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Warning for obese mothers-to-be

Women should be encouraged to achieve a healthy weight before they become pregnant and advised that there is no need to "eat for two".
These are just two of the recommendations included in new public health guidance published by NICE on dietary and physical activity interventions for weight management before, during and after pregnancy.

The aim of this new guidance is to help health professionals support women who are pregnant or who are planning a pregnancy, and mothers who have had a baby in the last two years.

Health professionals can help women to understand the risks of being overweight or obese during pregnancy and the importance of achieving a healthy weight before pregnancy, but also advise them not to try to lose weight while they are pregnant.

Professor Mike Kelly, Director of the Centre for Public Health Excellence at NICE said: "This new guidance is about helping health professionals to help women have a healthy pregnancy - it's not about preaching to women. About half of women of childbearing age are either overweight or obese and although obese women can have healthy babies, the evidence does suggest that there are more risks associated with pregnancies in women who have a BMI of over 30 when they become pregnant.

"It's also important that women do not feel pressurised into rapid weight loss or crash diets after pregnancy; they should understand that weight loss after birth takes time and that physical activity and gradual weight loss will not affect  their ability to breastfeed. Losing weight gradually can actually help women maintain a healthy weight in the long-term.

"At the moment health professionals do not generally give women information about the risks of obesity during pregnancy and the importance of weight management before or after pregnancy. We want all women to be supported before, during and after they have children so that both they and their babies have the healthiest outcome possible. The aim of developing this new guidance is to provide health professionals with clear recommendations to help them support women during this important time."

The new guidance will be aimed at GPs, obstetricians, midwives, health visitors, dietitians, community pharmacists and all those working in antenatal and postnatal services and children's centres. The recommendations cover three key areas:

  • Preparing for pregnancy.
  • Pregnant women and women who may become pregnant - particularly those with a BMI over 30kg/m2.
  • Supporting women following childbirth.

Louise Silverton, Deputy General Secretary of the Royal College of Midwives, said: "There is a real need to address the issue of obesity, and this new guidance shows this is particularly important for pregnant women. The growing volume of evidence shows that the health of a mother with obesity is further compromised by the pregnancy, also impacting the health of her unborn baby. Midwives are ideally placed to assist women in developing healthy lifestyles during pregnancy and during the postnatal period.

"As a result of the increase in obesity among pregnant women, midwives are, (on top of the continuing baby boom) dealing with more complex births. These women need to see a midwife as early as possible in their pregnancy. They need more time to spend with a midwife to help and advise them as well as involving the wider health care team."