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Expert Q&A
Question:
I just went to a WIC appointment and I have gained 10 pounds in one month. The counselor told me I had too much salt in my diet, but didn't give me any information on what I needed to do. I weighed 175 pounds when I became pregnant and now I weight 185 pounds. I am five months along and in the first three months I had only gained one pound. I still fit my jeans and my tummy is no bigger than before so I guess this is water that I am retaining but now what do I do? What kinds of things do I need to buy or cook? My husband works through dinner four days out of the week so I just fix light for my daughter and I. I already checked the sodium in my potpies that my husband bought me six of and I know not to eat them! How much sodium is OK in a day? What do I do to get rid of the water I am retaining now?
Answer:

First, I would like to suggest you go back and talk to your physician regarding your concerns related to your weight gain. I think they should be able to determine if it is normal or not. I will try to give you a couple reasons behind the weight gain, but please discuss your concerns with your obstetrician.

Swelling in the second trimester is normal since your blood volume expands by up to 50 percent -- which can raise your blood pressure. The cells in your body are holding more water during pregnancy, so mild edema (swelling) is normal and salt restriction isn't necessary, nor are diuretics (medications that promote water loss). Salt intake, in general, should not be less than 2-3 grams (or 2000 to 3000 mg). Edema can be a sign of pre-eclampsia, but not all women who have edema develop this condition. Pre-eclampsia is the condition of high blood pressure, protein loss in the urine and swelling. Pre-eclampsia tends to occur around the 20th week of gestation. The rate of fluid retention differentiates between normal edema and pre-eclampsia. Gradual gain in fluid is normal. Sudden weight gain, more than normal for your stage in pregnancy, followed by these symptoms, blurred vision, dizziness, vomiting and headaches are not normal. If you have been going in for regular check-ups, hopefully they have weighed you at all of them, then you can see if your weight gain has been gradual, and appropriate for where you are in your pregnancy.

During the first trimester normal, total weight gain is around 2 to 4 pounds, and about 1 pound per week is gained thereafter. You gained 1 pound in your first trimester, and let's say in the fourth month you gained about a pound a week, that would be another 4 pounds. You are now in your fifth month -- let's say two weeks into it, and let's say you have gained about 2.5 pounds per week, that would put you at 10 pounds of weight gain. Everyone is different, and maybe your weight gain was slow in the beginning, but now you are catching up.

I don't know if the counselor at WIC was relating your weight gain to your sodium intake, or telling you simply to cut down on it. I think your weight gain is probably normal, but again double-check with your physician.

Meanwhile, your diet could use some room for improvement. Based on the brief diet information you told me it sounds like you are relying on "fast foods" and not getting a whole lot of variety. Chicken nuggets and Ramen noodles are not the best ways to nourish a developing fetus. Even though they are quick and convenient, they are not very healthy for you, your fetus or you daughter -- not because of the high sodium content, but because they are not well-rounded. Try getting boneless chicken breasts and broil, bake or grill them instead of chicken nuggets. Incorporate some fresh vegetables and fruit (not juice) with a dairy source. Juice is not a replacement for fruits. Juice should also not be used to quench thirst -- drink water for that. You need vitamins and minerals to support the growing demands of your fetus and fruits and vegetables are essential to providing them!

If your time is limited, use what you have to plan meals in advance. Do it on the weekend with your husband and get the grocery shopping done for the week. Try planning about three days or more worth of meals. Make sure you have all the ingredients you need, or else add them to your grocery list. Keep some of your quick prep foods around so that when you are really short on time you have some back up. I cannot stress the importance of eating healthy enough. I really hope you will do the best you can to improve your variety. Your health, and your baby's future health depend on it! (Not to mention your husband's and daughter's.)

Please see your doctor to determine whether or not your weight gain is normal. You might even want to have one of the counselors at WIC do a dietary analysis for you and really break down your diet to see what food groups you could use a boost in.

Good luck!

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