Brewer’s Pregnancy Diet for Overweight Mothers

Posted on July 15, 2009. Filed under: Pre eclampsia, Pregnancy, Pregnancy Brewer Diet | Tags: brewer's diet overweight, brewers diet obesity, Joy Jones, Joy Jones Brewer diet, joy jones rn, overweight pregnancy |

Overweight mothers often times are told to restrict their calories and to only gain a small amount of weight or even none at all. I have read so many stories of care providers giving over weight moms a really hard time. The Well Rounded Mama talks about this here and shares stories from other women.  The scare tactics used against overweight moms range from ‘you will have a large baby and have a stroke while trying to push it out’ to ‘you will develop blood clots’ to ‘you will not be able to sustain a pregnancy.’ It’s really a shame and instead of berating these mothers for being overweight, it would be so nice if mainstream medical care would help them to be healthier and have the healthiest pregnancies possible by focusing on exercise and proper nutrition throughout pregnancy rather than numbers on a scale. Like I have said before, contrary to popular belief, you can not grow a baby with the extra fat on your hips!

In thinking about this topic, I decided to ask Joy Jones what her thoughts were. Joy is an RN and has been working with pregnant women and the Brewer’s Diet for more than thirty years.  She has  so much knowledge and insight on this that I asked her if I could repost our emails to each other here on my blog. THIS is the information women need. This is what they need to see when they are googling “pregnancy and obesity” and “weight gain recommendation for overweight moms” and ” diet for overweight pregnancy.” So here goes…

Hi Joy, 

I wanted to ask what your experience is with Brewer's and the overweight mother.
I would like to be able to advise an overweight client as I am not sure how she will
be treated by the doctors and what kind of dietary guidance and weight restrictions they will give her.
She walks daily and hired a personal trainer a few months ago and she said that as long she walks
regularly, her borderline high bp stays in the normal range. 

What are your thoughts?

Thanks,

Amy

Dear Amy,

Dr. Brewer's most basic response to this kind of question was......

1)  The kind of food eaten during pregnancy is more important than the number of pounds 
gained—both weekly and overall.

http://home.mindspring.com/~djsnjones/id11.html

2)  Each pregnancy grows a new placenta which needs an expanded blood volume in order to 
function  properly.All pregnancies have this need, regardless of the mother's beginning 
weight.

3)  In order to service the placenta adequately, the mother's blood volume needs to increase
 by 60% by the end of the second trimester, and then it needs to be maintained at that level
for the rest of the pregnancy.

4)  In order for that blood volume to expand by that much by the 24th week, and stay expanded
throughout the third trimester, the mother needs to eat according to a plan that includes a 
certain level of calories PLUS salt PLUS protein (it's not just about protein, and without 
all three components,this plan is not likely to work as it's designed to do).

5)  The mother's body can expand the blood volume only from the food that she eats.  It 
CANNOT create what she needs for expanding the blood volume, or for creating baby cells, or for creating 
new uterine  cells, by breaking down her extra body fat.

6)  There are many different reasons for a woman to become overweight.  But if part of the 
reason for a specific individual woman to be overweight includes too many carbohydrates or 
fats and too little exercise, then she may actually lose weight on the Brewer Diet, simply 
because she is changing her lifestyle to a more healthy way of eating.  But weight loss should
not be her goal, only a consequence of eating in a better way.

7)  If a mother adds extra exercise to her lifestyle, she needs to be careful to add enough 
calories to the Basic Plan of the Brewer Diet to compensate for that extra exercise.  
Otherwise, she may be at risk of burning up some of her precious protein intake for energy, 
thus risking having her blood volume drop and triggering the pre-eclampsia process.

http://home.mindspring.com/~djsnjones/id95.html

8)  A healthy eating style for a healthy pregnancy needs to also include a good level of 
healthy kinds of fats and a good level of healthy kinds of carbohydrates.  The Basic Plan 
of the Brewer Diet includes both of those food groups, and you can see how many servings 
of each (and examples of good  sources) at this page...

http://home.mindspring.com/~djsnjones/id96.html

If you haven't done it already, I also suggest that you check out the "Obesity" page on my 
website....

http://home.mindspring.com/~djsnjones/id69.html

PART II

Dear Amy,

I was answering in a hurry earlier because I was thinking that the laptop was going to walk 
off again  with my husband,but he is using something else today, so I can add a few things 
to my previous response.

"I wanted to ask what your experience is with Brewer's and the overweight mother."

