Large babies in prior pregnancies: Will it happen again?

I am six weeks pregnant with my third child. Can I do anything to try to keep my baby from being too large? My last two were eight pounds, 10 ounces, and nine pounds, 11.8 ounces. My doctor told me I could easily have a 10-pounder this time.

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Peg Plumbo CNM

Peg Plumbo has been a certified nurse-midwife (CNM) since 1976. She has assisted at over 1,000 births and currently teaches in the... Read more

This is a very good question and, like all good questions in midwifery, there are several answers or no adequate answers.

When a baby is born that weighs over about nine pounds, midwives and doctors suspect that the mother may have gestational diabetes (GDM). Whenever the mother has a higher-than-average circulating glucose level, the babies tend to get fatter. Large babies of mothers with GDM have trouble in the newborn period with their own glucose levels. They are also more at risk for birth injury, as is the mother.

If you have been screened adequately for this and do not have this condition, you could be genetically programmed to have large babies. In this case, there is no safe way to limit the baby's size.

If a mother takes in more calories than she, baby and the pregnancy require, the baby is also at higher risk of becoming too large. Yet restricting calories below safe levels is not the answer either.

You should look into many of the excellent books on prenatal care and nutrition or consult a nutritionist during your next pregnancy, especially if you feel you tend to gain more than the recommended weight in pregnancy. Increasing your activity level or exercising will definitely help control weight gain in pregnancy.

Caloric needs only increase about 200 calories per day in pregnancy for the average woman. This means that the diet must be dense with good food, and there is no room for the higher calorie treats.

I think that a nutritionist would be a good resource for you. They are an excellent source of information on sensible eating and cooking.

I wish you well.

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