old wives' tale of “eating for two” or drinking full-fat milk, and instead be encouraged to follow a healthy diet based on starchy and wholegrain foods such as bread, pasta and rice.
“Energy requirements for pregnant women do increase but not until the last trimester,” said Professor Annie Anderson, a member of the guidance development group and an expert in food choice at the University of Dundee.
“They increase by a very small amount of 200 calories a day, so that's a couple of slices of toast or a milky drink at bedtime.”
Although weight loss is recommended before pregnancy, the guidance advises against pressurising women into rapid weight loss or crash diets during or after pregnancy as this can harm the health of the child.
Lucilla Poston, a Professor of Maternal and Fetal Health at King's College London who worked on the guidance, warned: “That is absolutely the worst thing to do because it is potentially dangerous and can lead to a condition known as ketoacidosis where there is very high levels of certain fatty acids in the blood, and that can be associated with death of the baby and cognitive impairment of the child in later life.
“I think that the issue of losing weight quickly after pregnancy can be problematic for younger women, who see celebrities doing this and look to them as role-models.”
Professor Mike Kelly, Director of the Centre for Public Health Excellence at NICE, added: “Women should understand that weight loss after birth takes time and that physical activity and gradual weight loss will not affect their ability to breastfeed.
“Losing weight gradually can actually help women maintain a healthy weight in the long-term.”
Elsewhere, the guidance calls for local authority leisure and community services to offer women with babies and children the opportunity to take part in a range of physical or recreational activities, such as swimming, cycling or dancing.
Jane Brewin, Chief Executive of the baby charity Tommy's, welcomed the guidance as a “step in the right direction” to mitigating the impact of obesity on mums and their babies.
28 July 2010
This page was last updated: 30 July 2010