Years ago, I had a pregnant patient in my care who began her pregnancy with a healthy BMI of around 24. However, in her third trimester, she started gaining weight rapidly. After ruling out gestational diabetes, I had a detailed discussion with her about her daily diet.
It turned out that her mother was encouraging her to “eat for two,” a common but incorrect belief regarding pregnancy nutrition. Her mother, a great cook, was regularly preparing delicious but calorie-dense meals.
I explained the correlation between excessive weight gain during pregnancy and the size of the baby, and I recommended a healthier, more balanced diet. Unfortunately, she didn’t take my advice seriously, and by the end of her pregnancy, she had gained approximately 80% of her pre-pregnancy weight.
This resulted in a large baby, weighing around 4500g, and a complication known as severe shoulder dystocia (where the baby’s head is delivered, but the shoulders get stuck due to their large size relative to the mother’s pelvis). The baby was born with very low APGAR scores, required resuscitation, and was admitted to the NICU. Fortunately, the baby eventually recovered, but the birth and immediate postpartum was a highly stressful experience to say the least.
A few years later, she returned to my care during her second pregnancy. This time, she followed a healthy diet and exercised throughout the pregnancy. As a result, she had a smooth birth, delivering an average-sized baby.
Edit:
With 20,000 views in less than 12 hours since posting, I feel the need to clarify a few points to avoid any misunderstandings.
What I shared in the story is just one example. One story cannot be considered ‘research.’ There is a statistical correlation between significant weight gain during pregnancy and larger baby size. This means that if you gain a lot of weight during pregnancy, there’s an increased chance of having a larger baby. However, this does not mean that every person who gains weight will have a big baby, nor that eating healthily guarantees a small baby.
In my career, I’ve seen many different scenarios: people who gained a lot of weight and had an average-sized/small baby, and others who ate healthily, exercised with minimal weight gain but still had big babies.
There are numerous other factors that influence a baby’s weight at birth. These include genetics—some people are genetically predisposed to having larger or smaller babies, or one baby might take after a larger parent while the next takes after a more petite one. Other factors include diabetes, placenta function—some placentas don’t function optimally, limiting the baby’s growth potential—and the weight a person begins pregnancy with, among others.
In the story, in her 1st pregnancy the woman was consuming meals like an extra-large pizza (enough for four people) by herself for breakfast, or eating a large family-sized pack of ice cream meant to last a month. Additionally, her Russian mother’s cooking was delicious but high in calories, including dishes like Russian pelmeni (again, in family-sized portions), Belyashi (Беляши), Chebureki (Чебуреки), Pirogi (Пироги), and plenty of pastries.
No judgment here! Russian food is absolutely delicious. When I was pregnant with my second child, the hunger was overwhelming—I even had frequent dreams about eating! I had to go on a strict, healthy diet to control my weight gain because I was highly motivated to avoid delivering a huge baby.😁