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 poundsgained—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 tofunction properly.All pregnancies have this need, regardless of the mother's beginningweight. 3) In order to service the placenta adequately, the mother's blood volume needs to increaseby 60% by the end of the second trimester, and then it needs to be maintained at that levelfor 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 acertain level of calories PLUS salt PLUS protein (it's not just about protein, and withoutall 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. ItCANNOT create what she needs for expanding the blood volume, or for creating baby cells, or for creatingnew 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 thereason for a specific individual woman to be overweight includes too many carbohydrates orfats and too little exercise, then she may actually lose weight on the Brewer Diet, simplybecause she is changing her lifestyle to a more healthy way of eating. But weight loss shouldnot 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 enoughcalories 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 ofhealthy kinds of fats and a good level of healthy kinds of carbohydrates. The Basic Planof the Brewer Diet includes both of those food groups, and you can see how many servingsof 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 mywebsite.... http://home.mindspring.com/~djsnjones/id69.html PART IIDear Amy, I was answering in a hurry earlier because I was thinking that the laptop was going to walkoff again with my husband,but he is using something else today, so I can add a few thingsto 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 thatthere were some, since I've been working with pregnant mothers for almost 32 yrs, and probablyabout 500-700 mothers. Whenever I worked with natural-oriented midwives, we tried to focusmore on what the mother was eating between prenatal visits, more than on the number of poundsshe was gaining during those times. The mothers who stand out in my mind are the one who wasapparently eating so poorly that when I showed up to help with the birth, her bones weresticking out of her body, like those on an anorexic woman (I was not included in the teachingor monitoring of her diet during the prenatal care)....or the mother who ate little morethan cocoa puffs, no matter how hard we tried, and ended up with PUPP syndrome and nursingproblems.....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 onsalt or calories or to exercise a little extra and ended up with elevated BPs andpre-eclampsia symptoms and hospitalization and premature births as a result.....orthe mothers who were able to hold back their creeping BPs with hourly doses of protein andcalories and sodium....and the mother who weaned her baby at 4 weeks so that she could goon a cruise with her extended family (leaving the baby at home)....and the ESL mother whoinsisted on bottle-feeding her baby for the first 3 days because colostrom is obviously notbreast milk or adequate for feeding a baby. I also remember a few pregnant women who had losta lot of weight before the pregnancy, who had to stand with their backs to the number displayon the scales, at every prenatal visit, so that they could eat well and not be anxious aboutthe number of pounds that they were gaining. For those women we also had to put many noteson the outside and inside of their charts to caution all the people caring for them to NOTtell them what their weight gain was. I don't consider age or being slightly overweight or having recently lost a lot of weightas being risk factors on their own. I think that the groups of women with those factorsin their lives may have higher rates of pre-eclampsia (and the other complications associatedwith low blood volume),simply because when those women go to mainstream care-givers they arelabeled "high risk" and put on inadequate diets, which then creates the very complicationswhich they are trying to prevent. In addition, on the subject of age, depending on lifestyle, you might have a 40 yr old womanwho 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 kindof dietary guidance they will give her." I can almost guarantee you that most doctors will treat her as "high risk" and try to controlher pregnancy and birth to pieces. I think that the only way that she will have a chanceat a normal pregnancy and birth is to go to a very good midwife. Homebirth would be herbest bet. But if she is not comfortable with that option, she should not evenattempt 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 feelssafe to her, and with care-givers who feel safe to her. Her next best option would be abirth 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 midwivesare 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 theirback-up doctors, but work in a practice which is independent from that of their back-updoctors. She can also interview midwives and see which ones insist on all the testspossible, 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 checkvarious homebirth websites for suggested lists of questions to ask midwives to see if theyare the kind of midwife that is more natural-birth oriented. She can also use the questionsthat 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 30Workbook", by Gail Brewer (or she can get it through inter-library loan, through her localpublic 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 wellcertified doula (and preferably one who has extensive experience in both home and birth centerand hospital births), from the FIRST DAY that she knows that she is pregnant. This doulacan help her work her way through finding out what are the best options for prenatal carein her area, help her to choose a more natural-birth oriented care-giver who also fits herunique comfort level and needs, and help her through every step of the way as hercare-giver offers (or insists on) various tests, procedures, or life-style changes, helpingher 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 forthird-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 shemight 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 hypertensionwas able to go off of her anti-hypertension drugs when she got pregnant, just by adding moresalt 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 muchexercise 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 tothe diet when a pregnant woman has extra exercise in their lives (exercise of daily livingas well as recreational exercise). You can scroll down to the bottom of the page to wherethe paragraph in red lettering is. I don't remember precisely, but I think that this studysuggests that more than 15-20 min of moderate recreational exercise a day is too much for apregnant woman. http://home.mindspring.com/~djsnjones/id95.html Again, I hope that this helps. Best wishes, JoyRead Full Post | Make a Comment ( 1 so far )
This website is very informative and explains how the Brewer Pregnancy Diet works in great detail. The author if the site is Joy Jones. She is an RN and childbirth educator with extensive knowledge of the Brewer diet and nutrition in pregnancy.
The Brewer Diet, as I discussed in a previous post, focuses on protein, salt and calories. Joy goes into depth on the benefits of the diet and how nutrition can affect:
As I have said before, diet cannot necessarily cure every pregnancy issue but it can affect many aspects of pregnancy and it is something that we can and should control. Please be sure to read about the Brewer diet if you are pregnant and pass this on to anyone you know that is pregnant.Read Full Post | Make a Comment ( 2 so far )