Healthy eating advice

• High BMI poses higher risks of pregnancy related issues such as gestational diabetes and developing pre-eclampsia (high blood pressure condition in pregnancy which affects the placenta function)
• High BMI can also cause issues with assessing fetal size and monitoring of the baby’s heart rate in pregnancy.
• Evidence suggests that initiation and maintenance of breastfeeding can also be more difficult
• Birth defects—Babies born to women who are obese have an increased risk of having birth defects, such as heart defects andneural tube defects (NTDs)
• Increased risk of obstructive sleep apnoea
• Increased risk of baby over 4kg
• Women who are obese are twice as likely to have a stillborn than those with a healthy BMI
• Incidence PPH (post-partum haemorrhage) in women with BMI of over 35 is 38%- Almost 4 times higher than the general population. 
• Caesarean deliveries are more common in those with BMI over 50- approx. 46%
• Caesarean sections are more likely to have higher rates of infection
• Maternal obesity increases the risk of adverse long-term health outcomes in mother and child including childhood obesity
• Risk of developing Thrombosis or Pulmonary Embolism
• Increased risk of miscarriages and stillbirths
• Premature labour
• Increased chance of instrumental/ operative delivery  

Your midwife can support you in pregnancy and answer any questions you may have. If you have a BMI of 30 or more (or 28 and over with additional concerns) you can be referred to Fitter Futures by a health professional. This referral can support you with a 12 week slimming world programme or reduced membership to a selected gyms for an exercise programme. 

Healthy Recipes
Support and Financial Support during your pregnancy

• St Michael’s Children Centre on Hazel Grove in Bedworth have a community café every week where the adults can have a hot meal for £3.50 and the children eat free. They also hold Food Explorer courses as and when.
• St Michael’s children centre also have a “cot gossip” group where mums can attend and they discuss things such as weaning (this is not a formal group).
• In terms of other support that families in Warwickshire can access for info regarding finances, child care, parenting, mental and physical wellbeing and housing etc., they can visit the Family Information Service website or can telephone 01926 742274

Empire Gym in Nuneaton offer a 12-week personalised plan for mums-to-be. Please speak to your GP regarding accessing this service and eligibility. 

Our midwives can also offer a referral to those who are eligible to Fitter Futures, please speak to your community midwife for more information.

Women should “Eat for two”

MYTH
There are no requirements for extra calories in the first 6 months of pregnancy and this only increases by 200kcals in the last 3 months (equivalent to 35g peanut butter, 30g mixed nuts or 2 slices of wholemeal bread) 

It is not safe to exercise in pregnancy

MYTH
Although it is not recommended that you take on exercise that you are not used to; for example, taking up HIIT sessions or running when you have not been doing this previously. It is recommended that you keep active during pregnancy as this can help with maintaining a healthy weight in pregnancy and can also help with labour and childbirth.

Low impact exercise as walking, cycling, swimming and yoga can all be very beneficial and also looking at increasing your NEAT (non-exercise activity thermogenesis) can help. NEAT includes the normal day to day activities we do that burn calories, for example breathing, eating and sleeping. This can also be increased by activities such as shopping, cleaning and fidgeting. Women should aim for 30 minutes of exercise per day-150 mins per week.

Those who are sedentary should start with 15 minutes 3 times per week, increasing to 30 minutes per day gradually- you should be able to still hold a conversation.

FACT: WOMEN WHO EXERCISE ARE 1/3 LESS LIKELY TO HAVE A CESEAREAN SECTION

Exercise can reduce the following:  headaches, swollen feet, cramps, constipation, stress and depression due to the release of oxytocin, Pelvic girdle pain, tiredness and backache.

Breastfeeding rates are high among obese women

MYTH
Breastfeeding rates are poor among obese women, with only 80 percent initiating and less than 50 percent continuing beyond six months, even though it is associated with less postpartum weight retention and should be encouraged as it benefits the health of mum and baby.

Women should lose weight in pregnancy

MYTH
It is not advisable for women to diet and lose weight in pregnancy, instead it is advised that they are encouraged to make lifestyle changes and adapt these in order to make healthier choices. For example, smaller portion sizes and eating healthier foods and fibre rich meals.

Establishing healthy eating and exercise habits pre-conception can help create a lifelong habit which will give the best chance of avoiding ill-health and conditions such as cancer, heart disease and diabetes. Being in the best health pre-conception gives a stronger chance of a healthy baby and mother. Here are a few tips.

