More than one in four women in Singapore are putting on too much weight during their pregnancies, a study has shown.
In the neonatal and obstetric risk assessment conducted between 2010 and 2014 by the Integrated Platform for Research in Advancing Metabolic Health Outcomes of Women and Children, 26.2 per cent of 704 pregnant women here had gestational weight gain above recommended guidelines. The guidelines differ for pregnant mothers of different body mass indexes.
"Many people feel that when a woman is pregnant, she should eat for two. But in fact, the additional calories that she needs to take a day are only about 300, which is 10 per cent to 15 per cent of her baseline calorie requirement," said Dr Chua Mei Chien, senior consultant and head of the neonatology department at KK Women's and Children's Hospital (KKH) yesterday.
Gaining excessive weight during pregnancy has been linked to a higher risk of macrosomic babies - those who are significantly larger than average. For Asian babies, this is above 4kg.
Macrosomic babies in turn are more likely to become obese by the time they reach kindergarten, according to a 2017 study by researchers from the University of Virginia School of Medicine.
Nurse Jaslin Teo, 29, gave birth to her first child four months ago. She said: "It was hard initially for me to watch my diet. But after some time it got better. I love eating honeyed cornflakes before I sleep, but after I noticed my weight had increased quite fast, I stopped eating it. I was worried that it would increase the risk of gestational diabetes."
High gestational weight gain, maternal obesity and excessive milk-feeding were some issues raised at the launch of a set of new guidelines on optimal perinatal nutrition at KKH. "Perinatal" refers to the first 1,000 days of life from conception to age two.
The guidelines build on those for gestational diabetes launched last year and were developed with reference to local research findings, as well as recommendations from key international publications.
Increasing evidence from international and local studies has emphasised the need to optimise perinatal nutrition, said Senior Minister of State for Health Amy Khor, guest of honour at the event. "New evidence also shows that adverse BMI (body mass index) trajectories in childhood can be successfully modified only through interventions made before six years of age," she added.
Additional calories that a pregnant woman needs to take a day, which is 10 per cent to 15 per cent of her baseline calorie requirement. She should not be eating for two.
Professor Tan Kok Hian, president of the Perinatal Society of Singapore, noted: "Childhood obesity is likely to persist and progress into adulthood, and these individuals are at higher risk of getting chronic diseases like diabetes and hypertension."
Dr Chua also highlighted exclusive breastfeeding and appropriate weaning in the post-natal period in the new guidelines. "Exclusive breastfeeding offers moderate protection against excessive weight gain in infancy and later obesity, with the risk reducing by 4 per cent for each month of breastfeeding up to nine months."
Dr Khor noted that by 2020, all nine maternity hospitals here will be certified under the Baby-Friendly Hospital Initiative, which is awarded by the World Health Organisation and United Nations Children's Fund and encourages breastfeeding by facilitating skin-to-skin contact between mother and baby for at least an hour immediately after delivery.