When To Consider Pregnancy?
Let’s look at ideally, when is the best time to fall pregnant following weight loss surgery?
- At least 1 year post surgery
- You have lost most of your excess weight or are close to your ideal weight
- You are able to maintain your weight ie no longer loosing large amounts of weight
- Have good food tolerance ie no vomiting, regurgitation and you are managing to eat a wide variety of foods throughout the day
Weight Gain During Pregnancy
More often than not, women who have undergone gastric banding or a sleeve gastrectomy experience the most variation in weight gain. Some lose weight, some maintain, others can gain above recommendations. Standard weight gain recommendations during pregnancy are based around pre pregnancy BMI. However, women who delay pregnancy for at least 2 years post-surgery are more likely to experience a normal or restricted weight gain throughout their pregnancy. As a result of the surgery, there is potential for growth restriction therefore regular checks should be performed including ultrasounds and examinations.
The key to monitoring post-partum weight is to ensure each women’s weight loss goals of returning to their pre pregnancy weight do not compromise their own or if breastfeeding, the babies nutritional health. Linking in again with your bariatric multidisciplinary team for follow up can help women to achieve the best results possible.
Children born to obese parents are genetically at risk of becoming obese themselves. Breastfeeding for at least six months lowers the child’s obesity risk and is strongly encouraged.
Ensuring mothers have adequate nutrition on board to support not only the body’s requirements, but is paramount to producing nutrient rich breastmilk. Most people think that pregnant women have to “eat for two” however it’s the time during breastfeeding when a mothers requirements increase the most. In women who have had weight loss surgery, these increased requirements whilst breastfeeding can decrease maternal stores increasing risk of nutrient deficiency in addition to impacting on milk quality and subsequently, effect infant growth and development. Therefore ongoing monitoring and assessment is required.
The most ideal time for monitoring pathology is as close to conception as possible and at the start of each trimester which will guide multivitamin supplementation throughout your pregnancy.
Similarly to many other nutrients, pregnancy increases your requirements for vitamin A however vitamin A in high levels can be a teratogen. A teratogen is an agent that can disturb the development of the embryo or fetus causing miscarriage or birth defects. Therefore bariatric specific multivitamins or supplements with Retinol or Retinyl esters should not be used in pregnancy. It is preferred to commence a pregnancy specific multivitamin daily if you are a band patient. For all sleeve and bypass patients, a pregnancy specific multivitamin in addition to calcium, vitamin D, Vitamin B12 and iron may be necessary.