• Seek support from GP preconception for advice
• Higher dose folic acid 5mg if BMI over 30
• Take 10mcg vitamin D daily
• Aim for a realistic weight loss of approx.5-10%
• 10% reduction in preconception BMI was associated with a 10% risk reduction in pre-eclampsia, gestational diabetes, and stillbirth.
• Obesity can affect menstrual periods, and this may reduce a woman’s chance of becoming pregnant. It may also have a damaging effect on the regulation of the hormones needed to become pregnant reducing or even stopping ovulation

*Peanuts are safe to eat in pregnancy if you do not have an allergy to them*

Top Tips

• Start the day with a nutritious breakfast as this is likely to keep you fuller for longer.
• Try and have healthy snacks available such as fresh or dried fruit, nuts or oatcakes or yoghurts
• Foods that release energy slowly, such as wholemeal pasta, basmati rice, granary bread, quinoa or couscous will keep you fuller for longer.
• Eat fish twice a week, including at least 1 serving of oily fish such as salmon, fresh tuna or mackerel.
• Fresh, frozen, tinned, or dried fruit and veg all count towards your 5 a day and these can keep the prices down
• Stay hydrated. Drink around 6-8 medium (200ml) glasses of water a day.

After you have had your baby

• Post-partum period can be a challenge for all new mums as you may still be recovering from the birth and also be facing the new challenges of looking after yourself and a new bundle of joy.
• It is important that you take time out to look after yourself during this time and accept help you can get from family and friends.
• It is a good idea to batch cook meals in the final weeks before birth so you can freeze these and use them when you first get home. This will not only save the pennies but help you not reach for less nutritious and processed foods.
• Again try and stock the house with healthy snacks (the change for life website has great ideas for snack swaps)
• If you have had an operative delivery such as a caesarean section it is best to wait until you have seen your GP for the 6-8 week check to ensure everything is healing well before you restart exercising
• Pelvic floor exercises are vital to prevent future incontinence or issues in later life.
• Diastasis rectum can be common post birth. Please seek advice from your midwife, GP, health visitor or physio for more information
• Start back with gentle exercises and build up gradually based on what you can do (do not try and go straight back into what you were doing before as you want to avoid any injuries).

Breastfeeding is recommended for the first year of a baby’s life.

Breastfeeding may also help with postpartum weight loss. Women who breastfeed their babies for at least a few months tend to lose pregnancy weight faster than women who do not breastfeed.

Breastfeeding has many benefits for mum and baby as listed below. 

• Babies are less likely to develop diabetes, less likely to have ear infections, cardiovascular diseases, asthma, eczema, allergies, infections, gastroenteritis. They are more likely to be accepting of different foods when weaning. Breastfed babies are more likely to have a stronger bond due to the close interactions with the mother.
• The benefits of breastfeeding to mothers include a reduction in breast and ovarian cancers, cardiovascular diseases and osteoporosis.
• Additionally, breastfeeding is free which can save families a lot of money and you do not have to worry about sterilising of equipment or making up feeds, unless you are also expressing or supplementing with formula
• Breast milk is tailored uniquely to your baby so will pass on your antibodies and can fight off infection and pass on immunity.

Some families may be eligible for support and may be entitled to receive healthy start vouchers. These vouchers can be used from 10 weeks of pregnancy until the child is 4 years of age.

If you get Universal credit, you can apply online if:

• You’re at least 10 weeks pregnant or have at least one child under 4 years old
• Your family’s monthly ‘take-home pay for this period’ is £408 or less from employment

If you get Child Tax Credit, you can apply online if:

• You have at least one child under 4 years old
• Your family’s annual income is £16,190 or less

The healthy start money can be used to buy milk, fruit and vegetables and vitamins. If you do not want to buy cow’s milk, fresh, frozen, or tinned fruit and vegetables, you could use your Healthy Start payment to buy infant formula or fresh, dried, or tinned pulses.

Money is added to the card every 4 weeks as follows:
£4.25 each week of your pregnancy from the 10th week
£8.50 each week for children from birth to 1 year old
£4.25 each week for children between 1 and 4 years old
Your money will stop when your child is 4 years old, or if you do not get benefits that make you eligible.

Paper vouchers have now stopped, and a card is now issued which will be loaded with the money. It is accepted in most places that sell milk, infant formula, fruit and vegetables. They must display a Mastercard® symbol. The symbol is normally shown on the shop door or at the till. Ask an employee inside the shop if they take Mastercard if you’re unsure.

Please see How to apply – Get help to buy food and milk (Healthy Start) for more information.