Group: soc.women
From: Exzuberant1@yahoo.com (Exzuberant)
Date: Wednesday, August 15, 2007 5:17 AM
Subject: Docs seek change in pregnancy weight-gain guidelines

/2007/HEALTH/08/14/ / ?iref=mpst
oryview

Story Highlights

. medical panel considering changes pregnancy weight-gain guidelines
Docs: Current recommendations don't factor in . obesity epidemic
April study: Current advice may raise risk of moms having overweight
toddlers
In 2003, about 1 in 4 pregnant . women gained more than 40 pounds

ATLANTA, Georgia (AP) -- Before Jennifer Lepine became pregnant, she heard
other soon-to-be moms say she should "eat for two."

But that conflicted with what her doctor told her: Consume only 300 extra
calories a day and gain no more than 35 pounds.

The slightly overweight suburban Atlanta, Georgia, woman decided to ignore
her friends and watched what she ate after she became pregnant with her
first child. The 5-foot-2, 145-pound Lepine gained 35 pounds before her
son, Bryson, was born last year. It took her four months to drop the extra
weight through healthy eating and exercise.

An influential . medical panel is considering changes to the medical
guidelines for how much weight a woman should gain during pregnancy. It's
acting on the insistence of doctors who say heavy moms are gaining too much
weight and the current recommendations do not factor in the country's
obesity epidemic.

Carrying too much weight while pregnant increases the risk of complications
for mother and baby, including birth defects, labor and delivery problems,
fetal death and delivery of large babies, according to the March of Dimes.

A revision is long overdue, said Dr. Raul Artal of the Saint Louis
University School of Medicine.

"The reality is for too long we are telling pregnant women to take it easy
during pregnancy, be confined and to eat for two," he said. "This has been
one factor in causing the epidemic of overweight and obesity that we see in
our country."

This fall, the Institute of Medicine, a private organization that advises
the federal government, is expected to begin the lengthy process of
gathering scientific evidence to decide whether the guidelines should be
changed, said spokeswoman Christine Stencel.

"The decision ultimately should be driven by real data ... but most of us
think overall the weight gain recommendations are too high and particularly
for women who have high body mass indexes to begin with," said Dr. Charles
Longwood of Yale University School of Medicine.

Under the institute's 1990 guidelines, those with a "normal" body mass
index -- a combination of height and weight -- were encouraged to gain 25
to 35 pounds. Women with a higher BMI have a lower target -- 15 pounds only
for the most obese women. Women with a lower BMI should gain more weight
during pregnancy -- up to 40 pounds.

A study in the April issue of the American Journal of Obstetrics and
Gynecology suggested that the current guidelines may raise the risk of
mothers having overweight toddlers. Women in the study who followed the
IOM's recommendations ran four times the risk of having a child who was
overweight at age 3, compared to women who gained less than the advised
amount.

Other countries, including Britain and France, have similar advice for
pregnant women and weight gain. In Japan, doctors recommend a weight gain
of about 10 pounds less than . guidelines.

About one in four pregnant . women gained more than 40 pounds during
their pregnancy in 2003, up from about one in five in 1990 when the
guidelines were issued, according to an institute report.

"If I get a patient who's gained 25 pounds throughout her entire pregnancy,
I'm overjoyed," said Dr. Michael Dawson, Lepine's physician. "A lot of them
will gain 50 pounds and 60 pounds and ... people are not that mindful on
that impact on overall health and pregnancy complications."

Dr. Patrick Catalano of Case Western Reserve University in Cleveland,
Ohio,said an obese woman has nutrients stored away and doesn't need to gain
weight to provide for the baby. The original guidelines were created to
make sure babies weren't born small, he added.

But not everyone agrees that changes are needed, said Dr. Naomi Stotland of
the University of California at San Francisco.

"People are afraid if you push too hard on the guidelines with excessive
weight gain then you'll get inadequate weight gain," Stotland said.

Experts say women should follow existing guidelines while the organization
studies whether any changes should be made.

Now pregnant with her second child, Lepine says she is taking a different
approach with a healthier diet and participating in new form of exercise
with her infant son.

"Chasing a toddler around takes a lot of energy," she said.