Pregnancy and Bariatric Surgery

Pregnancy is an exciting time for a woman. It is also a time for her body to undergo many changes. Pregnancy and bariatric surgery can go together well as long as proper steps and precautions are taken. Most bariatric programs encourage patients to wait 1-2 years after undergoing surgery. Within the first year of bariatric surgery your body is undergoing many changes on it’s own, specifically excessive restrictions. At times getting in proper nutrition to care for one person seems impossible let alone two. When patients feel the need to eat more than their bariatric restriction allows for, they often stretch their pouch. Waiting until full recovery will also allow some co-morbidities to resolve. Decreasing co-morbidities and achieving hormonal stability before pregnancy will minimize risks of lower birth weights.

Getting in adequate nutrition is essential for not only pregnant mothers but especially those who are limited, such as bariatric patients. Protein should be adding up to 65-90g per day. Your meal plates should consist of 75% protein. When restriction or lack of hunger happens, using protein drinks is an acceptable option for expecting mothers. Protein drinks in the first 1-2 trimesters are encouraged. For bariatric patients who have not achieved their target BMI, it is alright to lose weight during pregnancy. Patients should keep complex carbohydrates (whole grains, fruits, vegetables) to no more than 100g per day. Adequate fat content is also important in helping develop the nerve sheath in a fetus. No more than 25-35g of mono-saturated/poly-saturated fats should be consumed. As well as including 25-35g of fiber a day. Due to bariatric restrictions, larger meals will not be possible. Bariatric excepting mother should eat 5-6 small meals a day keeping portion sizes to 6-8 oz. Water intake is always important and the general recommended intake of 64 oz will still be advised.

Vitamins are essential to maintain proper health in all bariatric patients. Most pregnant women just take a prenatal vitamin, however for bariatric mothers you may be required to take more. Prenatal vitamins usually include iron which will help proper growth and cognitive development in the fetus. Iron levels for a pregnant bariatric patient should be between 30-60mg a day. According to the Bariatric Times taking a Vitamin B12 with 1000 mcg a day and Omega 3 1000-2000mg per day is also recommended. This will also help assist in brain and eye development. Taking extra steps to ensure you are getting proper vitamins will allow your baby to develop the best it can.

It’s important for bariatric excepting mothers to follow up with both their obstetricians as well as their bariatric office. Some normal pregnancy issues such as discomfort, morning sickness may also be related to reflux, food intolerance, internal hernias or other underlying bariatric issues. Having two sets of specialized eyes during this period is safer than one. It will also keep your weight gain during pregnancy in check. According to the 2009 recommendations from the ASMBS an appropriate weight gain goes as follows for weight before pregnancy; BMI <18= 28-40lbs weight gain, BMI 18.5-24.9 = 25-35lbs, BMI 25-29.9= 15-25 lbs, and lastly BMI >30 = 11-20lbs. Following up with your bariatric program will help keep your weight gain to an appropriate range. Waiting after bariatric surgery before getting pregnant is something that is highly recommended. Give yourself proper time to achieve weight loss and get your body stabilized before undergoing a whole new change.

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