18/09/2018 12:49 BST | Updated 18/09/2018 12:49 BST

Midwives Call For Clearer Advice Around Healthy Pregnancy Weight Gain

A recent study linked pregnancy weight to the child's future health.

Midwives should be given guidelines for healthy weight gain in pregnant women, the Royal College of Midwives has said, after a new study suggested women who put on excessive weight are more likely to have overweight children.

The UK does not have official guidance about how much weight women should gain during pregnancy, but the Royal College of Obstetricians and Gynaecologists suggests women only need an extra 200 calories a day - and not until the final three months of their pregnancy.

The new study, published in the journal Diabetologia, found that women who put on excessive weight during pregnancy are more likely to have children who are overweight, suffer high blood pressure, and develop insulin resistance, which is a precursor to type 2 diabetes, by the age of seven.

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The researchers followed 905 pairs of mothers and children in Hong Kong, and found that women who did not gain enough weight during pregnancy were also found to have children with increased risk of high blood pressure and insulin resistance.

NHS advice states that weight gain varies greatly during pregnancy and will depend on a woman’s weight before they conceived.

“Most pregnant women gain between 10kg and 12.5kg (22lb to 26lb), putting on most of the weight after week 20,” the NHS advice states, explaining that much of the extra weight is due to the baby growing and the mother’s body storing fat to make breast milk after a baby is born.

“Putting on too much weight or too little weight can lead to health problems for your unborn baby,” the NHS advice adds.

But last year the Royal College of Obstetricians and Gynaecologists stated that one in five pregnant women in the UK are obese. Dr Rajasingham, a spokesperson for the body, said at the time: “It is a myth that women need to ‘eat for two’ during their pregnancy - energy needs do not change until the last three months of pregnancy, when women need an extra 200 calories a day.”

Earlier this year, the Royal College of Midwives called for UK guidelines to be published on safe weight gain for women during pregnancy.

Following the results of the study, the RCM said midwives are being forced to “use their own initiative and refer to American guidance” when informing pregnant women about the amount of weight they should be gaining.

The National Institute of Health and Care Excellence is reviewing its current weight advice for pregnancy, which suggests women’s weight and height should be measured at the first appointment, but not repeatedly thereafter.

America’s Institute of Medicine has a set of recommendations about weight gain, however. Underweight women are expected to gain between 28lb - 40lb (12.7kg - 18.1kg) during pregnancy, while normal weight women should gain between 25lb - 35lb (11.3kg - 15.9kg), overweight women 15lb - 25lb (6.8kg - 11.3kg), and obese women 11lb - 20lb (5kg - 9.1kg).

Mandy Forrester, head of quality and standards at the RCM, said women are receptive to messages and advice about weight management issues during pregnancy and midwives “can have a real impact” on improving women’s health and wellbeing.

“This research highlights the need for guidelines on weight gain in pregnancy in the UK,” she said, adding that without this, “midwives have to use their own initiative and refer to American guidance”.

“There is a clear need for midwives to have the tools, guidance and training they need so that they can offer women the best possible support and care,” Forrester said.

“This is especially pressing because of the potentially serious complications that can arise in pregnancy as a result of women being overweight or obese. It is a real concern that some midwives do not have access to that most basic piece of equipment, scales.

“We are calling for clear guidance on healthy weight management in pregnancy and will be looking at how we can take this forward so that women and midwives have the information, support and resources needed.”

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