I don't remember any specific overweight mothers from my experience, although I am sure that 
there  were some, since I've been working with pregnant mothers for almost 32 yrs, and probably 
about 500-700 mothers.  Whenever I worked with natural-oriented midwives, we tried to focus 
more on what the mother was eating between prenatal visits, more than on the number of pounds 
she was gaining during those times.  The mothers who stand out in my mind are the one who was 
apparently eating so  poorly that when I showed up to help with the birth, her bones were 
sticking out of her body, like those on an anorexic woman (I was not included in the teaching 
or monitoring of her diet during  the prenatal care)....or the mother who ate little more 
than cocoa puffs, no matter how hard we tried,  and ended up with PUPP syndrome and nursing 
problems.....or the 2-3 mothers who had 10 lb babies with no problems pushing them out 
(and the one who had to work harder at it)....or the mothers who got advised to cut back on 
salt or calories or to exercise a little extra and ended up with elevated BPs and 
pre-eclampsia symptoms and hospitalization and premature births as a result.....or 
the mothers  who were able to hold back their creeping BPs with hourly doses of protein and 
calories and sodium....and the mother who weaned her baby at 4 weeks so that she could go 
on a cruise with her extended family (leaving the baby at home)....and the ESL mother who
insisted on bottle-feeding her baby for the first 3 days because colostrom is obviously not
breast milk or adequate for feeding a baby. I also remember a few pregnant women who had lost 
a lot of weight before the pregnancy, who had to stand with their backs to the number display
on the scales, at every prenatal visit, so that they could eat well and not be anxious about 
the number of pounds that they were gaining. For those women  we also had to put many notes 
on the outside and inside of their charts to caution all the people caring for them to NOT 
tell them what their weight gain was.

I don't consider age or being slightly overweight or having recently lost a lot of weight 
as being risk factors on their own.  I think that the groups of women with those factors 
in their lives may have higher rates of pre-eclampsia (and the other complications associated
with low blood volume),simply because when those women go to mainstream care-givers they are 
labeled "high risk" and put on inadequate diets, which then creates the very complications 
which they are trying to prevent.

In addition,  on the subject of age, depending on lifestyle, you might have a 40 yr old woman 
who  is healthier than a 25 yr old--aside from the issue of increased difficulty in conceiving.

"I want to advise her as I am not sure how she will be treated by the doctors and what kind 
of dietary  guidance they will give her."

I can almost guarantee you that most doctors will treat her as "high risk" and try to control 
her  pregnancy and birth to pieces.  I think that the only way that she will have a chance 
at a normal  pregnancy and birth is to go to a very good midwife.  Homebirth would be her 
best bet.  But if she  is not comfortable with that option, she should not even 
attempt it, because if she does not believe  in her gut that homebirth is her safest option, 
she will most likely just get transported to a hospital  mid-labor, for lack of progress.  
Her cervix simply will not open if she is not laboring and giving birth in a place that feels 
safe to her, and with care-givers who feel safe to her.  Her next best  option would be a 
birth with a midwife in a free-standing birth center.  Her next best option would
be a hospital birth with a midwife--preferably a non-mainstream type of midwife (many midwives
are just  as medically-minded as OBs are, or almost as much).

For that last category, she should look for midwives who do not share an office with their 
back-up  doctors, but work in a practice which is independent from that of their back-up 
doctors.  She can  also interview midwives and see which ones insist on all the tests 
possible, and which ones make at least some of the various prenatal tests optional 
(the latter being the more natural-birth oriented  ones, in my opinion).She can also check 
various homebirth websites for suggested lists of questions  to ask midwives to see if they
are the kind of midwife that is more natural-birth oriented. She can also use the questions 
that I have listed on my first "Registry" page....

http://home.mindspring.com/~djsnjones/id97.html

I also suggest that she go to her local public library and check out "The Pregnancy After 30
Workbook",  by Gail Brewer (or she can get it through inter-library loan, through her local 
public library, if they don't have it).  The following is Dr. Brewer's chapter in that book....

http://home.mindspring.com/~djsnjones/id72.html

At the very least, I suggest that she hire a very, very good, very experienced, very well 
certified doula (and preferably one who has extensive experience in both home and birth center 
and hospital births), from the FIRST DAY that she knows that she is pregnant.  This doula 
can help her work her  way through finding out what are the best options for prenatal care 
in her area, help her to choose a more natural-birth oriented care-giver who also fits her 
unique comfort level and needs, and help  her through every step of the way as her 
care-giver offers (or insists on) various tests, procedures,  or life-style changes, helping 
her to see how much broader her choice of options is than her care-giver  might be giving her. 
A doula might charge a little more for this all-pregnancy kind of care than she  would for 
third-trimester/labor kind of care, but I suspect that she will be able to find a doula
willing to do this, especially if she explains why she needs this kind of help, and that she 
might be  willing to pay a little more for this kind of care.

She might also be interested in the article about how a woman with pre-existing hypertension 
was able to go off of her anti-hypertension drugs when she got pregnant, just by adding more 
salt to her diet....

http://home.mindspring.com/~djsnjones/id70.html

She might also be interested in the recent study which cautions women against doing too much 
exercise  when they are pregnant because it can increase their risk of developing pre-eclampsia – 
which I think underlines the Brewer caution to be very sure to add enough calories and salt to
the diet  when a pregnant woman has extra exercise in their lives (exercise of daily living 
as well as recreational exercise).  You can scroll down to the bottom of the page to where 
the paragraph in red lettering is.  I don't remember precisely, but I think that this study 
suggests that more than 15-20 min of moderate recreational exercise a day is too much for a
pregnant woman.

http://home.mindspring.com/~djsnjones/id95.html

Again, I hope that this helps.

Best wishes,
Joy
			

			
			
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